Tool tree
CoAuth - an agent-native prior-authorization cockpit. A clinician and an AI agent complete payer forms together via WebMCP tools, with a human signature gate.
Implementation
gradeNot graded
gradeNot graded
load_patient_contextAction
Load a patient's structured clinical record into the workspace.
View tool JSON
{
"name": "load_patient_context",
"kind": "act",
"impl": "imperative",
"description": "Load a patient's structured clinical record into the workspace.",
"inputSchema": {
"type": "object",
"properties": {
"patientId": {
"type": "string",
"enum": [
"priya-raman",
"jane-doe",
"marcus-lee",
"ana-torres"
],
"description": "Identifier of the patient whose record to load. Available: priya-raman, jane-doe, marcus-lee, ana-torres."
}
},
"required": [
"patientId"
],
"additionalProperties": false
},
"page": "/"
}check_payer_rulesAnswer
Fetch a payer's required fields, coverage criteria and policy. Call this before filling anything: each payer asks for a different set of fields.
View tool JSON
{
"name": "check_payer_rules",
"kind": "answer",
"impl": "imperative",
"description": "Fetch a payer's required fields, coverage criteria and policy. Call this before filling anything: each payer asks for a different set of fields.",
"inputSchema": {
"type": "object",
"properties": {
"payer": {
"type": "string",
"enum": [
"uhc",
"aetna",
"cigna"
],
"description": "Insurer to submit to. Available: uhc, aetna, cigna. Each has its own required fields and coverage criteria."
}
},
"required": [
"payer"
],
"additionalProperties": false
},
"page": "/"
}fill_fieldAction
Set the value of one required field, sourced from the patient record. Clinician-judgment fields are refused by this tool; use draft_field to propose text for those.
View tool JSON
{
"name": "fill_field",
"kind": "act",
"impl": "imperative",
"description": "Set the value of one required field, sourced from the patient record. Clinician-judgment fields are refused by this tool; use draft_field to propose text for those.",
"inputSchema": {
"type": "object",
"properties": {
"fieldId": {
"type": "string",
"enum": [
"member_id",
"prescriber_npi",
"diagnosis_code",
"hcpcs_code",
"dose",
"quantity",
"step_therapy",
"tb_screen"
],
"description": "Field to set. Call check_payer_rules first: the payer decides which of these are required. Fields: member_id (Member ID); prescriber_npi (Prescriber NPI); diagnosis_code (Primary diagnosis (ICD-10)); hcpcs_code (Requested drug (HCPCS)); dose (Dose & SIG); quantity (Quantity / days supply); step_therapy (Step therapy - DMARDs tried & failed); tb_screen (TB screening result). The clinician-judgment fields (step_exception_rationale, medical_necessity, attending_attestation, specialist_attestation) are not settable through this tool and will be refused; propose text for those with draft_field, which the clinician accepts or rejects."
},
"value": {
"type": "string",
"description": "Value to write, sourced from the patient record. Coded fields are validated: diagnosis_code must be ICD-10 (e.g. M06.9), hcpcs_code must be a J-code (e.g. J0135), prescriber_npi must be exactly 10 digits."
}
},
"required": [
"fieldId",
"value"
],
"additionalProperties": false
},
"page": "/"
}attach_evidenceAction
Link a clinical document to a field that requires supporting evidence. Only evidence fields accept a document; clinician-judgment fields are refused.
View tool JSON
{
"name": "attach_evidence",
"kind": "act",
"impl": "imperative",
"description": "Link a clinical document to a field that requires supporting evidence. Only evidence fields accept a document; clinician-judgment fields are refused.",
"inputSchema": {
"type": "object",
"properties": {
"fieldId": {
"type": "string",
"enum": [
"tb_screen"
],
"description": "Evidence field to attach the document to. Accepts: tb_screen. Clinician-judgment fields are refused, as they are by fill_field."
},
"docId": {
"type": "string",
"enum": [
"doc-cbc",
"doc-tb",
"doc-notes",
"doc-mtx",
"doc-imaging"
],
"description": "Document from the patient's chart. Available: doc-cbc (CBC panel (2026-08-10)); doc-tb (TB screening (QuantiFERON)); doc-notes (Rheumatology consult note); doc-mtx (Methotrexate trial summary); doc-imaging (Hand X-ray report)."
}
},
"required": [
"fieldId",
"docId"
],
"additionalProperties": false
},
"page": "/"
}validate_submissionAction
Run the payer rules engine and report which fields pass, fail, or need human judgment.
View tool JSON
{
"name": "validate_submission",
"kind": "act",
"impl": "imperative",
"description": "Run the payer rules engine and report which fields pass, fail, or need human judgment.",
"inputSchema": {
"type": "object",
"properties": {},
"additionalProperties": false
},
"page": "/"
}get_workflow_guidanceAnswer
Return the recommended sequence for completing a prior authorization and the rules the agent must follow (e.g. never fabricate clinician-judgment fields, never bypass the signature gate). Call this first to learn how to drive this page correctly.
