@agenticmail/core 0.9.32 → 0.9.33

package/dist/skills/built-in/utility-payment-plan-avoid-disconnect.json

@@ -0,0 +1,122 @@
+{
+  "id": "utility-payment-plan-avoid-disconnect",
+  "name": "Set Up a Utility Payment Plan to Avoid Disconnection",
+  "version": "1.0.0",
+  "category": "customer-service",
+  "tags": [
+    "utility",
+    "payment-plan",
+    "disconnect",
+    "deferred-payment",
+    "phone-call",
+    "hardship",
+    "utility-telecom"
+  ],
+  "description": "Call a utility (electric / gas / water) when a shutoff notice has arrived (or is imminent) and negotiate a Deferred Payment Arrangement (DPA), hardship credit, or LIHEAP referral so service stays on while the balance is paid down over time.",
+  "disclaimer": "If service has already been disconnected, ask immediately about reconnection fees and same-day vs. next-day reconnection windows. If a household member is medically vulnerable or the weather is in a state-defined cold/heat-shutoff-moratorium window, say so first — most states legally prohibit disconnection in those cases.",
+  "context": {
+    "when_to_use": "User has received a disconnect / shutoff notice, OR sees a past-due balance large enough that they cannot pay in full this cycle, OR has already been disconnected. Time-sensitive — call before the disconnect date on the notice, not after.",
+    "preconditions": [
+      "User has the shutoff notice with disconnect date and amount due.",
+      "User knows what they can realistically pay TODAY and what they can pay per month going forward.",
+      "User knows whether the household qualifies for state/federal energy assistance (LIHEAP, ratepayer assistance) — even rough income bracket helps.",
+      "User has documented any medical or weather-vulnerability factors."
+    ],
+    "estimated_call_duration_minutes": 30
+  },
+  "principles": [
+    "Call BEFORE the disconnect date. Pre-disconnect, you negotiate; post-disconnect, you pay reconnect fees and a deposit on top of arrears.",
+    "There are three layers of help, request in order: (1) Deferred Payment Arrangement, (2) hardship credit / one-time forgiveness, (3) LIHEAP / state energy-assistance referral. Don't lead with assistance — DPAs require no income verification.",
+    "Mention vulnerability factors EARLY (medical, infants under 1, seniors over 62, active-duty military, recent job loss). Many utilities have program codes that only activate when the rep ticks the right box.",
+    "If routed to collections instead of customer-care / billing assistance, recognise it within 60 seconds — collections agents are scripted on payment-in-full, not on plans.",
+    "Be specific with numbers. 'I can pay $X today and $Y per month for 6 months' is a proposal; 'I'm struggling, what can you do?' is a wish."
+  ],
+  "phrases": {
+    "opener": "Hi, I received a shutoff notice on account [number] for $[amount] dated [disconnect date]. I want to keep service on — I can pay $[amount] today, and I'd like to set up a deferred payment arrangement for the balance. Can we walk through options?",
+    "queue_check": "Quick check — am I in customer care / payment assistance, or in collections? I'm here to set up a payment plan, and I want to make sure I'm with the team that can authorise one.",
+    "transfer_request": "Could you do a warm transfer to the payment-arrangement team and stay on the line until they pick up? I don't want to lose my hold position if they can't take me right now.",
+    "vulnerability_flag": "Before we go further — there's [an infant under 1 / a senior over 62 / someone on powered medical equipment / recent job loss] in the household. Does that change the options available on this account?",
+    "weather_moratorium_check": "Is this a [cold weather / heat] moratorium period in [state]? I'd like to understand whether disconnect can proceed before [moratorium end date] regardless of the plan.",
+    "propose_dpa": "Here's what I can do: $[down payment] today, then $[monthly] on top of the regular bill for [N] months. That clears the arrears in [N] months. Does that work, or what does your standard DPA look like?",
+    "ask_hardship_credit": "Does the company have a one-time hardship credit or arrears-forgiveness program I could apply for? I'd rather match my plan with that than borrow to catch up.",
+    "ask_liheap": "Can you refer me to LIHEAP / [state-specific assistance program] and put a 14-day hold on disconnect while my application is processed? Most programs guarantee that hold once you have an application reference number.",
+    "lock_in_writing": "Can you email or text me the DPA terms — down payment, monthly add-on, end date, and confirmation that disconnect is removed — before we hang up? I want it in writing.",
+    "graceful_close": "Thanks. So down payment of $[X] today, then $[Y]/month for [N] months, disconnect lifted, confirmation number [number], and I'll watch for the email."
