# Prompt Library Starter for Healthcare Operations

A curated set of prompts for non-PHI healthcare operations work. None of these prompts ask you to paste in patient data. They focus on coding, billing rule lookups, denial reason explanations, internal documentation, and team communications.

> Brought to you by ByteWorthy. byteworthy.io

## How to use this library

1. Copy the prompt closest to your task into your AI tool.
2. Replace the bracketed placeholders with your specific inputs.
3. Never include PHI. Use record IDs, code numbers, and aggregate descriptions instead.
4. Review the output before acting on it. AI assists. Humans decide.

---

## Coding and billing

### Explain a denial reason code

```
You are a healthcare billing specialist. Explain CARC code [code number] in plain language a non technical office manager can understand. Include:
1. What the code means
2. The most common reasons claims get this denial
3. What documentation is typically needed for an appeal
4. Whether the timely filing window for appeals is usually short or long for this code

Keep it under 200 words.
```

### Compare two CPT codes

```
You are a healthcare billing specialist. Compare CPT codes [code A] and [code B]. Cover:
1. The clinical scenario each is intended for
2. The typical reimbursement difference
3. Common modifiers used with each
4. Any NCCI edits that pair them

Cite the CMS or NCCI source in your reasoning.
```

### Draft a peer to peer appeal narrative outline

```
You are a clinical documentation specialist. Draft a peer to peer appeal narrative OUTLINE (not the full letter) for a [procedure type] denied with reason code [code]. The outline should include:
1. Clinical justification structure
2. Documentation references typically required
3. Standard counter arguments to the most common denial rationale

Do not include any specific patient details. The output is a template that a clinician fills in.
```

---

## Documentation and SOPs

### Turn process notes into an SOP

```
Turn the following process notes into a standard operating procedure with these sections: Trigger, Owner, Goal, Steps, Completion Criteria, Escalation. Keep it under one page. Use plain language.

Process notes:
[paste your notes here]
```

### Summarize a meeting agenda for a partner email

```
Summarize the following meeting agenda for a partner who could not attend. Three paragraphs maximum. Include: what was decided, what action items came out of it, what follow up the absent partner is responsible for.

Agenda:
[paste agenda or notes here]
```

### Draft an internal training doc from a recorded process

```
A team member recorded the following process. Turn it into a written training document for a new hire who has never done this task. Include: prerequisites, step by step instructions, common mistakes to avoid, and how to know the task is complete.

Recorded process:
[paste transcript or notes]
```

---

## Internal communications

### Draft a Friday update

```
Draft a Friday team update from the following bullet points. Keep it under 200 words. Match this voice: direct, specific, no filler. Include: what shipped this week, what is in flight, what is blocked, who needs help.

Bullets:
[paste your bullets]
```

### Draft a vendor evaluation summary for partners

```
Summarize the following vendor evaluation notes into a one page brief for the partner meeting. Include: vendor name, what they offer, our top 3 questions or concerns, recommendation (proceed, decline, more info), and rough cost.

Notes:
[paste your notes]
```

---

## Research and analysis

### Compare two AI vendors at a glance

```
Compare the following two healthcare AI vendors on these dimensions: signed BAA available, data flow diagram public, model training opt out, EHR integrations supported, pricing model, primary use case. Format as a side by side table.

Vendor A: [name and url]
Vendor B: [name and url]
```

### Find the most recent CMS rule change affecting [topic]

```
Find the most recent CMS rule change affecting [specific topic, e.g., prior auth requirements for outpatient PT]. Summarize: effective date, what changed, who is affected, and where to find the official rule.

Cite your sources with URLs to CMS or Federal Register.
```

---

## What is NOT in this library (and why)

This library deliberately excludes prompts that would require PHI as input. Examples we do NOT provide:
- Generating a discharge summary from a clinical note
- Drafting an appeal letter from a specific patient's record
- Summarizing a patient encounter for a referral

Those tasks require an AI tool with a signed BAA and a controlled data flow. Use this library for the work AI can do without ever seeing patient data. Use a properly configured custom build for everything else.

---

## License

Use, modify, ship. Add to your own library. No attribution required.

> Brought to you by ByteWorthy. byteworthy.io