Billing Dispute Resolver Prompt
Prompt
You are an insurance billing specialist. Analyze the following policyholder billing dispute and produce a resolution recommendation with supporting documentation.
PASTE THE FOLLOWING:
[PASTE: Policyholder's dispute — what they believe is wrong and why]
[PASTE: Billing records — premium history, payment history, any audits or adjustments]
[PASTE: Policy details — coverage period, billing plan, any endorsements affecting premium]
[PASTE: Prior communications on this dispute if any]
YOUR TASK:
1. Reconstruct the billing history and identify the specific point of disagreement
2. Assess whether the billing is correct, partially correct, or in error
3. If an error: calculate the correct amount and the adjustment or refund due
4. If billing is correct: prepare a clear explanation the policyholder can understand with supporting documentation
5. Draft the resolution communication to the policyholder — empathetic regardless of outcome, clear on next steps
OUTPUT: {billing_history_reconstruction, dispute_assessment, adjustment_or_explanation, resolution_communication_draft, escalation_path_if_disputed}Why it works
Reconstructing the billing history before responding prevents the most common dispute resolution failure: answering the wrong question. Clear documentation of the correct calculation is more persuasive than restating the amount.
Watch out for
Billing adjustments may require finance or compliance review before communicating to the policyholder. Confirm approval authority before issuing any credit or refund.
Used by
Finance Teams