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nha-in/nhcx

v0.1.0MIT

Agent skills for building on the National Health Claims Exchange (NHCX), one per use case in episode order: nhcx-coverage, nhcx-insurance, nhcx-preauth, nhcx-claim, nhcx-payment, nhcx-communication and nhcx-reprocess. Each builds its use case into a hospital information system or a claims desk, held to the NHCX package's pinned FHIR bundles, and installs and runs alone.

nhcx-preauth

Add NHCX pre-authorisation to a hospital information system or a standalone claims desk. Link the admission, capture the dossier, ask the auth-requirements ruling, send the pre-auth (12), answer a PMJAY query (19, 131), raise an enhancement (13), cancel (PC01) and ask for a predetermination, reading every answer (20, 21, 22, 23, 24, PC02), held to the pinned bundles. Starts by checking whether the app already sends pre-auths or any of these legs, and whether the coverage and plan it depends on exist, then builds, extends or reuses only what is missing. Self-contained; needs no other skill installed. Use for pre-authorisation, enhancement, pre-auth query answers, cancelling a pre-auth, auth requirements, predetermination, NHCX use cases B3, B8 cancel, B9, D2 and D4 to D8, flow steps F5 to F9e.

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