pa_predict
Predict prior authorization approval probability for medical procedures using CPT/HCPCS codes, diagnosis codes, and patient data to estimate approval likelihood, confidence level, and processing time.
Instructions
Predict prior authorization approval probability for a procedure. Returns approval likelihood (0-1), confidence level, estimated processing days, and contributing factors.
Input Schema
| Name | Required | Description | Default |
|---|---|---|---|
| procedureCode | Yes | CPT/HCPCS procedure code | |
| diagnosisCodes | No | Supporting ICD-10 diagnosis codes | |
| payerId | No | Insurance payer ID | |
| patientAge | No | Patient age in years | |
| patientGender | No |