Insurance Pre-Authorization Letter Builder

Generate professional medical necessity letters for insurance coverage in minutes. Free letter templates for therapists.

Build Your Letter

Provider Information
Insurance Information
Client Information
For de-identified drafts: leave out names, dates of birth and other details that identify a client. Writing about real clients? Use MentalNote. It's HIPAA-compliant, with a BAA included on every plan (accepted in the app before your first session).
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.

Try it free Explore Other Tools

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?

Use this free letter builder with de-identified details only. For real client information, use MentalNote. It's HIPAA-compliant, with a BAA included on every plan and accepted in the app before your first session.

Write Better Notes, Faster

HIPAA-compliant AI clinical notes in your browser or in Microsoft Word. Free plan: 5 web-app scribe sessions a month, no credit card.

Try it free

Prefer Microsoft Word? Get the free Word add-in. Installs from Microsoft AppSource.

More Free Tools

Related Tools

Other free MentalNote tools that pair naturally with this one. All are free to use, no signup required.

📋

Treatment Plan Generator

Build a treatment plan with goals, objectives, ASAM dimensions, and Stanley-Brown safety planning.
📝

SOAP Note Builder

Generate SOAP-format clinical notes with structured risk and impairment fields.
✅

Note Audit Checker

Paste a draft note; get audit feedback on compliance, completeness, and risk documentation.
🔤

Clinical Phrase Library

Searchable library of clinically appropriate phrases for findings, observations, and interventions.
Browse all 8 free tools →
📝

Writing case reports, referrals, or supervision notes?

GenText is our sister product — an AI writing assistant for Microsoft Word that drafts case reports, referral letters, intake summaries, supervision write-ups, CE materials, and manuscripts. Formats citations (APA, AMA, Vancouver) and pulls from 200M+ peer-reviewed papers when you need them. 100k+ professionals use it. Free to install.

Try GenText for Word — free →