Build a PA-Ready Practice

Use this prompt to create a reusable EHR smart phrase (dot phrase) with fill-in fields for documentation that may support diabetes technology prior authorizations. Adapt the resulting template to your practice and EHR. Do not enter protected health information (PHI) into a general AI tool unless your organization has approved that tool for PHI. Review the output before implementation.

Create a reusable EHR smart phrase (dot phrase) for documenting clinical information that may support prior authorization requests for [technology]. Use the following payer criteria and documentation requirements: [paste current payer criteria, if available]. Develop a structured clinical documentation template with clearly labeled, editable fill-in fields based on the relevant items in the diabetes technology documentation checklist. For example, for continuous glucose monitoring (CGM), include fields for diagnosis, most recent A1C and date, glucose monitoring frequency (if applicable), current insulin regimen, documented hypoglycemia events, and the clinical rationale for medical necessity. Include these fields when clinically relevant or required by the payer. The template should help the care team capture information during routine clinical encounters so the documentation needed to support a future PA request is available when needed. Distinguish payer-required documentation from optional supporting clinical information. Make the template concise, practical for routine clinical documentation, and easy to adapt to the practice's EHR and workflow. Include a reminder to review and update the template quarterly, and whenever relevant payer requirements change. Follow these rules: Use only the information and payer criteria I provide. Do not invent clinical facts, payer requirements, dates, outcomes, or citations. Do not imply that a test, treatment trial, or documentation element is universally required. If information is missing, identify the field that needs to be completed or verified rather than filling it in. Do not state that a coverage criterion is met unless the documentation provided supports it. Use only payer criteria or clinical references I provide. The care team must verify the final template against current payer requirements and organizational policies before implementation.