View tool JSON
{
"name": "get_workflow_guidance",
"kind": "answer",
"impl": "imperative",
"description": "Return the recommended sequence for completing a prior authorization and the rules the agent must follow (e.g. never fabricate clinician-judgment fields, never bypass the signature gate). Call this first to learn how to drive this page correctly.",
"inputSchema": {
"type": "object",
"properties": {},
"additionalProperties": false
},
"page": "/"
}get_submission_stateAnswer
Read the whole current workspace: the loaded patient, the payer, every field value with who set it, outstanding conflicts, the denial-risk score, and whether the clinician has signed. Call this after reconnecting, or at any point you are unsure what has already been done.
View tool JSON
{
"name": "get_submission_state",
"kind": "answer",
"impl": "imperative",
"description": "Read the whole current workspace: the loaded patient, the payer, every field value with who set it, outstanding conflicts, the denial-risk score, and whether the clinician has signed. Call this after reconnecting, or at any point you are unsure what has already been done.",
"inputSchema": {
"type": "object",
"properties": {},
"additionalProperties": false
},
"page": "/"
}assess_denial_riskAction
Return a heuristic denial-risk score (rule-based, not a trained model) for the current submission, plus the contributing factors.
View tool JSON
{
"name": "assess_denial_risk",
"kind": "act",
"impl": "imperative",
"description": "Return a heuristic denial-risk score (rule-based, not a trained model) for the current submission, plus the contributing factors.",
"inputSchema": {
"type": "object",
"properties": {},
"additionalProperties": false
},
"page": "/"
}detect_conflictsAction
Check the request against the patient record for clinical contradictions (e.g. contraindications, unmet step therapy) that a clinician must review.
View tool JSON
{
"name": "detect_conflicts",
"kind": "act",
"impl": "imperative",
"description": "Check the request against the patient record for clinical contradictions (e.g. contraindications, unmet step therapy) that a clinician must review.",
"inputSchema": {
"type": "object",
"properties": {},
"additionalProperties": false
},
"page": "/"
}draft_appealAction
Draft a payer appeal letter for a denied or high-risk prior authorization, grounded in the patient record, the payer's policy, and the specific denial drivers. Draft only - requires clinician review and signature.
View tool JSON
{
"name": "draft_appeal",
"kind": "act",
"impl": "imperative",
"description": "Draft a payer appeal letter for a denied or high-risk prior authorization, grounded in the patient record, the payer's policy, and the specific denial drivers. Draft only - requires clinician review and signature.",
"inputSchema": {
"type": "object",
"properties": {},
"additionalProperties": false
},
"page": "/"
}draft_fieldAction
Propose grounded draft language for a clinician-judgment field (e.g. medical necessity). The draft is a suggestion only - the clinician must review, edit, and accept it. Never counts as filled until accepted.
View tool JSON
{
"name": "draft_field",
"kind": "act",
"impl": "imperative",
"description": "Propose grounded draft language for a clinician-judgment field (e.g. medical necessity). The draft is a suggestion only - the clinician must review, edit, and accept it. Never counts as filled until accepted.",
"inputSchema": {
"type": "object",
"properties": {
"fieldId": {
"type": "string",
"enum": [
"medical_necessity",
"step_exception_rationale"
],
"description": "Clinician-judgment field to draft language for. Available: medical_necessity, step_exception_rationale. The draft is a proposal only and does not count as filled until the clinician accepts it."
}
},
"required": [
"fieldId"
],
"additionalProperties": false
},
"page": "/"
}flag_for_humanAction
Mark a field as needing clinician input; surfaces it in the review queue.
View tool JSON
{
"name": "flag_for_human",
"kind": "act",
"impl": "imperative",
"description": "Mark a field as needing clinician input; surfaces it in the review queue.",
"inputSchema": {
"type": "object",
"properties": {
"fieldId": {
"type": "string",
"enum": [
"member_id",
"prescriber_npi",
"diagnosis_code",
"hcpcs_code",
"dose",
"quantity",
"step_therapy",
"tb_screen",
"step_exception_rationale",
"medical_necessity",
"attending_attestation",
"specialist_attestation"
],
"description": "Field that needs clinician attention."
},
"reason": {
"type": "string",
"description": "Why the clinician needs to look at it, in one sentence."
}
},
"required": [
"fieldId",
"reason"
],
"additionalProperties": false
},
"page": "/"
}submitSensitive Action
Submit the completed prior authorization. Requires a human clinician signature first.
View tool JSON
{
"name": "submit",
"kind": "transact",
"impl": "imperative",
"description": "Submit the completed prior authorization. Requires a human clinician signature first.",
"inputSchema": {
"type": "object",
"properties": {},
"additionalProperties": false
},
"page": "/"
}