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Healthcare

Prior-Authorization Letter

Clinical details in, a payer-ready justification letter out.

Production proof: Prior-auth letters that took 30–60 minutes of clinician time can be drafted in under 5 (~5× ROI industry-wide). Read the case study →

recorded · replayed

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How it’s engineered
  • The letter is assembled only from documented facts (diagnosis, severity, prior therapies) and maps them to the payer's step-therapy criteria — the structure reviewers look for.
  • Placeholders for identifiers keep PHI out of the draft until a human fills them in, which pairs with the PHI-redaction gate.
  • In production this pulls the tried-and-failed history straight from the EHR and attaches the guideline citation, cutting the clinician to a review-and-sign step.