+  },
+  "tactics": [
+    {
+      "name": "Lead with a specific proposal",
+      "when": "First substantive turn after opener.",
+      "script": "Use `propose_dpa`. Naming the down payment + the monthly add-on first anchors the negotiation. Most utility DPA defaults are 25% down + balance over 6-12 months — proposing inside that envelope gets fast approval.",
+      "priority": 1
+    },
+    {
+      "name": "Recognise wrong-queue fast",
+      "when": "Rep starts pushing for payment-in-full or threatens 'we cannot stop the disconnect'.",
+      "script": "Use `queue_check` and `transfer_request`. Collections is incentivised on collection rate; payment-assistance is incentivised on retention.",
+      "priority": 2
+    },
+    {
+      "name": "Surface vulnerability factors early",
+      "when": "Within the first 2 minutes if any apply.",
+      "script": "Use `vulnerability_flag`. This is not leverage — it changes which program codes the rep can apply.",
+      "priority": 3
+    },
+    {
+      "name": "Check the weather moratorium",
+      "when": "Cold-weather (typically Nov-Mar) or heat-event states.",
+      "script": "Use `weather_moratorium_check`. If active, disconnect is often legally barred — that buys time even if the DPA negotiation stalls.",
+      "priority": 4
+    },
+    {
+      "name": "Layer hardship + assistance referrals",
+      "when": "DPA alone leaves a monthly burden the user cannot sustain.",
+      "script": "Use `ask_hardship_credit` AND `ask_liheap`. The DPA covers arrears; assistance can knock down the principal so the monthly is sustainable.",
+      "priority": 5
+    },
+    {
+      "name": "Get it in writing before hanging up",
+      "when": "All terms agreed.",
+      "script": "Use `lock_in_writing`. Verbal DPAs evaporate at shift change. Confirmation email + case number is the proof you need if collections action restarts."
+    }
+  ],
+  "boundaries": [
+    "Do NOT agree to a monthly add-on the user cannot actually pay. Default-breaking a DPA usually triggers immediate disconnect with no second chance.",
+    "Do NOT pay anything before the rep has confirmed the DPA is set up in the system — paying down the arrears voluntarily can be applied to current charges, leaving the past-due intact.",
+    "Do NOT misrepresent income for hardship credit. Most programs verify and a fraudulent claim disqualifies the account from future assistance.",
+    "Do NOT cancel autopay during a DPA — autopay default often disables the DPA automatically."
+  ],
+  "success_signals": [
+    "DPA terms confirmed: down payment, monthly add-on, end date, removal of disconnect.",
+    "Confirmation number issued and written confirmation incoming.",
+    "Vulnerability flag accepted; medical-baseline or shutoff-protection added to account.",
+    "LIHEAP / assistance referral with a hold-on-disconnect window."
+  ],
+  "failure_signals": [
+    "Rep insists on payment in full and refuses to transfer to assistance.",
+    "DPA monthly add-on offered is larger than the user can sustain — accepting would set up a default.",
+    "Disconnect proceeds despite confirmed moratorium (escalate to PUC same day).",
+    "No written confirmation arrives within 48 hours."
+  ],
+  "exit_strategy": {
+    "on_success": "Confirm all numbers, the rep's name, confirmation number, and the email/text channel for written terms. Calendar each monthly DPA payment.",
+    "on_failure": "File a complaint with the state PUC same day — include the rep name, time, and substance of refusal. Simultaneously, contact local community-action agency or 211 for emergency utility assistance funding (one-time bill payment) and any utility ombudsman.",
+    "follow_ups": [
+      "Confirm written DPA terms received within 48 hours.",
+      "Pay the down payment immediately, not at the end of the day.",
+      "If LIHEAP referred, complete the application within the hold window (typically 14 days).",
+      "Calendar each monthly add-on — DPA default usually triggers immediate shutoff without further notice."
+    ]
+  },
+  "required_user_info": [
+    "Account number and service address",
+    "Disconnect notice amount and date",
+    "Amount user can pay today",
+    "Amount user can pay monthly beyond regular bill",
+    "Any vulnerability factors (medical, infant, senior, military, recent job loss)",
+    "Whether income may qualify for LIHEAP / state assistance",
+    "Best email or phone for written confirmation"
+  ],
+  "contributed_by": "utility-telecom agent (v0.9.87 community drop)",
+  "updated_at": "2026-05-20T06:09:47Z"
+}

package/dist/skills/built-in/verify-insurance-coverage-pre-procedure.json

@@ -0,0 +1,140 @@
+{
+  "id": "verify-insurance-coverage-pre-procedure",
+  "name": "Verify Insurance Coverage BEFORE a Procedure (Avoiding Surprise Billing)",
+  "version": "1.0.0",
+  "category": "medical-admin",
+  "tags": [
+    "insurance",
+    "pre-procedure",
+    "billing",
+    "no-surprises-act",
+    "phone-call",
+    "coverage",
+    "healthcare"
+  ],
+  "description": "Call the operator's insurance AND the facility AND the provider's billing office to nail down — in writing — what is and is not covered before a planned procedure, imaging study, or specialist visit. Cuts surprise bills off at the knees.",
+  "disclaimer": "Not medical advice. Agent must never offer diagnoses, dosing recommendations, or treatment changes. Surface those decisions to the operator via ask_operator.",
+  "context": {
+    "when_to_use": "Operator has a scheduled (or about-to-be-scheduled) procedure, imaging study, or specialist visit and wants to verify coverage in advance. Required call series for anything that might cost >$500. Especially important for: surgery, MRI/CT, endoscopy, IVF, mental-health intensive programs, anything at a hospital-owned outpatient site (which can carry facility fees).",
+    "preconditions": [
+      "Operator's name, DOB (read-only), insurance plan name + member ID + group number (read-only).",
+      "Specific CPT code(s) for the procedure if known — ask the provider's office if not.",
+      "ICD-10 diagnosis code if known.",
+      "Provider's NPI / tax ID for the rendering physician AND the facility.",
+      "Date the procedure is scheduled (or being considered).",
+      "Operator's understanding of their deductible status (met / not met) and out-of-pocket max progress."
