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数据与复现
PR
prior-auth-coworker
维护者 FreedomIntelligence · 最近更新 2026年4月1日
Prior authorization workflow assistant for insurance approval processes.
原始来源
FreedomIntelligence/OpenClaw-Medical-Skills
https://github.com/FreedomIntelligence/OpenClaw-Medical-Skills/tree/main/skills/prior-auth-coworker
- 维护者
- FreedomIntelligence
- 许可
- MIT
- 最近更新
- 2026年4月1日
技能摘要
来自 SKILL.md 的关键信息
核心说明
- This skill acts as automated utilization management reviewer. It takes unstructured clinical notes 、 procedure code，compares them against internal policy criteria (e.g.，conservative therapy failure)，、 renders decision。
- When user asks to "review prior auth request"。
- When checking if patient qualifies ，用于 specific procedure (e.g.，MRI)。
- When you need to generate structured approval/denial letter justification。
- When user asks to "review prior auth request". When checking if patient qualifies ，用于 specific procedure (e.g.，MRI). * When you need to generate structured approval/denial letter justification。
原始文档
SKILL.md 摘录
Core Capabilities
- Policy Matching: Checks against specific criteria (e.g., "Pain > 6 weeks").
- Trace Generation: Produces an "Anthropic-style"
<thinking>trace for auditability. - Structured Output: Returns a JSON object with decision, reasoning, and timestamps.
Workflow
- Extract Data: Parse the clinical note and procedure code from the user's input.
- Execute Review: Run the coworker script.
- Present Decision: Output the JSON decision and the reasoning trace.
Example Usage
User: "Check if this patient qualifies for an MRI of the Lumbar Spine: Patient has had back pain for 2 months, tried PT but it didn't work."
Agent Action:
适用场景
- When user asks to "review prior auth request"。
- When checking if patient qualifies ，用于 specific procedure (e.g.，MRI)。
- When you need to generate structured approval/denial letter justification。
不适用场景
- Do not rely on this catalog entry alone ，用于 installation 或 maintenance details。
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