What you'll accomplish
By the end of this guide, you'll be able to draft a complete, clinically appropriate prior authorization or appeal letter for home respiratory equipment — CPAP, BiPAP, home oxygen, nebulizers, or home ventilators — in 10–15 minutes instead of 45–60 minutes. Claude generates letters with the right clinical structure, qualifying criteria language, and payer-appropriate documentation.
What you'll need
- A free Claude account at claude.ai (or Claude {{tool:Claude.plan}} for longer conversations)
- Patient's clinical data (diagnosis, relevant test results, prescribed equipment)
- The payer name and any denial reason (for appeals)
- Time needed: 20 minutes to learn the approach; 10–15 minutes per letter
- Cost: Free for basic use / {{tool:Claude.price}} for {{tool:Claude.plan}}
HIPAA reminder: Do not include patient name, date of birth, SSN, or MRN in your Claude prompts. Use clinical data only (diagnosis, test values, equipment prescribed). Add patient-identifying information after downloading/printing the Claude output.
How-To Guide: Insurance Authorization Letters with Claude
Step 1: Gather Your Clinical Data First
Before opening Claude, collect the key documentation. For the most common equipment types:
Home oxygen: SpO2 on room air (documented ambulatory or nocturnal), qualifying ABG values (PO2 ≤55 or SpO2 ≤88%), diagnosis, hospitalization history
CPAP/BiPAP: AHI from polysomnography or home sleep test, REM AHI if relevant, Epworth Sleepiness Scale score, diagnosis (OSA, UARS, OHS)
Home nebulizer: FEV1 % predicted (post-bronchodilator), diagnosis, failure of MDI therapy, documentation of exacerbations
Home ventilator: Ventilator settings, ABG on those settings, diagnosis, qualifying criteria (hypercapnia, neuromuscular disease, etc.)