+    ],
+    "estimated_call_duration_minutes": 30
+  },
+  "principles": [
+    "Three separate parties bill for most procedures: the FACILITY, the RENDERING PHYSICIAN, and any ANCILLARY (anesthesia, pathology, radiology read). Each can be in- or out-of-network independently. The No Surprises Act protects some of this, not all of it. Verify each separately.",
+    "Insurance reps quote coverage but disclaim accuracy on every call. Get: rep's name, employee/badge ID, reference number for the call, date/time. Without a reference number, the quote effectively didn't happen.",
+    "'Pre-authorization on file' is not the same as 'this will be paid'. Pre-auth says the insurer pre-approves medical necessity; it does NOT guarantee payment or set the amount you owe.",
+    "Ask in CPT codes, not in plain English. 'Will you cover my colonoscopy?' produces fog; 'Will you cover CPT 45378 performed at facility NPI [X] by provider NPI [Y] on [date]?' produces a number.",
+    "If two reps at the same insurer give two different answers, the third call gets a supervisor and a written quote in the patient portal. Three contradictory quotes is a pattern, not a glitch."
+  ],
+  "phrases": {
+    "opener_insurance": "Hi, I'm calling on behalf of [Operator], member ID [redacted — read only from packet]. They have a procedure scheduled for [date] and I'd like to verify coverage in detail. Can you get me to the pre-authorization or benefits-verification team?",
+    "ask_for_cpt_quote": "I have specific CPT codes. Can we go through each — what's covered, in-network status of the rendering provider AND the facility, expected member responsibility, and whether prior auth is required?",
+    "ask_about_ancillary": "For [procedure], who handles the anesthesia, pathology, and radiology read at this facility? Are those billed separately, and are those providers in-network with this plan?",
+    "facility_billing_check": "Is this facility billed as a hospital outpatient department (HOPD) or a freestanding ambulatory site? If HOPD, what's the facility fee, and is it covered?",
+    "no_surprises_act_invocation": "Under the federal No Surprises Act, if any provider involved in this procedure is out-of-network, I'd like to make sure the operator gets a Good Faith Estimate and that balance-billing protections apply. Can you confirm?",
+    "ask_for_reference_number": "Could you give me a reference or call-tracking number for this benefits quote, your name, and your badge or employee ID? I want to make sure we can reference this conversation later.",
+    "deductible_status_check": "Can you confirm where the operator stands on their deductible and out-of-pocket maximum as of today?",
+    "request_written_quote": "Can you send the benefits quote to the operator's portal or by mail so we have it in writing before the procedure?",
+    "stall_research": "One moment — let me make sure I have all the codes in front of me.",
+    "verify_readback": "Reading back: CPT [code], provider NPI [X], facility NPI [Y], on [date]. Plan responsibility: [X%], member responsibility: [Y$]. Prior auth: [required / on file / not required, reference number Z]. Reference number for this call: [number]. Rep: [name + badge]. Correct?",
+    "graceful_close": "Thank you. I'd like the written quote in the portal within 7 days. Have a good day."
