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Create a prior-authorization review packet
Parse a submission, retrieve the matching version of CMS policy, assess each criterion, and return a cited human-review queue without a coverage decision.
Goal
Parse a submission, retrieve the matching version of CMS policy, assess each criterion, and return a cited human-review queue without a coverage decision.
Steps
- Parse the sample PDF and validate required fields. [src-openai-create-prior-authorization-review-packet]
- Resolve the application-owned policy ID/version and retrieve CMS text for each criterion. [src-openai-create-prior-authorization-review-packet]
- Validate evidence citations and review queue, then return
review_ready. [src-openai-create-prior-authorization-review-packet]
How to verify
Each criterion must cite the selected policy version, clinical evidence must cite the submission, and the final state must be `review_ready`.
Troubleshooting
Reject unknown policy IDs/versions; if a citation is absent from retrieved chunks, inspect KB identity/results and fail validation.
Permissions
Prerequisites
- Python 3.12, sample submission PDF, public CMS policy; AWS/Bedrock credentials only for an isolated test with explicit opt-in.
Permissions
- Optional setup creates AWS resources such as S3/Knowledge Base, uploads documents, and incurs model charges; keep provision/deploy disabled and make no coverage decision.
Limitations
Sample CMS policies do not define a real plan’s rules; a payer reviewer must handle every result.
Pinned upstream source
- Repository
- openai/openai-cookbook
- File path
- examples/partners/AWS/policy_to_review_prior_authorization_agents_sdk_agentcore.ipynb
- Pinned commit
5bd6cb40b6b84b69b2032d810610aa85064102df- Source checked
- 2026-10-14 · Reviewed against the pinned upstream source
Repository metrics
These values describe the upstream repository, not popularity or likes for an individual skill or playbook.
- Stars
- Not collected
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No metrics snapshot is available yet.
License: MIT
Main topic
Turn ecommerce campaign materials into a reviewable weekly brief