Insurance letters: the agent that drafts pre-authorisation requests for a medical practice

An internal medicine practice in French-speaking Switzerland. Four doctors, two medical secretaries. We ran an audit last week. The recurring complaint: each secretary spends half a day per week drafting letters to insurers. Pre-authorisation requests, Tarmed coding justifications, responses to rejections, appeals.

None of that correspondence is medicine. All of it follows a template. It is a textbook agentic candidate.

The current workflow

For a supplementary insurance pre-authorisation request (say, an MRI outside LAMal coverage), the secretary:

1. Retrieves the patient file, medical history, and the doctor's report.
2. Identifies the insurer, the type of cover, and the form to use.
3. Drafts the justification using the wording the insurer expects (each fund has its quirks).
4. The doctor reviews and signs; the secretary sends.

Thirty minutes per case. Fifteen to twenty cases a week.

The agent

1. Reading the file. Triggered by the doctor (one click in the EHR — electronic health record), the agent reads the relevant patient records, prior reports, and the stated reason for the request.

2. Drafting. The agent writes the letter using the wording expected by the target insurer. We calibrate that wording against fifteen to twenty past letters from the practice, anonymised. The draft lands in the doctor's inbox.

3. Medical sign-off. The doctor reads, adjusts if needed, signs electronically, and the letter is sent by the secretary or directly via secure message. Every action is logged.

What it gives back

• From 30 minutes to 5 minutes per file. Most of the time saved comes from drafting and formatting.
• Fewer wording errors. The agent never misses the relevant Tarmed code or the regulatory grounds that must be cited.
• Secretarial time redeployed toward what patients actually notice: reception, phone support, and care coordination.

What it does not do

• The agent makes no diagnosis and never rewrites a medical indication. It reformulates the administrative argument.
• It sends nothing without sign-off. Every outgoing letter requires the doctor's explicit signature.
• It does not process records in plain text on foreign servers. Data hosted in Switzerland, Swiss FADP compliance verified, full access log maintained.

Cost and timeline

A pilot covering a single insurer in three weeks, full deployment in six to eight weeks — including Swiss hosting, EHR integration, logging, and a one-click shutdown procedure.

---

A free 30-minute audit looks at whether administrative correspondence is a friction point in your practice — and whether an agent would fix it.