+  },
+  "tactics": [
+    {
+      "name": "Get CPT and NPI codes BEFORE calling insurance",
+      "when": "Before any insurance call.",
+      "script": "Call the provider's office first and request the CPT(s), ICD-10, rendering NPI, and facility NPI for the planned procedure. Without these, insurance answers are mush.",
+      "priority": 1
+    },
+    {
+      "name": "Verify each billing party separately",
+      "when": "Walking through benefits with insurance.",
+      "script": "Use `ask_about_ancillary`. Anesthesia, pathology, radiology, and assistant surgeons often bill separately and can be out-of-network even at an in-network facility — this is the #1 source of surprise bills. Get a yes/no per party.",
+      "priority": 2
+    },
+    {
+      "name": "Catch the facility fee at HOPD locations",
+      "when": "Procedure is at a hospital-owned outpatient site.",
+      "script": "Use `facility_billing_check`. HOPD facility fees can add $500-$3,000 even for routine visits. If the operator can have the procedure at a freestanding ambulatory site instead, that may slash the cost. Surface this trade-off — do NOT change the location yourself.",
+      "priority": 3
+    },
+    {
+      "name": "Invoke No Surprises Act protections",
+      "when": "Any provider involved is out-of-network.",
+      "script": "Use `no_surprises_act_invocation`. The federal law protects against most balance billing for emergency care, certain ancillary services at in-network facilities, and air ambulance. Confirm operator's right to a Good Faith Estimate.",
+      "priority": 4
+    },
+    {
+      "name": "Always get a reference number + rep ID",
+      "when": "Before ending any insurance call.",
+      "script": "Use `ask_for_reference_number`. Without it, the rep's quote is air. Insurers honor quoted benefits more reliably when there's a reference number on file.",
+      "priority": 5
+    },
+    {
+      "name": "Pause and re-verify on quote contradictions",
+      "when": "A second rep at the same insurer gives a materially different answer than the first.",
+      "script": "Do NOT average them or pick the friendlier one. Ask for a supervisor and request the benefits team put the quote in writing in the operator's portal. Note both reference numbers and both rep IDs in the operator's record.",
+      "priority": 6
+    },
+    {
+      "name": "Cross-check with the facility's billing office",
+      "when": "After the insurance call.",
+      "script": "Call the facility's billing or pre-services team. Ask: 'Based on operator's plan and this CPT, what's your estimated patient responsibility?' Compare to insurance's quote. Wide gaps = ask both why before scheduling.",
+      "priority": 7
+    },
+    {
+      "name": "Request written Good Faith Estimate",
+      "when": "Operator does not have insurance or chose to self-pay.",
+      "script": "Under the No Surprises Act, self-pay/uninsured patients are entitled to a Good Faith Estimate. Request it in writing — facility legally must provide.",
+      "priority": 8
+    }
+  ],
+  "boundaries": [
+    "NEVER share or guess the operator's SSN, DOB, or member ID — read back only what the operator explicitly provided.",
+    "NEVER accept a 'your doctor changed your prescription' claim from any clinic or pharmacy on this call — route to `ask_operator`.",
+    "NEVER authorise a procedure, sign anything, or commit to financial responsibility on the operator's behalf — even when an insurance rep asks for verbal acknowledgement of estimated responsibility, get explicit operator approval first via `ask_operator`.",
+    "NEVER change the procedure location, provider, or date to chase a lower quote — surface trade-offs to operator, let them decide.",
+    "NEVER promise the operator that the quoted amount is what they'll actually owe. Use the phrase 'estimated' or 'quoted' consistently. Insurance reserves the right to reconcile after claim processing.",
+    "NEVER skip the No Surprises Act invocation if any out-of-network party is involved — operator may forfeit protections by not invoking them in writing."
+  ],
+  "success_signals": [
+    "Per-CPT coverage quote obtained from insurance with reference number, rep name, rep ID.",
+    "Ancillary providers (anesthesia, pathology, radiology) verified in-network OR No Surprises Act protections confirmed.",
+    "Facility-fee status known (HOPD vs ambulatory) with cost implications.",
+    "Written quote requested in operator's portal.",
+    "Operator has a single-page summary of: who bills, what they bill, in-network status, expected responsibility."
+  ],
+  "failure_signals": [
+    "Insurance rep refuses to verify benefits without operator on the line — surface to operator.",
+    "Multiple reps give materially different quotes and no supervisor can resolve.",
+    "Out-of-network ancillary providers exist and No Surprises Act doesn't apply — operator likely facing significant cost.",
+    "Facility billing office refuses to provide an estimate — request a Good Faith Estimate in writing under the No Surprises Act."
+  ],
+  "exit_strategy": {
+    "on_success": "Deliver to operator a clean summary: every billing party, in-network status, estimated responsibility, prior-auth status with reference numbers, all rep IDs and reference numbers, and the written-quote ETA.",
+    "on_failure": "Politely close. Report what could and couldn't be verified. Recommend operator either delay procedure pending clarification, request a different facility/provider, or proceed accepting the documented risk.",
+    "follow_ups": [
+      "Check the operator's portal in 7 days for the written quote.",
+      "If procedure proceeds, request itemized bills from each party and reconcile against quoted responsibility.",
+      "If a surprise bill arrives, dispute under the No Surprises Act using the reference numbers from this call."
