Healthcare

Skill packages tagged with “Healthcare”

Appeal letter builder

Draft a denial-specific appeal letter grounded in the normalized denial reason, prior-therapy history, and payer policy. Enforces denial-reason rebuttal, plan-preferred-therapy failure arguments, contradiction checks, and appeal-specific completeness (RE line with denial date and reference number, rebuttal section, requested resolution, enclosure manifest including the LOMN). Hands the draft to the clinical-claim-evidence-mapper for citation and export gating.

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    Clinical claim evidence mapper

    Persist a citation from every clinical claim (diagnosis, prior therapy, contraindication, lab value, score, outcome, coverage criterion, guideline) asserted in a drafted appeal or letter of medical necessity back to a chart excerpt. Blocks export of any drafting skill's output when claims are unmapped — the trust gate for all pilot-ready healthcare packets.

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      Clinical Report Writing

      Write comprehensive clinical reports including case reports (CARE guidelines), diagnostic reports (radiology, pathology, lab), clinical trial reports (ICH-E3, SAE, CSR), and patient documentation (SOAP notes, H&P, discharge summaries). Includes regulatory compliance and validation tools.

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        Clinical Trial Protocol (ICH E6(R3) GCP)

        Draft and validate clinical trial protocols per ICH E6(R3) Good Clinical Practice and ICH E8(R1) General Considerations for Clinical Studies. Ensures the protocol contains all required elements for ethics committee / IRB submission and regulatory filing (EMA, FDA IND, ANVISA).

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          CQC Statement of Purpose

          Draft, update, and validate the legally required Statement of Purpose for CQC-registered healthcare providers in England. Maps service descriptions to the Five Key Questions (Safe, Effective, Caring, Responsive, Well-led) and validates regulated activities against CQC registration categories. Covers care homes, GP practices, dental surgeries, domiciliary care, and hospitals.

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            Denial intake normalizer

            Parse payer denial letters, EOBs, Medicare Advantage IDNs, NOMNC/DENC, and appeal forms into a structured case.json. Classifies the denial, routes the appeal type, and computes the appeal deadline — the intake step for every downstream denial-appeal and prior-auth skill.

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              DiGA Fast-Track

              Prepare and validate Fast-Track applications for listing Digital Health Applications (DiGA) in the BfArM directory per DiGAV. Cross-checks clinical study protocols against claimed Positive Versorgungseffekte and audits technical documentation for ISiK interoperability standards compliance.

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                Dossier AMM France — HAS / ANSM

                Préparer et vérifier les dossiers d'Autorisation de mise sur le marché (AMM/MAA) pour le marché français. Contexte HAS et ANSM, structure CTD, cohérence des données d'essais cliniques (avec maa_dossier_check).

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                  eCTD Cross-Module Verifier

                  Verify consistency and data integrity of eCTD pharmaceutical dossiers. Cross-checks Module 2 (Summaries) against Module 5 (Clinical Study Reports) to ensure study references, p-values, N-counts, endpoints, and safety data are aligned before regulatory submission to FDA, EMA, or PMDA.

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                    FDA Submission Wizard

                    Draft and validate FDA medical device submissions. Supports 510(k) Premarket Notifications (eSTAR format) with predicate comparison and substantial equivalence arguments, and PMA (Premarket Approval) dossiers with clinical and non-clinical data sections.

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                      Health Canada & MDSAP

                      Align QMS documentation to MDSAP and Health Canada expectations. Guides users to map procedures and records to MDSAP/ISO 13485, prepare for audits, and use the mdsap_audit_aligner skill when available.

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                        HIPAA Security Risk Assessment (SRA)

                        Draft and validate the Security Risk Assessment required by the HIPAA Security Rule (45 CFR §164.308(a)(1)). Defines scope and ePHI boundaries, inventories assets and Business Associate relationships, maps threats and vulnerabilities, assesses Required and Addressable safeguards, and produces the SRA report and risk register aligned with HHS/OCR audit protocol.

