{"id":"wri-hc-portal-billing-reply","audience":"healthcare","category":"customer-replies","technique":"audience","title":"Answer a patient's billing question in plain words","free":false,"task":"A patient messaged the clinic portal confused about a $180 bill. As front desk staff, reply under 90 words in plain words, with no billing jargon ('out-of-network', 'adjudicated', 'EOB', 'claim'). The first sentence says why the bill is $180, then tell her not to pay it yet, give the exact steps to upload her new card in the portal, and say when she'll get a corrected bill. Write a prompt that gets that reply.","materialLabel":"Her message and billing notes (attached to your prompt automatically)","material":"PORTAL MESSAGE from Linda Park:\nWhy did I get a bill for $180 for my Oct 14 checkup? I have insurance! My copay is supposed to be $25. Please explain.\n\nBILLING NOTES (Elmwood Family Medicine)\n- Oct 14 visit billed to her OLD insurance (Crestline Health), which ended Sept 30. Crestline denied it, so the full $180 visit cost went to her.\n- She has new insurance (Bayview Health Plan) since Oct 1, but we never got the new card. Our file still has Crestline.\n- Fix: she uploads her new card. Billing re-sends the visit to Bayview. Then she'll owe her $25 copay.\n- Steps in the portal: Profile > Insurance > Upload new card (front and back photos).\n- Corrected bill arrives in 2-3 weeks after upload.\n- Her $180 bill is on hold for 30 days once she uploads, so no late fees.\n\nOTHER\n- Front desk can't see her diagnosis and shouldn't discuss medical details.\n- Billing office direct line: 555-0137, Mon-Fri 8-4.","rules":[{"type":"maxWords","max":90}],"mistakes":[{"title":"Trusting the AI to count words","why":"AI is bad at counting. Ask for \"under 90 words\" and it often lands well over.","fix":"Cap each part: \"4 sentences, each under 20 words.\"","checks":["maxWords"]},{"title":"Opening with filler","why":"AI replies start with \"Thank you for reaching out about your bill\" before explaining anything.","fix":"Say it: \"Sentence 1: the visit went to your old insurance, which ended Sept 30.\"","checks":["r0"]},{"title":"No clear next step","why":"The AI explains the problem but doesn't say 'don't pay yet' or give the exact menu path.","fix":"Add: \"Tell her not to pay yet; give Profile > Insurance > Upload new card; corrected bill in 2-3 weeks.\"","checks":["r1"]},{"title":"Billing jargon","why":"AI explains with \"claim denied\" and \"EOB\", which confuses most patients.","fix":"Ban them: \"No out-of-network, adjudicated, EOB or claim.\"","checks":["r2"]}],"promptHints":[{"label":"Sets a word limit","patterns":["\\d+\\s*words","word (limit|count)"]},{"label":"Leads with why","patterns":["first sentence","why","old insurance"]},{"label":"Says not to pay yet","patterns":["don'?t pay","not (to )?pay","hold"]},{"label":"Gives the exact steps","patterns":["profile","upload","steps"]},{"label":"Bans jargon","patterns":["jargon","eob","claim","plain (words|english|language)"]}],"hint":"A worried patient needs the why, the do-nothing-yet and the exact fix. Tell the AI the order, the steps and the words to avoid.","rubricLabels":["The first sentence (after a greeting) explains the $180 came from the visit being sent to her old insurance (Crestline), which ended Sept 30","Tells her not to pay the $180 yet, gives the upload steps Profile > Insurance > Upload new card, and says a corrected bill comes in 2-3 weeks (with her $25 copay)","Uses none of these: out-of-network, adjudicated, EOB, claim"]}