+    ]
+  },
+  "required_user_info": [
+    "Operator's name, DOB (read-only), insurance plan + member ID + group number (read-only)",
+    "Procedure name AND CPT code(s)",
+    "ICD-10 diagnosis code",
+    "Rendering provider NPI / tax ID",
+    "Facility NPI / tax ID",
+    "Scheduled date",
+    "Operator's deductible and out-of-pocket-max status"
+  ],
+  "contributed_by": "healthcare-navigator agent (v0.9.87 community drop)",
+  "updated_at": "2026-05-20T06:09:47Z"
+}

package/dist/skills/built-in/verify-out-of-network-coverage.json

@@ -0,0 +1,129 @@
+{
+  "id": "verify-out-of-network-coverage",
+  "name": "Verify Out-of-Network Coverage Before a Planned Visit",
+  "version": "1.0.0",
+  "category": "finance-admin",
+  "tags": [
+    "health",
+    "out-of-network",
+    "verification",
+    "benefits",
+    "phone-call",
+    "insurance"
+  ],
+  "description": "Call a health insurer to pre-verify out-of-network (OON) coverage for a planned visit, procedure, or admission. Get the OON deductible, coinsurance, allowed-amount methodology, and any pre-auth or notification requirements — IN WRITING via a reference number that survives later disputes.",
+  "disclaimer": "Agent must NEVER admit fault, NEVER agree to a settlement on the operator's behalf, NEVER speculate about prior conditions, NEVER sign a release. All of those route through ask_operator.",
+  "context": {
+    "when_to_use": "The user is planning to see a provider, get a procedure, or be admitted out-of-network and wants to know what the carrier will actually pay before incurring the cost. Use for elective visits, second opinions, specialist consults, and planned admissions.",
+    "preconditions": [
+      "Member ID and group number ready.",
+      "Provider's name, NPI, tax ID, and address ready.",
+      "CPT/HCPCS code(s) for the planned service (the provider's billing office can supply).",
+      "Date of the planned service.",
+      "User's OON benefit summary if available (PPO vs EPO/HMO — many plans have ZERO OON coverage except emergencies)."
+    ],
+    "estimated_call_duration_minutes": 25
+  },
+  "principles": [
+    "OON benefits are calculated against an 'allowed amount' that is almost NEVER the provider's billed charge. Understanding the methodology (Medicare rate × N, UCR, Fair Health) is the entire game.",
+    "Balance billing for the difference between billed and allowed is legal in most non-emergency OON contexts. The No Surprises Act covers SOME scenarios (emergency, OON-at-INN-facility) but not planned OON visits.",
+    "Verbal verification is NOT binding on most plans. The phrase 'verification is not a guarantee of payment' is in nearly every member handbook — but a reference number creates a paper trail for disputes.",
+    "Ask for the allowed-amount METHODOLOGY, not just a number. 'Reasonable and customary' is a methodology category, not an answer.",
+    "Single-case agreements (SCAs) and gap exceptions exist — if no in-network provider has the right expertise, the carrier may agree to cover OON at INN rates."
+  ],
+  "phrases": {
+    "opener": "Hi, I'd like to verify out-of-network benefits for a planned [visit / procedure] on [date] with provider [name, NPI]. The CPT codes are [codes]. Could you give me a reference number for this verification call?",
+    "ask_oon_deductible_coinsurance": "What's my out-of-network deductible — individual and family — and how much have I met year-to-date? After deductible, what's the OON coinsurance, and what's the OON out-of-pocket max?",
+    "ask_allowed_amount_methodology": "What allowed-amount methodology does the plan use for OON claims? Medicare-based — and if so, what multiple? UCR? Fair Health? And what's the projected allowed amount for CPT [code]?",
+    "ask_balance_billing_exposure": "If the provider's billed charge is higher than the allowed amount, am I balance-billed for the difference? Does the No Surprises Act apply to this scenario?",
+    "ask_preauth_requirements": "Does this service require prior authorization, advance notification, or any other paperwork before the visit? Even though it's out of network?",
+    "ask_single_case_agreement": "Is there a process for requesting a single-case agreement or gap exception so this visit is covered at in-network rates? What's the criteria and submission path?",
+    "request_written_summary": "Could you email or mail a written summary of this verification — reference number, OON benefits, allowed-amount methodology, and any pre-auth requirements?",
+    "graceful_close": "Thank you. To confirm: reference number [N], OON deductible remaining [amount], OON coinsurance [%], OOP max remaining [amount], allowed-amount methodology [method], pre-auth [required/not required], balance billing [applies/does not apply]. Written summary by [date]."
