prior-auth-packet-builder

Inspect the case scenario.json and transcript.txt, then run targeted rg searches against the policies directory for prior auth, referral, and imaging guidance. Write the determination to output/policy_findings.md and a reviewer checklist to output/human_review_checklist.md.

It needs a case directory containing scenario.json and transcript.txt, plus a policies directory with payer policy documents covering prior authorization, referrals, imaging, and PPO rules. Only policy files actually inspected may be cited.

Recommend human review when referral status is pending and the prior auth determination is unclear. The generated checklist tells the reviewer what to verify, what to tell the patient, and which queue should own the case.

Targeted rg searches locate only the payer, prior auth, referral, and imaging guidance relevant to the case, keeping outputs concise. Broad file reads waste context and risk citing policies that were never actually inspected.

The workflow only cites policy files it actually inspects, so incomplete policy directories can produce missing-information flags. Ambiguous cases with pending referrals are escalated to human reviewers rather than resolved automatically.