AI Prompt

Clinic Chart Prep

Complete daily chart preparation by collecting patient information from ECW, verifying authorization and insurance benefits, generating the chart-prep document and updated spreadsheet, saving all eligibility PDFs, and flagging coverage issues that require follow-up

I need you to run the Well & You chart prep report for [DATE]’s appointments. Here’s the full workflow:

Step 1 — Collect patient data from ECW Open eClinicalWorks in Chrome at flwayluqq62k96pi4iapp.ecwcloud.com. Navigate to the appointment schedule for [DATE]. For every patient on the schedule, click their appointment card to open the Info panel and collect: MRN, date of birth, PCP name, preferred pharmacy (with address), email address, cell phone number, insurance name, member ID, and copay. Also note their appointment time, provider, and procedure type. Save everything to /sessions/nice-wizardly-gauss/patient_data_collected.json.

Step 2 — Build the Word document Once all patient data is collected, update /sessions/nice-wizardly-gauss/build_chart_prep.js with the new patient list and all collected data — no field should say REVIEW if the information exists in ECW. For PCP and pharmacy: if the field is blank or unknown in ECW, write “Unknown.” Only use REVIEW for fields that genuinely could not be determined. Then run node /sessions/nice-wizardly-gauss/build_chart_prep.js to generate the file.

Step 3 — Auth tracker The authorization status for each procedure patient needs to come from the auth tracker. Jordan will either share it or you can ask her for it. Fill in each patient’s auth status, auth number, and any pending/denied notes.

Output: Save the final file to /Users/dezefresh/Library/Application Support/Claude/local-agent-mode-sessions/9ff786d6-4949-4a85-a97f-a01fcf31564d/63d989d3-2943-43d4-98a3-2cba970b1822/local_c4ef8aa7-44bf-4ac9-b11f-72120722640c/outputs/ChartPrep_[DATE].docx and present it when done.

The one thing to flag for whoever runs it: Step 3 (auth tracker) requires input from Jordan or access to wherever the auth tracker is stored — that context isn’t in ECW and needs to be provided manually each time.

 

INSURANCE VERIFICATION 

Take the previous report I provide and use the patient/member information in it to run eligibility and benefits in Availity for the following payers:

  • Aetna
  • Florida Blue / BCBS
  • Ambetter
  • CarePlus
  • Christian Care Ministry / Medi-Share
  • Devoted
  • Humana
  • Molina
  • Medicare
  • WellCare

For each patient/payer result:

  • Run Eligibility & Benefits in Availity using the information from the previous report.
  • Save the full eligibility/benefits results as a PDF.
  • Organize all PDFs into a clearly labeled folder.
  • Update the spreadsheet by adding the Specialist Copay and/or Specialist Coinsurance in the appropriate column.
  • If the specialist benefit is unclear, unavailable, inactive, out of network, requires a call, or cannot be verified, add a note explaining the issue.
  • Do not overwrite the original report. Create an updated copy with all completed benefit information.
  • Use consistent PDF naming conventions:
  • LastName_FirstName_Payer_Benefits.pdf

Additionally, review every eligibility result and FLAG the following:

  • Any HMO plan.
  • Any policy that requires a PCP referral for specialist visits.
  • Any account showing both a Primary and Secondary payer.
  • Any coordination of benefits (COB) indicators.
  • Any active secondary insurance coverage listed in the eligibility response.
  • Any plan where coverage information appears incomplete, conflicting, or requires further verification.

Create a separate “Flags” column in the spreadsheet and clearly note:

  • HMO
  • PCP Referral Required
  • Primary + Secondary Insurance
  • COB Listed
  • Verification Needed

For records with multiple flags, list all applicable flags in the same cell.

Before finalizing, verify that:

  • Every patient has a corresponding PDF saved.
  • Every patient has a Specialist Copay and/or Coinsurance value entered or a documented reason why it could not be obtained.
  • All HMO and Primary/Secondary payer cases have been flagged in the spreadsheet.
  • The total number of PDFs matches the total number of eligibility checks completed.

Return:

  • The folder containing all eligibility PDFs.
  • The updated spreadsheet with Specialist Copay/Coinsurance and Flags completed.
  • A summary of any records that could not be fully verified.