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healthcare-glossary

Define HealthFlow healthcare terms using schema fields and code locations.

Updated Aug 27, 2026
Search Tags:#glossary#healthcare#appeals#medicare advantage#provider network#formularies#healthtech data
One-click install
npx skills add https://github.com/saikamara59/health-insurance-agent --skill healthcare-glossary
Or copy as Structured Prompt for Agent▼
Please help me install this Agent Skill.
Skill: healthcare-glossary
Source: https://github.com/saikamara59/health-insurance-agent/tree/main/.claude/skills/healthcare-glossary
Command: npx skills add https://github.com/saikamara59/health-insurance-agent --skill healthcare-glossary

SYSTEM DOCUMENTATION & REQUIREMENTS

What problem does it solve?

Explaining healthcare concepts is hard because terms like “formulary,” “NPPES,” and “appeal stage” can mean different things in different systems, so this Skill provides clear definitions mapped directly to how HealthFlow models those concepts in its data and agents.

Core Features & Use Cases

  • HealthFlow-anchored definitions: Explains key marketplace, plan, formulary, network, and appeals concepts using the codebase’s own schema, fields, and workflows (e.g., where “plan_type,” “star_rating,” “prior_auth,” and drug tiers live).
  • Broker-friendly translation: Turns technical attributes (deductible, OOP max, in-network status, appeal redetermination) into plain-English meaning tied to broker decisions.
  • Code pointers for reviewers: Includes “where in code” guidance so engineers and power users can quickly jump to the relevant modules and scripts.

Quick Start

Ask healthcare-glossary to explain the meaning of a specific term as used in HealthFlow, such as “What does prior_auth mean in the formulary flow?”

Frequently Asked Questions about healthcare-glossary

High-intent search queries and answers about installing and using this skill.

FAQPage Schema
What does prior_auth mean in a Medicare Advantage formulary flow?▼

A formulary in HealthFlow is a structured list of covered drugs modeled across tiered schema fields. It maps drug tiers and prior_auth attributes directly to agent workflows for Medicare Advantage plan decisions.

How do I explain NPPES and NPI network checks for healthcare provider data?▼

NPPES and NPI network checks in HealthFlow validate provider in-network status using anchored schema locations. The glossary translates these technical NPI registry checks into plain-English for brokerage conversations.

What is the Medicare appeals process and how are appeal stages modeled?▼

The Medicare appeals process in HealthFlow tracks redetermination stages through specific database fields and agent workflows. It maps each appeal stage to concrete code locations for resolving claim disputes.

How do I find where plan_type and star_rating fields are defined in a healthtech codebase?▼

Plan_type and star_rating fields are located using the glossary's anchored references to concrete schema and file locations. It points engineers directly to relevant modules modeling Medicare Advantage and ACA Marketplace data.

Can I use healthcare glossary definitions for ACA Marketplace plan benefits and deductibles?▼

Yes, the glossary defines ACA Marketplace plan benefits including deductibles and OOP max attributes. It translates these technical schema fields into plain-English meanings tied to broker decisions.

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