Synthetic document · guided walkthrough
Sample review: a Medicare Advantage denial letter
Step through a completed review of a synthetic Medicare Advantage denial letter: findings, proposed edits, reviewer decisions, version compare, the report and a one-document evaluation brief.
Send a blank template, not a copy with a patient's or member's details.
1. The original letter
The synthetic denial letter as it was loaded into HealthLiteracyCopilot: two pages, in English.
Illustration · the numbers match the notes
- The deadline. The appeal deadline is in paragraph 4.
- The actions. Two things the member must do share one sentence.
- The terms. The denial reason uses plan terms without saying what they mean.
2. Findings linked to passages
Each finding points to the passage it is about and names the standard behind it.
Illustration · the numbers match the notes
- Ranked. The findings are ordered by what a member needs to act on first.
- Linked. Selecting a finding highlights its passage in the letter.
- Sourced. Each finding names the health-literacy criterion it applies.
3. Proposed edits with their rationale
Every edit shows what changed, why, and what a reviewer still has to check.
Illustration · the numbers match the notes
- The edit. "You must ask for an appeal within 65 days" moved to the first paragraph.
- The rationale. The deadline was in paragraph 4; members act on what they find first.
- What a reviewer still checks. Legal meaning of "within 65 days of the date of this notice".
4. A reviewer accepts or rejects each edit
Nothing changes in the letter until a named reviewer decides.
Illustration · the numbers match the notes
- Accepted. The deadline move and the split of the two actions.
- Sent for approval. The reworded denial reason goes to legal before it is used.
- Recorded. Each decision keeps the reviewer's name and the date.
5. The original and the approved version, side by side
Tracked changes show exactly what moved, and the meaning check result sits beside each edit.
Illustration · the numbers match the notes
- Tracked changes. Every accepted edit appears as a tracked change.
- Meaning check. Each edit is checked for a change in who acts, conditions, obligations or negation.
- Additions. Text the AI added is labelled as an addition.
6. The exported report
The findings, the edits and the reviewer decisions, exported for the people who approve the letter.
Illustration · the numbers match the notes
- Formats. PDF for reading, Word with tracked changes for editing.
- Decisions. Accepted, rejected and pending edits are listed separately.
- Limits. The report states what was checked and what was not.
7. The evaluation brief
One page for the person who approves your notices.
Synthetic example
Evaluation brief: MA denial letter (sample)
| Section | Contents |
|---|---|
| Document reviewed | Synthetic MA denial letter, English and Spanish, 2 pages |
| Three findings | Appeal deadline (65 calendar days) buried in paragraph 4 · Two actions in one sentence · Spanish SOL grade estimate above target |
| What was checked and what was not | Checked: Readability by instrument, Structure, Action placement. Not checked: Legal sufficiency, Clinical accuracy, Member comprehension. |
| Changes needing clinical/legal approval | Reworded denial reason; Moved appeal-rights paragraph |
| Proposed owner and reviewers | Owner: Member communications · reviewers: Compliance, Legal, Language services |
| Acceptance criteria | Deadline in paragraph 1 · One action per sentence · Reviewer sign-off recorded |
| Security-review questions | Where documents are processed · What is stored · Who can see it · The SOC 2 report request route |
| Next scope decision | Review one real template under the free review, or stop |
Send this brief to the person who approves your notices.
Scope, fee, reviewer availability, and delivery window are agreed before work begins.
Send a blank template, not a copy with a patient's or member's details.
Which CAHPS questions this letter touches
Members answer the CAHPS survey about the past six months. The documents they received are part of what they experience before they answer.
| Measure | Member documents |
|---|---|
| Customer Service "How often were the forms for your health plan easy to fill out?" | Enrollment forms, Appeal and grievance forms, Coverage-determination requests Last counted in the 2028 Star Ratings; on the display page from 2029. |
| Getting Needed Care | Denial letters, Prior-authorization notices |
| Care Coordination | Gap-in-care letters |
| Rating of Health Plan | ANOC and EOC, Welcome kits, Formulary notices |
Worksheet: when was each document last scored?
| Document | Last scored | Against what standard | Languages |
|---|---|---|---|
| Enrollment forms | |||
| Appeal and grievance forms | |||
| Coverage-determination requests | |||
| Denial letters | |||
| Prior-authorization notices | |||
| Gap-in-care letters | |||
| ANOC and EOC | |||
| Welcome kits | |||
| Formulary notices |
Type in the table, then download it for Excel or Google Sheets. Your entries stay in this tab: nothing is sent or saved, so download before you leave the page.
CAHPS surveys go to members in the first half of each year and ask about the previous six months. This map describes where documents meet the survey. It does not predict a score change.