| name | patient-intake |
| description | Establishes a comprehensive framework for the intake and registration of new patients, encompassing data collection, insurance verification, risk stratification, and pharmacy network validation. |
| required_tools | ["validateInsurance","validatePrescriptionBenefits","calculateLifestyleRisk","calculateOverallRisk","verifyPharmacy","registerPatient"] |
Step 1: Verify Primary Insurance Coverage
Access the payer portal to verify the patient's primary insurance coverage status and effective dates. Document benefit levels, copayment requirements, and confirm network participation. Record any authorization requirements.
Call validateInsurance with the following parameters:
patient_id: [patient_id]insurance_provider: [insurance_provider]policy_number: [policy_number]group_number: [group_number]coverage_start_date: [coverage_start_date]insurance_type: [insurance_type]
Step 2: Validate Prescription Benefits
Query the PBM database to verify current prescription coverage. Confirm formulary compliance parameters, document prior authorization requirements, and confirm specialty pharmacy protocols. Record the copayment structure.
Call validatePrescriptionBenefits with the following parameters:
patient_id: [patient_id]insurance_provider: [prescription_insurance_provider]policy_number: [prescription_policy_number]
