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Prior Auth Packet Builder

Build a concise prior authorization packet from local case files and payer policy docs. Use when this capability is needed.

tomevault-io Updated
Coding & Dev Tools

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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. Use rg against policies/ to find payer, prior auth, referral, imaging, and PPO guidance.
  3. Read only the most relevant policy files.
  4. Create output/policy_findings.md with:
    • case summary
    • matched policy files
    • prior auth determination
    • referral determination
    • missing information
  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

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.

Source: openai/openai-agents-python — distributed by TomeVault.

tomevault-io/skills-registry/tree/main/openai--openai-agents-python--openai-agents-python commit 72d2d1d0a9

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Frequently asked questions

npx skillmds@latest add tomevault-io/prior-auth-packet-builder