Will a Chatbot Be Just What the Doctor Ordered for Reimbursement Appeals?

Writing an insurance appeal letter is one of those frustrating but essential administrative tasks that physicians and their staffs look forward to about as much as reading payment denial correspondence.

So when Palm Beach, Fla., rheumatologist Clifford Stermer, M.D., placed a video on TikTok in November to demonstrate an efficient way to write an insurance appeal letter using the artificial intelligence (AI) program ChatGPT, it stood to reason other practitioners might seek it out. By early January the video had more than 143,000 views.

Stermer uses the Doximity digital platform for medical professionals. The company has launched a beta version of ChatGPT to help streamline time-sapping administrative tasks like drafting and faxing preauthorizations and appeals letters to insurers. The tools allow Doximity members to access a library of medical prompts where the AI-based tool can answer health care-specific questions.

The tool can be accessed free via DocsGPT.com.

In his video, Stermer prompts the chatbot to write a letter to an insurer asking it to approve an echocardiogram for a patient with systemic sclerosis, to reference supporting scientific literature and to list appropriate articles. About a minute later, the program produces a three-paragraph letter.

Stermer explains that the letter needs significant revisions but adds that it’s a great template to save time. References and author names need to be checked carefully, for example, and the program may not reference the proper journal. One way to get around this is to provide the specific articles you want the bot to reference. Another tip: Specify if you want the letter to be friendly, formal or “stern.”

Doximity is working with physicians to fine-tune the product. The DocsGPT site includes an expanding library of medical prompts in which the AI-based writing assistant has been trained on health care-specific prose.

Since its launch in November, ChatGPT has been making headlines for its ability to pass graduate-level exams for business, law and medical school. One thing it won’t do, however, is replace practitioners. But as Stermer notes, the technology is going to change the way practitioners lead their daily lives.