Claude Project: Your Personal Patient Access AI Assistant

What This Builds

You'll build a persistent Claude Project that already knows your hospital, your payer mix, your common procedures, and your financial assistance programs — so every conversation starts from that shared knowledge base. Instead of explaining your situation every time you open a new chat, you ask your question and get an answer in seconds. It's like a patient access specialist coworker who's always available, never on hold, and knows every payer policy you've loaded.

Prerequisites

• Active Claude Pro subscription ($20/month at claude.ai) — the free plan doesn't support Projects
• 60–90 minutes for initial setup (most of that is gathering the content to load)
• At least 3 months of experience in your patient access role (so you know what to load)

The Concept

A Claude Project is like a folder that remembers everything you put in it. You can upload documents, type in key information, and set instructions — and every new conversation in that project automatically has access to all of it. Think of it as training a very knowledgeable temporary employee on your specific hospital's policies and payers, once, so they can help you instantly any time you need.

Without a project: "I'm a patient access rep at a hospital. I work with Medicare, Medicaid, Aetna, BCBS, United, Cigna, and Humana. My hospital uses Epic. Here's my question..." [every single time]

With a project: You just ask the question.

Build It Step by Step

Part 1: Subscribe to Claude Pro and Access Projects

1. Go to claude.ai and log in to your account
2. Click "Upgrade to Pro" in the left sidebar (or go to claude.ai/upgrade)
3. Complete the payment — $20/month, cancel anytime
4. Once subscribed, look for "Projects" in the left sidebar — click it
5. Click "Create Project"
6. Name it: "Patient Access — [Your Hospital Name]"

What you should see: A project page with two areas: "Project Instructions" at the top and a "Knowledge" section where you can upload files.

Part 2: Write Your Project Instructions

Click on "Project Instructions" and paste the following, customized for your situation:

You are a knowledgeable patient access assistant for a [hospital type, e.g., large academic medical center] in [city/state].

MY ROLE: I'm a patient access representative. I register patients, verify insurance eligibility, collect prior authorizations, explain patient financial responsibility, and handle patient concerns at the registration desk.

MY PAYER MIX (top payers I work with):
- Medicare (including Medicare Advantage plans from [list your common MA plans])
- Medicaid ([state] Medicaid, managed Medicaid from [plans])
- [Commercial payers you work with most]

MY EHR: [Epic / Cerner / Meditech]

COMMON PROCEDURE TYPES I HANDLE: [e.g., outpatient imaging (MRI, CT, X-ray), lab work, surgical pre-registration, ED registration, outpatient therapy]

HOW TO RESPOND:
- Give direct, actionable answers — I'm usually at a busy desk
- For payer questions: give yes/no on PA requirements, then supporting detail
- For letters and scripts: use formal format, ready to customize with real names
- For patient explanations: plain language, 6th-grade reading level, no jargon
- For de-escalation: give specific phrases I can say out loud, not general advice
- Keep answers concise unless I ask for more detail

Click Save.

Part 3: Upload Knowledge Documents

In the "Knowledge" section, click "Add Content" to upload documents or paste text.

Priority content to add:

1. Payer Quick Reference — Create a document (in Word or Google Docs) listing your top 5–8 payers with: portal name, phone number, PA requirements for common procedures. Paste the text into the project.

2. Financial Assistance Program Details — Type or paste: program name, eligibility criteria, required documents, application deadline, contact information.

3. Common Procedure PA Matrix — A simple table of your most common procedures and whether each major payer requires PA: Procedure | CPT | Medicare | Medicaid | Aetna | BCBS | United

4. Your Hospital's Patient Rights and Consent Requirements — Which consent forms are required for which procedure types; ABN requirements for Medicare patients; HIPAA acknowledgment workflow.

5. De-escalation Scripts — Your current approved scripts for common difficult situations (patient refusing copay, patient upset about denial, patient angry about wait time).

What you should see: Each document or text block appears as a card in the Knowledge section with a checkmark indicating it's indexed.

Tip: You don't need to upload PDFs — pasting the text directly as a note works just as well and is faster to search.

Part 4: Test and Refine

Start a new conversation within your project (click "New Chat" inside the project).

Test with these questions:

1. "Does [payer name] require prior auth for an outpatient knee MRI?" — should answer based on your uploaded PA matrix
2. "A patient is upset about their $800 copay. Give me 3 de-escalation phrases." — should draw from your loaded scripts
3. "Draft a financial assistance eligibility letter for a patient who came in today." — should reference your program details

What good output looks like: Answers that reference specific details from your uploaded documents — your payer names, your program names, your procedures — not generic patient access advice.

Troubleshooting — if Claude doesn't use your uploaded content:

• Make sure you're starting the conversation inside the project (not a regular chat)
• Try asking explicitly: "Based on the payer matrix I uploaded, does [payer] require PA for [procedure]?"

Real Example: A Day With the Project

Setup: You've loaded your top 7 payers, your hospital's charity care program details, a PA matrix for 20 common procedure types, and 5 de-escalation scripts.

Morning: PA question (30 seconds) Input: "Does Cigna require prior auth for an outpatient sleep study (CPT 95810) for one of our commercial Cigna patients?" Output: "Yes, based on your PA matrix, Cigna commercial requires prior auth for outpatient polysomnography. Submit through Cigna's eviCore portal. Typical turnaround 2–3 business days."

Midday: Financial assistance (2 minutes) Input: "Patient came in today, household of 3, estimated income around $45,000. Would they qualify for our charity care program? Draft the eligibility screening letter." Output: Answers based on your loaded program details, drafts the letter with your hospital's program name and document requirements.

Afternoon: Difficult patient (1 minute) Input: "Patient threatening to leave without signing consent because they're angry about a balance from a previous visit. Give me 4 phrases." Output: Four specific, usable phrases drawn from and expanding on your loaded de-escalation scripts.

Time saved: What would have taken 45+ minutes of payer portal navigation, letter drafting from scratch, and improvised patient scripts — done in under 5 minutes total.

What to Do When It Breaks

• Claude references wrong payer rules → Check if the PA matrix document was uploaded correctly; ask "According to the PA matrix I uploaded, what does it say about [payer]?" to force it to reference the document directly
• Answers are too generic (not using your documents) → Confirm you're in the project (not regular chat); try reuploading the specific document as a fresh text paste
• Project instructions aren't being followed → Reopen Project Instructions, add "IMPORTANT:" before your key formatting rules, and re-save
• Claude Pro conversation limit hit → The free plan has a daily message limit; Pro has a higher limit. If you hit it, switch to Claude.ai free for simple questions and save the project for complex tasks.

Variations

• Simpler version: Skip the project setup entirely and use the Level 3 guide to set up Custom Instructions in ChatGPT — same benefit of persistent context, less powerful but faster to set up
• Extended version: Add your hospital's entire provider policy manual as a document — Claude can then answer policy questions directly from your own policies, not general knowledge

What to Do Next

• This week: Build the project and test with 5 real questions from your daily work
• This month: Add documents as you encounter new payer policies; refine the instructions based on what answers weren't quite right
• Advanced: Share the project framework with your supervisor and propose a team-level version with department-approved payer policies loaded — one project, shared across the registration team

Advanced guide for Patient Access Representative professionals. These techniques use more sophisticated AI features that may require paid subscriptions.