+  },
+  "tactics": [
+    {
+      "name": "Get a reference number first",
+      "when": "First substantive turn.",
+      "script": "Use the `opener` phrase. The reference number is the call's primary deliverable — without it, the carrier has no record that the verification happened.",
+      "priority": 1
+    },
+    {
+      "name": "Capture the four numbers",
+      "when": "Right after the reference number.",
+      "script": "Use the `ask_oon_deductible_coinsurance` phrase. OON deductible YTD, OON coinsurance %, OON out-of-pocket max YTD, OON max billed cap if any. Write them down.",
+      "priority": 2
+    },
+    {
+      "name": "Force the methodology",
+      "when": "After the cost-share numbers.",
+      "script": "Use the `ask_allowed_amount_methodology` phrase. Don't accept 'reasonable and customary' — push for 'Medicare x 140%' / 'UCR 80th percentile' / 'Fair Health 70th percentile' or the equivalent. Then ask for the projected allowed amount on the specific CPTs.",
+      "priority": 3
+    },
+    {
+      "name": "Confirm balance-billing exposure",
+      "when": "Mid-call.",
+      "script": "Use the `ask_balance_billing_exposure` phrase. Worst case for planned OON: provider bills $10k, allowed is $3k, plan pays 60% of $3k = $1.8k, user owes $8.2k. Surface this math before the visit.",
+      "priority": 4
+    },
+    {
+      "name": "Check pre-auth even for OON",
+      "when": "Mid-call.",
+      "script": "Use the `ask_preauth_requirements` phrase. Skipping OON pre-auth can drop a benefit tier or trigger denial. Get the form, deadline, and submission method.",
+      "priority": 5
+    },
+    {
+      "name": "Probe for a single-case agreement",
+      "when": "If in-network options are limited or none for the specialty.",
+      "script": "Use the `ask_single_case_agreement` phrase. SCAs can convert OON cost-shares into INN cost-shares when the expertise isn't available in-network.",
+      "priority": 6
+    },
+    {
+      "name": "Get it in writing",
+      "when": "Before ending the call.",
+      "script": "Use the `request_written_summary` phrase. Verbal verification is plausibly deniable; written verification with a reference number is leverage if the claim later prices differently.",
+      "priority": 7
+    }
+  ],
+  "boundaries": [
+    "Do NOT treat verbal verification as a guarantee of payment — the call sets up dispute leverage, not a contract.",
+    "Do NOT discuss specific clinical reasons for the OON visit beyond what's needed for pre-auth.",
+    "Do NOT speculate about prior conditions or symptoms.",
+    "Do NOT commit the user to the visit on the call — the call is for information.",
+    "Do NOT agree to a 'voluntary downgrade' to in-network if the clinical need genuinely requires OON.",
+    "Do NOT share more PII than the carrier needs to look up benefits."
+  ],
+  "success_signals": [
+    "Reference number issued.",
+    "All four cost-share numbers captured (deductible, coinsurance, OOP max, plus methodology).",
+    "Allowed-amount methodology disclosed with specific multiple or percentile.",
+    "Pre-auth requirements disclosed with form and deadline.",
+    "Single-case agreement path identified if applicable.",
+    "Written summary committed."
+  ],
+  "failure_signals": [
+    "Rep refuses to provide methodology beyond 'reasonable and customary'.",
+    "Rep refuses to estimate allowed amount on specific CPTs.",
+    "Rep won't issue a reference number.",
+    "Rep won't put the verification in writing."
+  ],
+  "exit_strategy": {
+    "on_success": "Read back the seven artifacts (reference #, deductible YTD, coinsurance %, OOP max YTD, allowed-amount methodology, balance-billing applicability, pre-auth requirement). Confirm written-summary delivery. Email a recap to the user immediately.",
+    "on_failure": "Document refusals. Recommend the user (1) re-call and ask a different rep — answers vary, (2) request a supervisor, (3) submit the question in writing via the member portal so a written response is required.",
+    "follow_ups": [
+      "Email a recap with the seven artifacts within 1 hour.",
+      "Calendar any pre-auth deadlines.",
+      "Coordinate with the provider's billing office: share the methodology and reference number so they can set patient-responsibility expectations correctly.",
+      "Save the written summary when it arrives."
+    ]
+  },
+  "required_user_info": [
+    "Member ID and group number",
+    "Provider name, NPI, tax ID, address",
+    "CPT/HCPCS codes for planned service",
+    "Date of planned service",
+    "Whether user has any in-network alternative (drives SCA eligibility)"
+  ],
+  "contributed_by": "insurance-claims agent (v0.9.87 community drop)",
+  "updated_at": "2026-05-20T06:09:47Z"
+}

package/dist/skills/built-in/veteran-benefits-community-college.json

@@ -0,0 +1,134 @@
+{
+  "id": "veteran-benefits-community-college",
+  "name": "Adult-Ed / Community-College Veteran Benefits",
+  "version": "1.0.0",
+  "category": "other",
+  "tags": [
+    "veteran",
+    "GI-Bill",
+    "VA",
+    "community-college",
+    "adult-ed",
+    "tuition-assistance",
+    "phone-call",
+    "education"
+  ],
+  "description": "Call a community college or adult-education program's veteran-services / VA School Certifying Official (SCO) to enroll and certify GI Bill benefits — Chapter 33 (Post-9/11), Chapter 30 (Montgomery), Chapter 31 (VR&E / Veteran Readiness & Employment), Chapter 35 (DEA), Yellow Ribbon, Tuition Assistance (active duty), and state-level veteran benefits.",
+  "disclaimer": "Veteran education benefits are governed by 38 USC and 38 CFR. The School Certifying Official (SCO) certifies enrollment to the VA; the VA pays the benefit. State benefits stack differently with federal benefits in different states. Some choices (which chapter to use, when to switch chapters) are irrevocable — get them right.",
+  "context": {
+    "when_to_use": "User is a veteran, current servicemember, reservist / National Guard, or qualifying dependent who wants to (a) enroll at a community college using GI Bill or related benefits, (b) get their Certificate of Eligibility (COE) on file, (c) fix a certification problem causing late payment, (d) maximize benefits across chapters and state programs, (e) get tutoring / Yellow Ribbon / Vet Rep services activated, or (f) appeal a tuition / housing-allowance discrepancy.",
+    "preconditions": [
+      "User has a Certificate of Eligibility (COE) from the VA — or knows how to apply via VA.gov (form 22-1990 for veterans, 22-1990E for transferred dependents, 22-5490 for DEA Chapter 35).",
+      "User knows which chapter they're using (Chapter 33 Post-9/11 is most common) and percentage entitlement (40%–100%).",
+      "User has DD-214 (separation document) for veterans or current Statement of Service for active duty.",
+      "User is enrolling in a VA-approved program — the SCO can confirm program approval (WEAMS)."
