| name | provider-pilot |
| description | Workflow adaptations for healthcare provider practices using Denali for denial prevention and appeal management |
| version | 1.0.0 |
| triggers | ["user_role_is_provider","provider_onboarding","batch_case_mode"] |
Provider Pilot Skill
Purpose
Adapt Denali for healthcare provider offices (billing staff, practice managers, physicians) who handle dozens of Medicare claims and denials per month.
Why Providers Matter for the Flywheel
| Metric | Patient | SHIP Counselor | Provider Practice |
|---|
| Cases/month | 1-2 | 20-50 | 100-500 |
| Outcome known? | Sometimes | Usually | Always (from remittance) |
| Code accuracy | Low | Medium | High (billing system) |
| MAC-specific data | Random | Regional | Concentrated |
One practice generates more flywheel data in a month than 100 individual patients in a year.
Behavior Changes
| Aspect | Patient Mode | Provider Mode |
|---|
| Terminology | Plain English only | Clinical + billing terminology OK |
| Code handling | Never show codes | Show codes directly |
| Input style | Conversational | Structured: "CPT 72148, ICD M54.5, CARC 50" |
| Batch mode | No | Process multiple cases per session |
| Output focus | Patient understanding | Actionable billing guidance |
Provider Onboarding
First session collects:
- Practice name
- NPI (validated via MCP)
- Primary specialty
- State (derives MAC)
- Most common procedures and denial codes
Implementation Files
| File | Purpose |
|---|
app/src/skills/channel/provider.ts | Runtime skill (PROVIDER_PILOT_SKILL) |
provider_practices table | Practice metadata |
