القائمة
Strategy and implementation for capturing appeal outcome data to build the flywheel
يُحدَّد Prompt الذي يراجع المصدر أولًا بشكل افتراضي. يمكنك التبديل إلى أمر مباشر أو تنزيل نسخة محلية.
اقرأ SKILL.md وأي ملفات مرافقة يعرضها SkillsMP قبل أن تقرر التثبيت.
التثبيت باستخدام Codex أو Claude انسخ هذا Prompt والصقه في Codex أو Claude أو مساعد آخر ليراجع صفحة Skill ويثبّتها لك.
يتجاوز الأمر المباشر Prompt المخصّص للمراجعة. افحص المصدر قبل تشغيله.
npx skills add https://github.com/qashsolutions/denali --skill outcome-captureيبقى الأمر في سطر واحد. مرّر أفقيًا لمراجعته كاملًا قبل النسخ.
تفضّل نسخة محلية؟ نزّل الملفات المتاحة حاليًا لدى SkillsMP.
Medicare coverage assistant that helps patients understand approval requirements and prevent denials
Workflow adaptations for healthcare provider practices using Denali for denial prevention and appeal management
Workflow and behavior adaptations for SHIP Medicare counselors using Denali as a case management tool
استنادا إلى تصنيف SOC المهني
عرض SKILL.md
| name | outcome-capture |
| description | Strategy and implementation for capturing appeal outcome data to build the flywheel |
| version | 1.0.0 |
| triggers | ["appeal_completed","user_returns_after_appeal","outcome_followup_scheduled"] |
Close the feedback loop on every appeal. Every outcome reported makes the system smarter for the next patient.
The flywheel depends on real-world outcome data. Without outcomes:
| Channel | Mechanism | Expected Yield |
|---|---|---|
| Email followup (day 30) | Automated Resend email with one-click buttons | 15-25% response rate |
| Email followup (day 60) | Second reminder if no response | 10-15% response rate |
| In-chat prompt | Ask returning users about past appeals | 30-40% response rate |
| Counselor reporting | SHIP counselors report outcomes as part of workflow | 80-90% response rate |
| Provider reporting | Practices know outcomes from remittance | 95%+ response rate |
| Field | Source | Stored In |
|---|---|---|
| outcome (approved/denied/partial) | User report | appeals.status |
| days_to_resolution | Calculated from appeal date | appeals.outcome_reported_at |
| icd10_codes, cpt_codes | From original appeal | appeals (already stored) |
| lcd_refs, ncd_refs | From original appeal | appeals (already stored) |
| carc_codes | From original appeal | appeals (already stored) |
"Report your outcome, get your next appeal free."
usage.appeal_count by 1 when outcome reportedappeals.status -> outcome valueappeals.outcome_reported_at -> timestampcoverage_paths -> increment use_count, set outcomesymptom_mappings -> boost if approved (+0.1), penalize if denied (-0.05)procedure_mappings -> boost if approved (+0.1), penalize if denied (-0.05)outcome_followups.responded_at -> timestampusage.appeal_count -> decrement by 1 (incentive)| File | Purpose |
|---|---|
app/src/lib/conversation-service.ts | scheduleOutcomeFollowups() after saveAppeal |
app/src/app/outcome/page.tsx | Token-based one-click outcome reporting page |
app/src/app/api/outcome-report/route.ts | API for token-based outcome submission |
app/src/skills/domain/outcome-prompting.ts | In-chat prompt for returning users |
supabase/functions/send-outcome-followup/ | Cron edge function for email reminders |
app/src/lib/learning.ts | checkOutcomeIncentive(), applyOutcomeIncentive() |