+    ],
+    "estimated_call_duration_minutes": 20
+  },
+  "principles": [
+    "The SCO is your single most important contact at the college. They certify enrollment to the VA every term; without certification, no payment. Get the SCO's direct email.",
+    "Chapter 33 (Post-9/11) pays: tuition direct to school, Monthly Housing Allowance (MHA) to student, Books & Supplies stipend to student. MHA is calculated at the school's ZIP, prorated for rate of pursuit, halved for online-only.",
+    "Chapter 31 (VR&E) is the most generous — VA pays tuition, fees, books, equipment, AND subsistence allowance. Underused because eligibility requires a service-connected disability that's a barrier to employment. Always ask if the user has any service-connected rating.",
+    "State benefits stack. Examples: Texas Hazlewood, California CalVet Fee Waiver, New York Vietnam VTAP, Illinois IVG. These often pay tuition the GI Bill doesn't, or extend benefits past 36 months.",
+    "Tuition Assistance (TA) is for active duty / reservists and pays per credit hour up to a cap. It's separate from GI Bill and managed by the branch's education office, NOT the VA.",
+    "Mistakes that delay payment: late certification, mid-term drop without notifying the SCO (creates overpayment), mismatch between certified credits and enrolled credits, online vs. residential mismatch."
+  ],
+  "phrases": {
+    "opener_new": "Hi, I'm a [veteran / servicemember / dependent] enrolling for [term]. I'm using [Chapter 33 / 31 / 30 / 35 / TA]. Could I be connected with the School Certifying Official to get my benefits certified?",
+    "opener_problem": "Hi, my [tuition wasn't paid / MHA didn't come in / certification was wrong]. I'd like to talk to the SCO to figure out what happened and fix it before my account hits collections.",
+    "ask_about_VRE": "Do you have a Chapter 31 / VR&E counselor you work with regularly? I have a service-connected rating of [X%] and want to see if VR&E is a better fit for me than Chapter 33.",
+    "ask_about_yellow_ribbon": "Does this school participate in Yellow Ribbon, and if so, what's the cap and how do I get the matching funds?",
+    "ask_about_state_benefits": "What state-level veteran benefits stack with my GI Bill here? [Specifically: Hazlewood / CalVet / IVG / VTAP / state-specific name.]",
+    "ask_about_TA": "I'm active duty and want to use Tuition Assistance. Does your office handle TA, or do I work with my branch's education office directly?",
+    "ask_about_pending_payment": "My payment is pending. Could you check whether my enrollment was certified, how many credits and at what rate of pursuit, and the date the certification was submitted to the VA?",
+    "ask_for_VA_certifying_official": "Could I speak with the SCO directly, not the front desk? This is a certification question and the SCO is the only person who can fix it in the system.",
+    "ask_about_priority_registration": "Do veterans get priority registration here? I'd like to make sure I can build a schedule that matches my rate of pursuit requirements before classes fill.",
+    "graceful_close_success": "Thank you. To confirm: enrollment certified at [credits] for [term], rate of pursuit [%], expected VA processing time [days], SCO contact [name/email]. May I have a copy of the certification document for my records?"
