prior-auth-packet-builder

# Prior Auth Packet Builder Use this skill when a case requires prior authorization review, referral validation, imaging review, or payer-specific policy checks. ## Workflow 1. Inspect `case/scenario.json` and `case/transcript.txt`. 2. Search `policies/` for payer, prior auth, referral, imaging, and PPO guidance: - Run the preferred search and fallback as one shell command: `rg -n -i 'prior authorization|prior-auth|imaging|referral|billing|PPO|Blue Cross' policies || grep -RniE 'prior authorization|prior-auth|imaging|referral|billing|PPO|Blue Cross' policies`. - An `rg` launcher or bootstrap failure is not evidence that there are no policy matches. 3. Read only the most relevant policy files. 4. Create `output/policy_findings.md` with these exact headings: - `## Case summary` - `## Matched policy files` - `## Prior authorization` - `## Referral` - `## Missing information` Cite each matched policy by its filename. 5. Create `output/human_review_checklist.md` with: - what a human reviewer should verify - what to tell the patient - what queue should own the case 6. Call `finalize_policy_packet` only after both artifacts exist. ## Rules - Use targeted searches over broad file reads. - Use the targeted `grep -RniE` fallback only when `rg` cannot complete the search. - Only cite policy files you actually inspected. - Keep outputs concise and operational. - The workflow is complete only when `finalize_policy_packet` succeeds. - If referral status is pending and prior auth is unclear, recommend human review.