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 |
| Verified | works · 2026-07-20 |
| Security | caution · 2026-07-20 — first-party Anthropic but no repo LICENSE; handles clinical PA documents |
How to install
/plugin marketplace add anthropics/healthcare
/plugin install healthcare@healthcare
The standalone prior-auth-review@healthcare plugin is now deprecated upstream — the anthropics/healthcare marketplace has consolidated its skills into a single healthcare plugin. Install that and invoke this workflow as /healthcare:prior-auth (the skill directory is prior-auth, namespaced by the plugin — not a bare /prior-auth).
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
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