Drug Interaction Checking
This is where AI can literally improve safety. If you take multiple medications, supplements, or even consume certain foods regularly, interactions matter.
Interaction check prompt:
"Check for interactions between these medications and supplements I take daily: [list everything — Rx, OTC, vitamins, supplements, herbal products]. For each interaction found: (1) Severity rating (minor, moderate, major) (2) What actually happens — the mechanism (3) Whether timing of doses can reduce the risk (4) Whether my doctor needs to know or if it's manageable. Also check common food interactions — am I taking anything that interacts with grapefruit, dairy, alcohol, or caffeine?"
Insurance Coverage Analysis
Understanding your insurance coverage is a research project in itself. AI can decode the complexity.
Coverage analysis prompt:
"I have [insurance plan name/type] through [employer/marketplace/Medicare/Medicaid]. My doctor wants to prescribe [medication] or perform [procedure]. Help me understand: (1) What formulary tier is this medication (if applicable)? (2) What's my likely copay or coinsurance? (3) Does this require prior authorization? (4) Is my provider in-network for this? (5) How much of my deductible have I met (I've spent $[X] so far this year)? (6) If it's denied, what's the appeals process?"
Medical Bill Analysis
80% of medical bills contain errors. AI can find them.
Bill audit prompt:
"I received a medical bill with these charges: [list CPT codes and amounts, or describe the services and costs]. The procedure was [describe what happened]. My insurance paid $[X], I owe $[X]. Audit this bill: (1) Are the CPT codes correct for the services I received? (2) Are there duplicate charges? (3) Are the amounts within the reasonable and customary range for [city/state]? (4) Did I receive an EOB from my insurance that matches? (5) Am I being balance-billed when I shouldn't be (in-network)? (6) What's the typical discount for asking for a cash-pay or prompt-pay discount?"
Prior Authorization Research
When insurance denies a prior authorization, most patients give up. 45% of denials are overturned on appeal.
Prior authorization prompt:
"My insurance denied prior authorization for [medication/procedure] for [condition]. The denial reason was: [quote from denial letter]. Help me: (1) Is this a common denial for this condition/treatment? (2) What medical necessity criteria does insurance typically require? (3) What documentation should my doctor provide to support the appeal? (4) Draft a patient appeal letter (I will review with my doctor before sending) that addresses the specific denial reason (5) What's the timeline for each level of appeal? (6) If the internal appeal fails, what are my external review options?"