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                          HIPAA Security Rule Modernization Roadmap

                          Build a 180-day remediation roadmap restricted to the deltas between the current HIPAA Security Rule (45 CFR Part 164 Subpart C) and a proposed amendment (e.g., the 2024 NPRM RIN 0945-AA22). Parses both XML sources by section, generates a delta matrix with citations, and produces a narrative roadmap and phased Gantt aligned to the 180-day window.

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                            HIQA Complaints Procedure

                            Draft or update a complaints procedure for healthcare services aligned with HIQA NSSBH and national complaints guidance.

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                              HIQA Consent Policy

                              Draft or update a consent policy for healthcare services aligned with HIQA NSSBH and Irish consent law.

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                                HIQA Healthcare Governance

                                Draft or update a governance and accountability framework for healthcare services aligned with HIQA NSSBH Theme 5.

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                                  HIQA Incident Investigation Report

                                  Draft an incident investigation report for healthcare services aligned with HIQA NSSBH and learning from incidents.

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                                    HIQA Incident Reporting Procedure

                                    Draft or update an incident reporting procedure for healthcare services aligned with HIQA NSSBH (internal reporting; for notifiable incidents use hiqa-notifiable-incidents-reporting).

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                                      HIQA Notifiable Incidents Reporting

                                      Draft or update the process for reporting notifiable incidents to HIQA/Chief Inspector under the Patient Safety Act 2023.

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                                        HIQA Open Disclosure Policy

                                        Draft or update an open disclosure policy aligned with the Patient Safety Act 2023 and HIQA NSSBH.

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                                          HIQA Quality Improvement Plan

                                          Draft or update a quality improvement plan for healthcare services aligned with HIQA NSSBH.

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                                            HIQA Risk Register

                                            Draft or update a risk register for healthcare services aligned with HIQA NSSBH (safe care, governance).

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                                              HIQA Safeguarding Policy

                                              Draft or update a safeguarding policy for healthcare services aligned with HIQA NSSBH and national safeguarding guidance.

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                                                HIQA Workforce Performance Management Policy

                                                Draft or update a workforce performance management policy for healthcare services aligned with HIQA NSSBH Theme 6.

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                                                  HIQA Workforce Recruitment Policy

                                                  Draft or update a workforce recruitment policy for healthcare services aligned with HIQA NSSBH Theme 6.

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                                                    HIQA Workforce Supervision Policy

                                                    Draft or update a workforce supervision policy for healthcare services aligned with HIQA NSSBH Theme 6.

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                                                      HIQA Workforce Training Policy

                                                      Draft or update a workforce training policy for healthcare services aligned with HIQA NSSBH Theme 6.

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                                                        HITRUST CSF Assessment

                                                        Draft HITRUST CSF Validated Assessment deliverables for e1, i1, or r2 certification: control requirement responses at all maturity levels, evidence artifacts, Corrective Action Plans, and the Validated Assessment Report.

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                                                          Letter of medical necessity builder

                                                          Draft a structured letter of medical necessity (LOMN) from a normalized case record and chart excerpts, using the Genentech/Novartis field model: patient identifiers, diagnosis and ICD-10, severity, prior therapies with outcomes, clinical rationale, treatment plan and dosing, supporting guidelines, and enclosure manifest. Enforces completeness, ICD-10 specificity, prior-therapy history structure, and disease-score capture before handing the draft to the clinical-claim-evidence-mapper for citation and export gating.

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                                                            LOMN overlay — musculoskeletal / spine / pain

                                                            Specialty overlay for letter-of-medical-necessity-builder that applies stricter MSK, spine, orthopedic, and pain-management validations: conservative-care step-therapy rules per procedure (spine surgery, neurostimulator, RFA, ESI, facet injection, DME), ODI/NDI/VAS-pain trend analysis across baseline and post-conservative-care follow-up, and imaging-to-symptom concordance checks. Invoked from within the core LOMN workflow when the case specialty is MSK; adds requirements, does not weaken the core.

