benefit-coverage-navigator

Plugin benefit-coverage-navigator in fmlin0429712024/healthplan-process-poc. Commands read from the repo's manifest — 1 month ago.

Skills (8)

• benefit-coverage-navigator

  Benefit Coverage Navigator — hub-and-spoke pipeline that turns real plan documents (medical, dental, vision) plus one mixed real/synthetic pharmacy domain into per-encounter cost lookups, consolidated into one member-level answer with clear escalation of anything that needs human review. Trigger on

• ingestion

  Ingestion pipeline — converts a plain-text description of a member's benefit encounters (a visit, a dental procedure, an eye exam, a prescription fill...) into a structured list of encounters, each tagged with the benefit domain it belongs to. Always run this FIRST when input is not already structur

• document-checker

  Validates that each ingested encounter has enough information for its domain verifier to look up a cost, before routing to coverage-verifier. Run this after ingestion, before coverage-verifier.

• coverage-verifier

  Benefit Coverage Verification Engine — coordinator. Dispatches each complete encounter to a real, isolated domain subagent (medical/dental/vision/pharmacy) via Task, running independent domains in parallel and consolidating their results before handing off to the case manager.

• case-manager

  Consolidates coverage-verifier results across all of a member's encounters into one answer: total estimated cost, out-of-pocket-limit progress, and exactly which items (if any) need human review. This is where cross-domain work happens — not a pass-through.

• eval

  Evaluation workflow — acts as a Teaching Assistant for the PA pipeline. Grades AI decisions against a golden set of expert-labeled cases, identifies mismatches, and escalates conflicts to Human-in-the-Loop (HITL) review. Run after the forward pipeline to measure decision quality and catch errors bef

• member-support-agent

  Answers a member's free-text follow-up questions about their already-computed Benefit Coverage Navigator results — why something priced the way it did, what they owe in total, what's still pending human review. Trigger on a member's question about an EXISTING consolidated-report.json, never on new e

• research

  Multi-agent research coordinator: dispatches specialized subagents that analyze documents, synthesize findings, and generate a cited report. Current scope: the FSA domain only, 9 real documents from the PBC full-corpus research collection. Trigger only when explicitly asked to run the FSA research p

MCP servers (1)

• benefit-coverage

  runs: python3 mcp-servers/benefit-coverage/server.py

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