Insurance Prior Authorization Prep
Build the documentation checklist and a draft medical-necessity justification for a prior authorization request.
The full canvas, before you import it
Click any node to see its config.
Click a node to select it — same as the Heym editor; the panel shows its settings.
3 nodes · Free & source-available
Insurance Prior Authorization Prep
Cut the busywork out of prior authorizations. Enter the procedure, diagnosis, and payer, and this template returns the documentation checklist a payer typically expects plus a draft medical-necessity justification for clinician review.
What this workflow does
- priorAuthIntake captures the procedure, diagnosis, payer, and plan type
- prepPriorAuth drafts a required-documents checklist and a medical-necessity justification
- priorAuthResult returns the package for staff and clinician review
Use cases
- Faster, more complete prior authorization submissions
- Consistent documentation across payers
- Reducing back-and-forth and denials from missing items
Setup
Connect an LLM credential in prepPriorAuth. This is an administrative aid only — it does not provide medical advice, and a qualified clinician must review and approve the justification and clinical details before submission.
How to import this template
- 1Click Import → Copy JSON on this page.
- 2Open your Heym and navigate to a workflow canvas.
- 3PressCmd+V/Ctrl+V— nodes appear instantly.
- 4Add your API keys in the node config panels and click Run.
Discover more automations
- HealthcareBlood Panel Triage TeamOrchestrator runs a deterministic 12-marker panic-value gate, then fans out three cross-lab sub-agents to interpret labs, push doctor questions, and enumerate differentials.
- HealthcareReferral Intake Priority RouterClassify referral or intake notes, separate urgent administrative follow-ups, and notify the review channel.
- HealthcarePatient Appointment Reminder & No-Show ReducerScan upcoming appointments daily, draft personalized reminders, and flag high no-show-risk visits for a confirmation call.
- HealthcarePost-Visit Follow-up DrafterTurn a visit summary into a clear, patient-friendly follow-up message with care reminders and next steps.
- HealthcareCare Coordination Intake RegistrySummarize a non-clinical care coordination request and save the structured intake record to Supabase.
- HealthcareClinical Trial Eligibility Intake AgentScreen patient-submitted trial interest against ClinicalTrials.gov criteria, redact sensitive context, and route qualified leads for coordinator review.
- HealthcareFHIR Lab Result Release QA AgentNormalize inbound FHIR lab observations, check portal-release readiness, and alert care ops when patient-facing wording needs review.
- HealthcareProvider Credentialing Expiry AgentMonitor provider licenses, payer enrollments, and NPI records, then route credentialing expirations before claims or scheduling are blocked.
- HealthcareReferral Leakage Network OptimizerAnalyze specialty referral records, find leakage patterns, and brief provider-network teams on retention opportunities.
- Customer SupportHITL Support Reply AgentDraft a customer-facing support response, pause for human approval, then continue with the reviewed reply.
- Dev & IT OpsCodex PR Fix AgentSend a coding task to Codex, open a draft PR when it succeeds, and notify Slack when Codex needs follow-up input.
- Dev & IT OpsAgent-Guided Codex PR DispatcherLet an Agent inspect a GitHub request, prepare a confirmed Codex task, open a ready PR, and notify Slack when Codex needs input.