Healthcare: Claims Denial Appeal Preparation with Claude Code: Result JSON Schema
A production playbook for claims denial appeal preparation in healthcare operations using Claude Code: result json schema, run-scoped inputs, logs, typed results, and artifacts.
Audience: Revenue cycle teams appealing payer denials
The problem
Revenue cycle teams appealing payer denials need claims denial appeal preparation to run repeatedly against EOBs, denial letters, medical records, payer policies, and appeal templates. In healthcare operations, the pain is not one good answer; it is repeatability, auditability, exception handling, and evidence that survives handoff.
Implementation path
Define the outer result contract once, let the claims denial appeal preparation skill own body.data, and reject terminal output that does not match the expected schema.
Tradeoffs and failure modes
Schema enforcement adds upfront design work, but removes prompt parsing from the product surface. For claims denial appeal preparation, the practical test is whether a second run can be debugged, retried, and consumed by a product without reading the raw agent transcript.
Result shape
{
"schema_version": "argo.result.v1",
"summary": "claims denial appeal preparation completed",
"body": { "type": "healthcare_claims_denial_appeal", "data": {}, "exceptions": [] },
"artifacts": []
}
Run this on Argo