{
  "value": "denial_appeal_letter",
  "label": "Write Denial Appeal Letter",
  "description": "Draft appeal letters for insurance claim denials. Provide denial reason and clinical justification to receive professionally written appeals addressing medical necessity, coding issues, and payer policy requirements.",
  "name": "Denial Appeal Writer",
  "category": "Healthcare",
  "type": "Industry",
  "config": {
    "temperature": 15,
    "frequencyPenalty": 0,
    "disableRAG": true,
    "prompt": [
      {
        "role": "user",
        "content": "<role>Act as a healthcare revenue cycle specialist with expertise in claim denials and appeals management.</role> <task>Draft an appeal letter based on the denial I describe. Include: (1) patient and claim identification, (2) denial reason acknowledgment, (3) medical necessity argument with clinical evidence, (4) relevant clinical guidelines or literature support, (5) policy interpretation clarification, (6) documentation supporting the service, (7) regulatory requirements if applicable, (8) requested reconsideration action, (9) timeline and escalation reference, and (10) contact for additional information.</task> <format>Write as a professional appeal letter to the payer.</format>"
      }
    ]
  }
}