Summary
This automates prior authorization reviews for health insurance payers, cutting review time from 30-60 minutes down to under 5 minutes. It validates provider credentials, checks diagnosis and procedure codes, searches CMS coverage policies, extracts clinical info from medical documents, and generates approve/deny/pend decisions with supporting rationale. Needs three MCP connectors: CMS Coverage for policy lookup, ICD-10 for diagnosis validation, and NPI for provider verification. The decision logic follows a rubric you can customize (strict mode auto-denies invalid codes, lenient mode pends when evidence is thin). Comes with sample files for a lung biopsy case if you want to test it out. Built for Medicare Advantage, commercial insurers, and Medicaid MCOs.
Install to Claude Code
npx -y skills add anthropics/healthcare --skill prior-auth-review-skill --agent claude-codeInstalls into .claude/skills of the current project.
Keeps your Mac awake while Claude Code, Codex or Cursor works. Lets it sleep when they are done.
Try free for 7 days →
Block distracting apps from your iPhone permanently without a 3rd party app. Free and open source.
Block now (100% free) →
Notes, actions and memory. Without a meeting bot. First month 100% off.
Download for free →
belt cli automatically finds the best tools and skills for your agent. image, video, music, tts...
one prompt install →
Free an open-source skills that make AI coding agents easier to understand, verify, and control.
Download for free →
Connect your Claude agent to live crypto prices and trading routes via 1inch
Get the MCP →Files
SKILL.md
Select a file.
Featured
Keeps your Mac awake while Claude Code, Codex or Cursor works. Lets it sleep when they are done.
Try free for 7 days →Block distracting apps from your iPhone permanently without a 3rd party app. Free and open source.
Block now (100% free) →Notes, actions and memory. Without a meeting bot. First month 100% off.
Download for free →belt cli automatically finds the best tools and skills for your agent. image, video, music, tts...
one prompt install →Free an open-source skills that make AI coding agents easier to understand, verify, and control.
Download for free →Connect your Claude agent to live crypto prices and trading routes via 1inch
Get the MCP →