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                                                              Medical Council Professional Ethics

                                                              Draft Informed Consent and Clinical Indemnity policies for private clinics in Ireland, aligned with the Irish Medical Council Guide to Professional Conduct and Ethics. Validate policies with the Guide and check Open Disclosure protocols against the Patient Safety Act 2023.

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                                                                Monitoramento de Infecções (IRAS) e RAM

                                                                Padroniza relatórios mensais de infecção hospitalar e resistência microbiana para hospitais e clínicas, com foco em notificação de indicadores nacionais obrigatórios e detecção de discrepâncias estatísticas. Regulação: ANVISA, Notas Técnicas 02/2026 e 03/2026.

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                                                                  Packet checklist and index generator

                                                                  Produce the evidence-bundle manifest for a denial-appeal or prior-authorization packet: required vs. optional attachments by denial category, service setting, and specialty; which items are attached; which are missing; and the structured manifest persisted to the workspace. Enforces inpatient-specific rules (complete medical records for acute inpatient appeals) and DMEPOS documentation lists. Consumes the normalized case record plus the drafted LOMN/appeal letter and their evidence map; produces the checklist, the packet-manifest JSON, and the human-readable packet index.

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                                                                    Peer-to-peer prep

                                                                    Build a one-page pre-call briefing document for a scheduled peer-to-peer conversation between the clinic's physician and the payer's medical director. Renders the opening line, denial reason quoted verbatim, 60-second clinical story, prior-therapy table, contraindications to preferred alternatives, specialty-society guideline citation, a specific ask, and likely reviewer questions with prepared answer frames. Grounded in Patient Advocate Foundation peer-to-peer guidance and common denial-category-specific reviewer-question patterns.

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                                                                      Pharmacy QMS (ApBetrO)

                                                                      Pflege und Erstellung des Qualitaetsmanagementsystems (QMS) fuer oeffentliche Apotheken gemaess Apothekenbetriebsordnung (ApBetrO). Erstellt QMS-Handbuecher, Hygieneplaeane nach RKI-Richtlinien, Rezepturprotokolle nach DAB/Ph.Eur. und prueft die Compliance.

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                                                                        PRD — Healthcare / Health Tech PM

                                                                        Draft and validate PRDs for healthcare and health tech: clinical workflows, HIPAA/safety, consent, data handling.

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                                                                          QMS CAPA Tracker

                                                                          Draft and validate CAPA (Corrective and Preventive Action) reports for medical device quality management systems. Standardizes root cause analysis using 5 Whys or Fishbone (Ishikawa) methods, enforces Effectiveness Check completeness, and validates CAPA structure against ISO 13485 and FDA 21 CFR Part 820 requirements.

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                                                                            Redaction tool (healthcare case studies)

                                                                            Pre-publication PHI-redaction reviewer-aid for Rakenne-generated healthcare artifacts (letters of medical necessity, appeal letters, peer-to-peer briefs, case.json, packet-index, cover-sheet) being prepared as anonymized case studies for external sharing. Surfaces the 18 HIPAA identifiers where heuristics are reliable, lets the LLM triage candidate names, applies reviewed redactions with relative DAY+n date anchoring, and blocks export when any reliably-detectable identifier remains. Not a HIPAA Safe Harbor or Expert Determination de-identification certification — compliance review is still required before publication.

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                                                                              Submission companion sheet

                                                                              Produce the routing cover sheet for submitting a denial-appeal, claim-reconsideration, or prior-authorization packet to a US payer. Encodes channel selection (fax vs. portal vs. mail), expedited-flag handling, member and claim identifiers, attachment count, and certified-mail reminders. The routing-lookup is scaffolded as patterns (Anthem pre-service vs. retro vs. expedited fax separation; UHC PRA-driven claim-reconsideration routing; CoverMyMeds for PA; payer portals) rather than hardcoded fax numbers — the clinic's routing table is injected at pilot time. Pairs with packet-checklist-and-index-generator (which produces the attachment manifest this cover sheet lists).

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                                                                                USA Medical Power of Attorney

                                                                                Draft and validate a healthcare proxy or advance directive (medical POA and optional living will) in the USA.

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