Prior Auth Review Skill
OfficialOfficial anthropics skill covering authentication, code review for implementing security and authentication.
Install on your platform
Showing Claude Code. One command installs this skill into any of the agents below.
- 1
Run this in your project
terminal$ npx skills add anthropics/healthcare --skill prior-auth-review-skill -a claude-code Uses the open-source
skillsCLI and needs Node.js. Add-gto install it for your user instead of this project.
What we know about this skill
Publisher
anthropics
Matched to the vendor's own GitHub organisation.
Install target
Live repository
Not pinned. Installing fetches whatever the repository holds at the time you run the command.
Automated safety checks
This skill passed all 6 checks. We read its files at one commit and looked for the things that make a skill dangerous to run — not for whether it works.
Declares what it does: passed
SKILL.md parses and declares a name and a description.
SKILL.md exists, its frontmatter parses, and it declares a name and a description.
No undeclared network calls: passed
Makes no network calls.
Every host the skill dials — from its scripts, its config endpoints or the commands it tells the agent to run — is either well-known package and API infrastructure or declared in its own frontmatter. Links in documentation are not counted.
No obfuscated payloads: passed
No encoded or obfuscated payloads.
No base64, hex or compressed blob is decoded and then executed, and no encoded shell commands.
No credential access: passed
Reads no keys, tokens, keychains or credential files.
Neither the code nor the SKILL.md instructions read SSH keys, cloud credentials, keychains, token stores, browser cookie databases or dotfiles that hold secrets.
No pipe-to-shell installers: passed
No pipe-to-shell or download-and-run installers.
No `curl … | sh` pattern, in the code or in the instructions, that runs code fetched at run time.
Pinned to a commit: passed
Scanned anthropics/healthcare at c7ed150d37.
The exact upstream commit SHA that was scanned is recorded, so the result refers to specific bytes.
- Commit
- c7ed150d37
- Scanned
- 7 files, 1,469 lines
About this skill
What it does
This skill enables AI agents to analyze and verify insurance pre-authorizations for healthcare services. It cross-references patient eligibility, coverage details, and specific procedure codes against payer requirements to determine approval status before treatment occurs.
When to use it
- Pre-service verification: Check if a scheduled MRI or specialist consult is covered under a patient's current plan.
- Claim denial prevention: Identify missing documentation or incorrect coding that could cause an insurance claim to be rejected later.
- Cost estimation accuracy: Confirm whether a service will be fully covered, partially covered, or require out-of-pocket payment.
- Compliance auditing: Review historical authorization records to ensure all necessary approvals were obtained prior to rendering care.
Key capabilities
- Validates patient eligibility against specific insurance policies.
- Interprets complex CPT and HCPCS procedure codes for coverage rules.
- Identifies gaps in pre-authorization documentation.
- Flags potential denials based on medical necessity criteria.
Example prompts
- "Review the pre-authorization status for a 70-year-old patient requesting a knee replacement under Plan ID #4592."
- "Check if this specific MRI procedure requires prior approval and list the missing documents needed for submission."
- "Analyze the coverage details for a pediatric asthma management plan and determine if the requested inhaler is covered."
Tips & gotchas
Ensure you have access to real-time payer databases or up-to-date policy documents, as insurance rules change frequently. Always verify that the patient's demographic data matches the eligibility records exactly to avoid false negatives in authorization checks.