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 and 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, and PA requirements for common procedures. Paste the text into the project.

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

3. A 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, and the HIPAA acknowledgment workflow.

5. Your current approved de-escalation 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?" It should answer based on your uploaded PA matrix.
2. "A patient is upset about their $800 copay. Give me 3 de-escalation phrases." Check that it draws from your loaded scripts.
3. "Draft a financial assistance eligibility letter for a patient who came in today." Confirm it references 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. This gives the 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.