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What you'll accomplish

Prior authorization letters that used to take 20-30 minutes now take 5, with stronger clinical language and a higher approval rate. You'll finish with letter templates ready for your most common authorization scenarios.

What you'll need

  • Claude account at claude.ai (free tier works for this; no special subscription needed)
  • Patient's de-identified clinical information (diagnosis, labs, BMI, previous interventions)
  • The CPT code for MNT you're requesting (97802 initial, 97803 follow-up, 97804 group)
  • Time needed: 20 minutes for setup; 5 minutes per letter after
  • Cost: Free

How-To Guide: AI-Assisted Insurance Prior Authorization Letters

Step 1: Gather the clinical information you'll need

Before opening Claude, have these details ready (use de-identified info, no patient names):

  • Primary diagnosis (ICD-10 code and description)
  • Key clinical indicators (A1c, BMI, eGFR, labs that support medical necessity)
  • Previous interventions tried and their outcomes
  • Number of MNT sessions requested
  • Insurance name (some payers have specific language they look for)
  • CPT code(s)
Tools:Claude