Best Practices

HorusAI Copilot – Best Practices

How to get the most accurate, policy-aligned answers from HorusAI

Our Copilot is designed to help you search internal policies, state regulations, CMS manuals, OIG guidance, and general compliance questions. These tips will help you consistently get clear, compliant, and citation-ready responses.

1. Be Specific About the Policy Source

If you want the Copilot to prioritize a certain source, say it explicitly.

Examples:

“Check our internal Utilization Management policy first, then confirm with CMS rules.”
“Refer only to Florida state regulations for this question.”
“Pull from our internal ‘Medical Necessity Policy’ (2024 version).“

2. Include Dates or Time Periods When Relevant

A lot of rules differ by year or effective date. Mention it in your question.

Examples:

“What are the CMS documentation requirements for telehealth as of 2025?”
“What did the OIG require for incident-to billing before 2024?”

If you don’t specify, Copilot will assume you want the most current rules.

3. Use Policy Language When You Know It

HorusAI performs best when you use keywords that match policy terminology.

Examples:

“What are the supervision requirements for incident-to billing in Florida?”
“Explain CMS’s definition of medical necessity for inpatient rehab.”

4. Ask for Step-by-Step Answers When You Need Operational Clarity

Instead of broad questions, ask for process-level guidance.

Examples:

“List the steps required for compliant prior authorization in Florida.”
“Summarize what documentation must appear in the medical record for billing CPT 99223.”
“Give me a checklist for verifying medical necessity based on our policy.”

5. When Reviewing a Policy, Ask for Summaries + Citations

This ensures Copilot returns precise excerpts from uploaded files within folders or regulations.

Examples:

“Summarize the key requirements and cite the exact lines from the policy.”
“What does CMS say about this? Provide the text and the citation.”
“Quote the relevant paragraph from our internal compliance manual in .“

6. Tell Copilot Whether to Use Internal Files, External Regulations, or Both

Examples:

“Use only our internal policies for this answer.”
“Combine internal policy with CMS guidance and identify any conflicts.”
“Check Florida state regs first, then confirm against CMS.”

7. If You Want a “Yes/No” Answer, Ask for a Rationale Too

This prevents misinterpretation and improves clarity.

Examples:

“Can this be billed as incident-to? Give a yes/no and explain the reasoning.”
“Is this service considered non-covered under Medicare? Provide citation.”

8. Upload Supporting Documents Before Asking

If users are referencing:

screenshots
policy PDFs
payer rules

Tell Copilot to use those documents in the response.

Example:

“Use the PDF I just uploaded and tell me if this documentation supports the diagnosis.”

9. When Unsure, Ask Copilot to Compare Policies

Compliance issues often come from conflicting sources. Copilot can highlight mismatches.

Examples:

“Compare our internal prior auth policy to Florida Medicaid requirements.”
“Tell me if our policy aligns with OIG Advisory Opinions.”
“Show any differences between our language and OIG guidance.”

10. Ask for Output Formats to Fit Your Workflow

Users can request answers in checklists, tables, summaries, or escalation notes.

Examples:

“Give me a 5-item checklist.”
“Create a table comparing CMS vs Internal rules.”
“Write an explanation I can send to leadership.”

Best “Power Prompts” for Compliance Users

Here are prompts that consistently produce strong results:

“Search all internal policies related to {topic} and summarize the key requirements with citations.”
“Combine CMS + Florida state regulation guidance to answer this question and flag contradictions.”
“Provide a step-by-step interpretation of the rule and explain how it applies operationally.”
“Tell me what documentation is required to support this service, with references to source policies.”