synthesis-decision

What problem does it solve?

The Synthesis Decision Skill evaluates provider prior authorization readiness by integrating outputs from the Documentation Completeness, Clinical Evidence Retrieval, and Policy Matching agents to determine if a submission is ready for payer review.

Core Features & Use Cases

• Gate-based readiness evaluation across credentials, codes, and policy requirements to produce a clear READY_TO_SUBMIT or NEEDS_REVIEW decision.
• Generates an auditable confidence score and structured audit trail for payer submission review.
• Supports fallback medical-necessity pathways when no LCD/NCD policy exists, ensuring a complete evaluation even in Medicare scenarios.

Quick Start

Pass the outputs of the Documentation Completeness, Clinical Evidence Retrieval, and Policy Matching agents; the skill will return ready_to_submit or needs_review.