Insurance Pre-Authorization Letter Builder

Generate professional medical necessity letters for insurance coverage in minutes. HIPAA-compliant templates for therapists.

Build Your Letter

Provider Information
Insurance Information
Client Information
⚠ Do NOT enter real client identifiers in this web demo. Use initials (e.g. "J.D.") and an approximate age instead of full name and DOB. This is a template generator — the full MentalNote add-in for Word is HIPAA-compliant for real client work.
Treatment Request
Clinical Justification
Document concrete, measurable impairment examples. Avoid generic phrases like "interferes with daily life."
Cite a guideline (APA, NICE, VA/DoD), a validated measure score, or peer-reviewed evidence supporting the requested modality and intensity.

Generated Letter

Fill in the form and click "Generate Letter" to create your pre-authorization request.

Streamline Your Insurance Authorization Process

Mental Note AI helps therapists manage clinical documentation efficiently. Beyond pre-authorization letters, generate SOAP notes, progress notes, and treatment plans directly in Microsoft Word.

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Frequently Asked Questions

What is a pre-authorization letter?

A pre-authorization letter (prior authorization or prior approval request) establishes medical necessity for mental health treatment and requests insurance coverage approval before services begin. It helps ensure the treatment will be covered and accelerates the approval process.

What should I include in the letter?

An effective pre-authorization letter should include: your credentials and contact information, client demographics and insurance details, DSM-5 diagnosis with code, presenting symptoms and functional impairment, proposed treatment plan with specific CPT codes, frequency and duration of sessions, medical necessity indicators, and evidence-based rationale for the recommended approach.

Can I submit this directly to insurance?

Yes, the letters generated are professional and suitable for direct submission to insurance companies. You may need to adjust them slightly for specific insurance requirements or add additional clinical details. Always verify current CPT codes and that your credentials are correct before submitting.

Is this HIPAA compliant?

This demo generates letters using templates and does not store any data. For production use with real client information, we recommend using the full Mental Note AI product, which is HIPAA-compliant and secure. Do not enter actual client names or details in this web tool—use it for reference or templates only.

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HIPAA-compliant AI clinical notes, directly inside Microsoft Word. Free tier: 2,000 words/month. No credit card.

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