What do I need to use Prior Authorization Letter?

Patient & policy; The request; Clinical justification; Prior treatments; If an appeal.

Is Prior Authorization Letter free to use?

Yes — run it free in the browser playground (no API key needed for the sponsored trial, or bring any provider key), or install it into Claude Code, Cursor, ChatGPT and more via npx pm-claude-skills. MIT-licensed and open source.

Prior Authorization Letter

Q: How do I know the Prior Authorization Letter output is good?

The skill verifies itself against its own quality checks: The exact request (with codes where available) is stated unambiguously up front; Medical necessity is tied to recognised guidelines/criteria, not just assertion; Step-therapy / prior-treatment history is documented (what was tried and why it failed/is unsuitable); For an appeal, the specific denial reason is quoted and directly rebutted.

🔵 Stable🕐 updated 2026-06-29 🔷 SkillSpec L3 pm-health

Write a persuasive prior-authorization / medical-necessity letter to an insurer. Use when asked to write a prior authorization letter, a letter of medical necessity, or to appeal a denied treatment/medication/procedure. Produces a structured letter — patient and request, clinical justification tied to guidelines, treatments tried, and the specific approval asked for — ready for clinician review and signature.

▶ Run it free — no key needed 📝 Grade your existing draft View SKILL.md ↗

What to give it

▸Patient & policy — patient identifiers and insurance/policy details (as provided).

▸The request — the specific medication/procedure/service, with codes (CPT/HCPCS/ICD-10) if available.

▸Clinical justification — diagnosis, severity, relevant history, and why this treatment is medically necessary.

▸Prior treatments — what's been tried and failed/contraindicated (step-therapy history).

▸If an appeal — the denial reason given by the insurer.

✅ The bar it holds itself to

Every skill in this library self-verifies — these are this skill's own quality checks, straight from its definition.

✓The exact request (with codes where available) is stated unambiguously up front

✓Medical necessity is tied to recognised guidelines/criteria, not just assertion

✓Step-therapy / prior-treatment history is documented (what was tried and why it failed/is unsuitable)

✓For an appeal, the specific denial reason is quoted and directly rebutted

✓No clinical fact, code, or citation is invented — unverified items are flagged to confirm

✓The letter is ready for clinician review and signature (signature block included)

⚠️ What it refuses to do

Do not invent diagnoses, codes, dates, prior treatments, or evidence to strengthen the case

Do not be vague about the request — name the exact service/drug and codes

Do not ignore the stated denial reason in an appeal — address it head-on

Do not present this as medical advice or submit without clinician review and signature

Do not pad with generic boilerplate that buries the patient-specific justification

Install

npx pm-claude-skills add --agent claude   # or codex · cursor · gemini · hermes
# or one-line MCP (every skill, any client):
claude mcp add pm-skills -- npx -y pm-claude-skills-mcp

Related skills

🔌 Embed this skill

Drop this on your blog, docs, or site — it renders a "Run this skill" card:

<div data-pm-skill="prior-authorization-letter"></div>
<script src="https://mohitagw15856.github.io/pm-claude-skills/embed.js" async></script>

💬 Discussion

Prior Authorization Letter is one of 750 open-source professional AI agent skills — all SkillSpec L3. Try them all in the browser · ⭐ Star on GitHub · Browse the full catalog