prior-auth-packetslisted

Assembles Medicare Advantage / managed-care authorization work products for skilled nursing facility (SNF) stays: initial prior-auth packets with medical-necessity narratives, concurrent/continued-stay review updates, denial triage with peer-to-peer prep and appeal letter drafts, and an authorization tracking log. Use whenever the user mentions prior auth, authorization, auth request, concurrent review, continued stay, ongoing certification, denial, peer-to-peer (P2P), appeal letter, NOMNC, medical-necessity letter, InterQual/MCG criteria, auth tracker, or getting more days approved from a Medicare Advantage or managed-care plan. Also use when the user pastes a denial notice or asks what documents a plan needs to approve a SNF admission.
magicare-ai/snf-skills · ★ 1 · API & Backend · score 75

Install: claude install-skill magicare-ai/snf-skills

# Prior Authorization Packets for SNF Stays Help SNF admissions and case management staff assemble authorization requests, continued-stay reviews, and appeals for Medicare Advantage (MA) and managed-care plans. The user is often non-technical and working against tight payer deadlines — be concrete, produce ready-to-send drafts, and keep jargon explained. ## Core rules (apply to every workflow) 1. **Never invent clinical facts.** Every clinical statement in a draft (diagnoses, dates, therapy minutes, vitals, functional levels, meds) must come from what the user supplied. Anything unknown becomes a `[BRACKETED PLACEHOLDER]` for the user to fill in. If the packet would be weak without a fact you don't have, ask for it or leave a labeled placeholder — do not fill the gap with plausible-sounding content. 2. **No PHI in your own examples.** When illustrating, use invented neutral names like "Sample Health Plan" and generic patients. When drafting from the user's real facts, use exactly what they gave you. 3. **Deadlines vary.** Plan-specific timeframes (auth turnaround, appeal windows, concurrent review cadence) differ by contract and change under CMS rules. State typical ranges only as "commonly" / "often," and always tell the user to verify against the plan's provider manual, the denial notice itself, and current Medicare rules. 4. **Clinician sign-off.** Anything with clinical content (narratives, appeal letters, P2P prep) must be reviewed