Sequential AgentHealthcareintermediate

Insurance Eligibility Checker Template

Acts as · Patient Access / Eligibility Specialist

Prepares an eligibility check for a planned service: plan active, network, cost-share, and whether a referral/prior-auth is required: using payer resources, and flags what to verify. Staff confirms and submits.

A single-purpose agent that runs an ordered list of tasks against your tools, knowledge and tables, the same way every run.

Officialby Akshay Gupta
How it works

Inputs in, an ordered run, a result out.

A Sequential Agent takes typed inputs, runs its tasks top to bottom against your tools and tables, and returns a structured result, the same way on every run.

Typed inputs
Values you pass in, validated before the run spends anything.
2 tasks
Each task runs in order, passing its output to the next.
Tools & tables
2 tools · 1 table
Result + trace
A structured output, with every step recorded.
The run loop
Read→Plan→Act→Check→Write→Tracerepeats until done

What's inside

Everything this template installs, by name.

Tables1
Referrals And Prior Auths
Tools2
SerperWeb Scraping
Tasks
2 ordered tasks

What it takes in

The inputs you provide on each run, validated before anything executes.

InputTypeRequired
Patient / Plan and Planned ServicedetailsLong textRequired
PayerpayerShort textOptional
The work, step by step

2 tasks, run in order.

Each task passes its result to the next. Here's what each does and what it produces.

  1. 01
    From {{details}} for {{payer}}, list what to verify (active plan, member/group, network, cost-share, referral/prior-auth need) and use Serper/Web Scraper to find the payer's public requirements for the planned service. Cite sources.
    Expected output
    An eligibility worksheet: each item with the finding or 'to verify', plus any public payer-policy citation. No JSON.
  2. 02
    Summarize likely coverage/cost-share and whether prior auth appears required, with a clear 'Verify in payer portal' note, and prepare the Referrals/Prior Auths record (Auth Status).
    Expected output
    A coverage summary + prior-auth-required flag + verify note + Referrals/Prior Auths record draft. No coverage guarantee. No JSON.

Tools it uses

SerperSearch the payer's public policy/requirements pages.
Web ScrapingRead public payer policy pages to confirm requirements.

What you can do with it

Streamlined Eligibility Verification
Quickly assess patient eligibility for services.
Reduce Claim Denials
Minimize errors by verifying requirements upfront.
Enhanced Patient Experience
Provide faster service with accurate eligibility checks.
Automated Workflow Integration
Seamlessly integrate with existing healthcare systems.

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