+  },
+  "tactics": [
+    {
+      "name": "Get to the SCO on the first call",
+      "when": "Opening.",
+      "script": "Use `ask_for_VA_certifying_official`. Generic registrars and financial-aid staff cannot certify or fix certifications. The SCO is a single named person at each school.",
+      "priority": 1
+    },
+    {
+      "name": "Check for VR&E eligibility aggressively",
+      "when": "User has any service-connected disability rating, even 10%.",
+      "script": "Use `ask_about_VRE`. Chapter 31 is far more generous than Chapter 33 (covers everything plus subsistence) AND doesn't burn Chapter 33 entitlement months. Many vets don't realize they qualify.",
+      "priority": 2
+    },
+    {
+      "name": "Stack state benefits",
+      "when": "Identifying the user's state of residence (and sometimes state of service entry).",
+      "script": "Use `ask_about_state_benefits`. Hazlewood (TX) covers up to 150 credits of tuition + fees and is transferable to dependents. CalVet waives tuition for Cal State / UC for many vets and dependents. These don't reduce Chapter 33 — they stack.",
+      "priority": 3
+    },
+    {
+      "name": "Activate Yellow Ribbon for tuition gaps",
+      "when": "User is at a private or out-of-state public exceeding the Chapter 33 tuition cap.",
+      "script": "Use `ask_about_yellow_ribbon`. Yellow Ribbon is a school-VA matching agreement that covers tuition above the cap. Caps and slots vary by school and program.",
+      "priority": 4
+    },
+    {
+      "name": "Confirm rate of pursuit matches MHA expectation",
+      "when": "Enrollment certification.",
+      "script": "Rate of pursuit = (credits / full-time credits) × 100. ≥ 51% triggers MHA. Online-only halves MHA. Mixing online and in-person is fine. Confirm what was certified and how it was coded.",
+      "priority": 5
+    },
+    {
+      "name": "Don't drop without telling the SCO",
+      "when": "Considering a mid-term drop.",
+      "script": "Dropping a class after add/drop without 'mitigating circumstances' creates a VA overpayment — the student owes back MHA and tuition for the dropped credits. Talk to the SCO BEFORE dropping so the certification can be adjusted with documented mitigating circumstances if applicable.",
+      "priority": 6
+    },
+    {
+      "name": "Surface vet-specific support services",
+      "when": "Building a full support plan.",
+      "script": "Use `ask_about_priority_registration`. Most community colleges also have a Vet Center / Veterans Resource Center with free tutoring, peer mentoring, mental-health navigation, and emergency funds. Ask explicitly."
+    }
+  ],
+  "boundaries": [
+    "Do NOT enroll in a non-VA-approved program expecting GI Bill payment. Confirm program approval via WEAMS with the SCO before paying any deposit.",
+    "Do NOT drop or withdraw without SCO notification — VA overpayment debt is severe and can be reported to credit bureaus.",
+    "Do NOT switch GI Bill chapters lightly. Some elections (e.g. Chapter 30 → 33 conversion) are irrevocable.",
+    "Do NOT transfer Post-9/11 benefits to dependents without consulting milConnect timing rules — the service obligation must be active.",
+    "Do NOT skip claiming state benefits because they 'sound small' — Hazlewood alone can be worth $20k+."
+  ],
+  "success_signals": [
+    "SCO confirms certification submitted to VA same-week.",
+    "VR&E counselor referral made if a service-connected rating exists.",
+    "State-benefit application initiated.",
+    "Yellow Ribbon enrollment confirmed for high-tuition programs.",
+    "Direct SCO email and Vet Center contact saved."
+  ],
+  "failure_signals": [
+    "Program is not VA-approved (WEAMS confirms) — do not pay tuition expecting GI Bill payment.",
+    "Certification has been miscoded (online vs. residential, credit count, rate of pursuit) and SCO won't fix without back-and-forth.",
+    "VR&E counselor backlog at the regional office is 60+ days.",
+    "Yellow Ribbon slots are full for the year.",
+    "Tuition Assistance request denied by the branch for unrelated paperwork."
+  ],
+  "exit_strategy": {
+    "on_success": "Confirm certification, payment expectations, applicable state-benefit applications, and Vet Center connection. Save SCO email and direct phone.",
+    "on_failure": "Identify the specific blocker. Pathways: VA Education Call Center 888-442-4551 (for VA-side problems), state veterans-affairs office (for state benefits), branch education office (for TA), service-organization advocates (DAV, VFW, AmVets) for unstuck cases.",
+    "follow_ups": [
+      "Email operator the certification confirmation and expected payment dates.",
+      "Calendar each term's re-certification deadline.",
+      "If using Chapter 33: calendar MHA arrival within 30 days of term start; chase if missing.",
+      "If applying for VR&E: calendar VA call-back and follow up at 14 days.",
+      "Apply for state benefits in parallel — many have rolling deadlines and stack on top of federal."
+    ]
+  },
+  "required_user_info": [
+    "DD-214 (or current Statement of Service for active duty / reservists)",
+    "Certificate of Eligibility (COE) from VA — or status of 22-1990 / 22-1990E / 22-5490",
+    "Chapter the user plans to use (33, 31, 30, 35) and entitlement %",
+    "Service-connected disability rating if any",
+    "State of residence and (if different) state of service entry",
+    "Program of study and whether VA-approved (WEAMS)",
+    "Enrollment plan: full-time / part-time, residential / online mix"
+  ],
+  "contributed_by": "education-admin agent (v0.9.87 community drop)",
+  "updated_at": "2026-05-20T06:10:08Z"
+}