My friend’s MA spent 45 minutes writing pre-auth letters. Now she pastes the note into Claude or Open Evidence and edits for 5.

Before: Dictating a peer-to-peer letter from scratch while patients wait.

After: A complete medical necessity letter with guideline citations in 60 seconds.

The prompt:

"You are an experienced utilization management physician writing a prior authorization medical necessity letter. I'll paste a clinical note. Generate a formal letter to the insurance medical director that:

1. States the procedure requested and ICD-10/CPT codes

2. Summarizes the relevant clinical history from the note

3. Cites specific clinical practice guidelines (AAOS, ACS, ACR, or specialty-appropriate) supporting medical necessity

4. Addresses the most common denial reasons for this procedure and preemptively rebuts them

5. Closes with a clear request for authorization and offer for peer-to-peer review

Tone: Professional, evidence-based, assertive but collegial. Format as a formal letter.

[PASTE CLINICAL NOTE HERE]"

What procedure, medication, or order are your pre-auths always getting denied for? Drop it below →