Use AI to prepare a clear talking points script before calling an insurance case manager about denied therapy claims.
When an insurance case manager denies or questions your therapy authorization, the phone call can feel stressful — especially when you need to advocate quickly and professionally. Use this prompt to organize your clinical reasoning, highlight key functional outcomes, and prepare confident responses to common pushback. AI helps you structure your argument so you sound prepared, not flustered. Remember: never enter real patient names or identifying details — use placeholders like 'Patient A' or generic descriptions. Always review and customize the output to match your actual clinical findings.
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“Act as a senior physical therapist who regularly handles insurance authorization calls. I need to call an insurance case manager who has denied continued PT visits for a patient. Help me prepare a clear, professional talking points script I can reference during the call. Here's the situation (all details anonymized): [describe the patient's condition in general terms, e.g., 'post-stroke patient with moderate balance deficits'], [number of visits used vs. requested], [specific functional goals not yet met, e.g., 'cannot safely navigate stairs to access bedroom'], and [the reason given for denial, e.g., 'plateau in progress']. Create a script with: 1) A concise opening statement, 2) Three key clinical points that justify continued care with measurable progress data, 3) Functional outcomes that matter to the patient's daily life, and 4) Confident responses to likely objections like 'progress has slowed' or 'home exercise is sufficient.' Keep the tone professional, evidence-based, and patient-centered.”
March 15, 2026
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