| name | prior-auth-packet-builder |
| description | Build a concise prior authorization packet from local case files and payer policy docs. |
Prior Auth Packet Builder
Use this skill when a case requires prior authorization review, referral validation, imaging review,
or payer-specific policy checks.
Workflow
- Inspect
case/scenario.json and case/transcript.txt.
- Use
rg against policies/ to find payer, prior auth, referral, imaging, and PPO guidance.
- Read only the most relevant policy files.
- Create
output/policy_findings.md with:
- case summary
- matched policy files
- prior auth determination
- referral determination
- missing information
- Create
output/human_review_checklist.md with:
- what a human reviewer should verify
- what to tell the patient
- what queue should own the case
Rules
- Use targeted
rg searches over broad file reads.
- Only cite policy files you actually inspected.
- Keep outputs concise and operational.
- If referral status is pending and prior auth is unclear, recommend human review.