prior-auth-review

Anthropic-published Claude Code plugin from the anthropics/healthcare marketplace. Reviews prior-authorization request bundles and surfaces missing documentation, miscoded items, and likely denial reasons before submission.

Type	Claude Code Plugin
Supplier	Anthropic
Availability	GA
Pricing	Free / OSS
Capabilities	Read/Write — reads PA documents, drafts a review summary

How to install

/plugin marketplace add anthropics/healthcare
/plugin install prior-auth-review@healthcare

What it does

A document-review workflow for prior-authorization requests: cross-checks supplied clinical documentation against payer criteria, surfaces missing items (ICD-10, CPT, labs, imaging, prior therapies), and drafts a structured review summary.

Primary use cases: Pre-submission QA of PA bundles, identifying denial-risk gaps before they reach the payer, structured triage for utilization-management teams.

Notes

Pair with the cms-coverage, icd10-codes, and npi-registry plugins from the same anthropics/healthcare marketplace for end-to-end PA workflows. Verify payer-specific rules against current policy — the plugin encodes general patterns, not vendor-specific schemas.

Sources

• anthropics/healthcare
• Marketplace manifest

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