Offline RL for Adaptive Policy Retrieval in Prior Authorization

Prior authorization (PA) requires interpretation of complex and fragmented coverage policies, yet existing retrieval-augmented systems rely on static top-$K$ strategies with fixed numbers of retrieved sections. Such fixed retrieval can be inefficient and gather irrelevant or insufficient information. We model policy retrieval for PA as a sequential decision-making problem, formulating adaptive retrieval as a Markov Decision Process (MDP). In our system, an agent iteratively selects policy chunks from a top-$K$ candidate set or chooses to stop and issue a decision. The reward balances decision correctness against retrieval cost, capturing the trade-off between accuracy and efficiency. We train policies using Conservative Q-Learning (CQL), Implicit Q-Learning (IQL), and Direct Preference Optimization (DPO) in an offline RL setting on logged trajectories generated from baseline retrieval strategies over synthetic PA requests derived from publicly available CMS coverage data. On a corpus of 186 policy chunks spanning 10 CMS procedures, CQL achieves 92% decision accuracy (+30 percentage points over the best fixed-$K$ baseline) via exhaustive retrieval, while IQL matches the best baseline accuracy using 44% fewer retrieval steps and achieves the only positive episodic return among all policies. Transition-level DPO matches CQL's 92% accuracy while using 47% fewer retrieval steps (10.6 vs. 20.0), occupying a "selective-accurate" region on the Pareto frontier that dominates both CQL and BC. A behavioral cloning baseline matches CQL, confirming that advantage-weighted or preference-based policy extraction is needed to learn selective retrieval. Lambda ablation over step costs $λ\in \{0.05, 0.1, 0.2\}$ reveals a clear accuracy-efficiency inflection: only at $λ= 0.2$ does CQL transition from exhaustive to selective retrieval.

Entropy Guided Diversification and Preference Elicitation in Agentic Recommendation Systems

Users on e-commerce platforms can be uncertain about their preferences early in their search. Queries to recommendation systems are frequently ambiguous, incomplete, or weakly specified. Agentic systems are expected to proactively reason, ask clarifying questions, and act on the user's behalf, which makes handling such ambiguity increasingly important. In existing platforms, ambiguity led to excessive interactions and question fatigue or overconfident recommendations prematurely collapsing the search space. We present an Interactive Decision Support System (IDSS) that addresses ambiguous user queries using entropy as a unifying signal. IDSS maintains a dynamically filtered candidate product set and quantifies uncertainty over item attributes using entropy. This uncertainty guides adaptive preference elicitation by selecting follow-up questions that maximize expected information gain. When preferences remain incomplete, IDSS explicitly incorporates residual uncertainty into downstream recommendations through uncertainty-aware ranking and entropy-based diversification, rather than forcing premature resolution. We evaluate IDSS using review-driven simulated users grounded in real user reviews, enabling a controlled study of diverse shopping behaviors. Our evaluation measures both interaction efficiency and recommendation quality. Results show that entropy-guided elicitation reduces unnecessary follow-up questions, while uncertainty-aware ranking and presentation yield more informative, diverse, and transparent recommendation sets under ambiguous intent. These findings demonstrate that entropy-guided reasoning provides an effective foundation for agentic recommendation systems operating under uncertainty.