Salesforce / Use Cases / 03 · Provider agent hands a prior-auth Case to a payer agent

03 STANDARD Healthcare

Provider agent hands a prior-auth Case to a payer agent

Two HIPAA-covered orgs exchange a provably-minimized prior-auth handoff, with PHI scope encoded in the receipt.

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01Scenario

A provider's Case for a prior-authorization request is escalated by an Agentforce agent. The payer org — a separate Salesforce instance, separate HIPAA covered entity — needs to receive a verifiable record of the handoff including the minimized PHI scope.

case.escalation.handoff mints a receipt where the payload references only the minimum necessary fields (CPT code set, diagnosis category, member identifier hash). The full PHI never leaves the provider; only the signed assertion about what was sent crosses orgs.

On the payer side, the Hive A2A Inbox LWC renders the receipt chain on the matching Case. The compliance team can subpoena the receipt JSONL and verify it offline without either org's Salesforce.

02Handles

action_type: case.escalation.handoff
handle: HiveReceiptMinter from Case Flow
lands on: Case
rail: STANDARD $0.50/receipt, Hive-billed

03APEX

Case c = [SELECT Id, AccountId, Status, Priority, ContactId
              FROM Case WHERE Id = :caseId];

// Minimize PHI surface — receipt encodes references only
Map<String, Object> payload = new Map<String, Object>{
  'case_id'            => c.Id,
  'cpt_set_hash'       => HiveHash.sha256(cptCodesJson),
  'dx_category'        => 'orthopedic.shoulder.arthroscopy',
  'member_id_hash'     => HiveHash.sha256(memberMRN + orgSalt),
  'urgency'            => 'standard',
  'requested_los_days' => 2,
  'preauth_window_hr'  => 72
};

Id receiptId = HiveReceiptMinter.mint(
  c.Id,
  'case.escalation.handoff',
  'did:hive:0xPayerOrgAgent',
  'salesforce:case:' + c.Id,
  payload
);

// receipt.Jurisdiction__c = 'US-HIPAA'
// receipt.Direction__c    = 'OUTBOUND' on provider side
// counterpart write on payer side = 'INBOUND' (paired by Action_Ref__c)

04Flow XML

<Flow xmlns="http://soap.sforce.com/2006/04/metadata">
    <processType>AutoLaunchedFlow</processType>
    <start>
        <connector><targetReference>mint_handoff</targetReference></connector>
        <object>Case</object>
        <recordTriggerType>UpdatedAndConditionMet</recordTriggerType>
        <filters>
            <field>Status</field><operator>EqualTo</operator>
            <value><stringValue>Escalated</stringValue></value>
        </filters>
        <triggerType>RecordAfterSave</triggerType>
    </start>
    <actionCalls>
        <name>mint_handoff</name>
        <label>Mint HIPAA-shape handoff receipt</label>
        <actionName>HiveReceiptMinter</actionName>
        <actionType>apex</actionType>
    </actionCalls>
    <status>Active</status>
</Flow>

05The receipt that lands in Hive_Receipt__c

{
  "agent_id": "did:hive:0xProviderAgent",
  "counterparty_did": "did:hive:0xPayerOrgAgent",
  "action_type": "case.escalation.handoff",
  "scope": "salesforce:case:5001a00000HJK",
  "action_ref": "sha256(...)",
  "payload_hash": "sha256:2e88...c0f3",
  "signature": "ed25519:c4b7...8821",
  "timestamp_ms": 1716333900000,
  "jurisdiction": "US-HIPAA",
  "direction": "OUTBOUND",
  "verification_status": "VERIFIED"
}

06Verification

Compliance subpoena flow — verify without either org's Salesforce

# Receipt JSONL is exported from Hive_Receipt__c by Compliance.
# Anyone with the public key can verify it.

curl -sS https://hivemorph.onrender.com/v1/verify \
  -H 'content-type: application/json' \
  --data-binary @case_handoff_receipt.json

# expected:
# {"verified":true,"jurisdiction":"US-HIPAA","payload_hash_matches":true}

07Economics

Per-handoff fee	$0.50 (Standard rail)
Free tier	100 handoffs/month free
Monthly cap	$499
Typical mid-size payer	~600 escalation handoffs/mo → $499/mo (capped)
HIPAA shape	Receipt payload is hashes + categories, not PHI
BAA required	Hive operates as a covered-entity processor under signed BAA

08Compliance and audit shape

Receipt body contains zero PHI — hashed member identifier, CPT-set hash, diagnosis category only.
Hive offers a Business Associate Agreement (BAA) to all healthcare customers.
Receipt JSONL is exportable for compliance review with no Salesforce login.
Action_Ref__c pairs INBOUND/OUTBOUND receipts across both orgs for end-to-end audit.

09Trust anchors

Every claim on this page is verifiable against these public constants. No login. No NDA.

Rail	STANDARD — $0.50/receipt, Hive-billed
Hive Ed25519 pubkey	`fd9d10abe60de7510c61ef649c8da598a519468dd2a2b827106d76487a899444`
Canonicalization	RFC 8785 JCS over the JSON receipt body
Signature algorithm	Ed25519 (RFC 8032)
Backend root	https://hivemorph.onrender.com
Verify any receipt	thehiveryiq.com/verify
MIT starter	thehiveryiq.com/salesforce/install
Billing	$0.50/receipt, 100/mo free, $499/mo cap. Square invoice or monthly ACH — buyer picks.
Pricing	thehiveryiq.com/pricing