Healthcare: Prior Authorization Packet Review with Claude Code: MCP Tool Boundary
A production playbook for prior authorization packet review in healthcare operations using Claude Code: mcp tool boundary, run-scoped inputs, logs, typed results, and artifacts.
Audience: Healthcare operations teams
The problem
Healthcare operations teams need prior authorization packet review to run repeatedly against clinical notes, payer rules, forms, lab results, and attachments. In healthcare operations, the pain is not one good answer; it is repeatability, auditability, exception handling, and evidence that survives handoff.
Implementation path
Expose only the MCP tools needed for prior authorization packet review, validate tool arguments, keep credentials in the owning service, and log each call outside the sandbox.
Tradeoffs and failure modes
Narrow tool boundaries reduce agent flexibility, but make the integration reviewable and supportable. For prior authorization packet review, the practical test is whether a second run can be debugged, retried, and consumed by a product without reading the raw agent transcript.
Tool policy
tool: healthcare-prior-auth_lookup
agent: Claude Code
input_scope: /skill/.argo/inputs
credential_owner: broker
log_arguments: true
network_policy: allowlisted
Run this on Argo