The Smart Phrase Library — EHR Templates for PA-Ready Documentation
Copy-paste EHR templates generate PA-supporting documentation as a byproduct of routine clinical notes — available for every major headache documentation scenario.
PA impact: This card directly affects prior authorization outcomes. Documentation language from this card can be used in PA letters and appeals.
What the Smart Phrase Library is
The Headache Vault maintains a library of copy-paste-ready EHR templates — "smart phrases" — designed to generate PA-supporting documentation as a byproduct of routine clinical documentation. Each phrase is structured so that documenting clinical care simultaneously builds the evidentiary record a payer reviewer needs to see.
Core library structure
Part 1 — Visit Documentation: Phrases for initial migraine evaluation, follow-up visits, preventive trial documentation, and acute treatment response tracking.
Part 2 — PA Letters and Appeals: Pre-structured PA submission letters, peer-to-peer preparation notes, and appeal language for common denial reasons.
Part 3 — After-Visit Summaries: Patient-facing summaries that reinforce medication instructions and set expectations for preventive therapy timelines.
Part 4 — Referral and Care Coordination: Specialist referral letters that do clinical work (see Card 11), ER follow-up documentation, and care transition notes.
Part 5 — Patient Resources: Educational handouts on medication overuse thresholds, trigger diary instructions, and ER preparedness information.
Part 6 — Quick Reference: ICD-10 code reference, step therapy requirement summaries, and common contraindication documentation shortcuts.
Volume 2: Specialized clinical documentation
Behavioral treatment documentation (.vaultbehavioral, .vaultbehavioral-barriers) — documents ongoing behavioral therapy for payers requiring it as step therapy, and access barriers that justify PA bypass.
Aura and contraception (.vaultaura-OCP, .vaultterato) — CHC contraindication in migraine with aura per WHO MEC Category 4, and teratogenicity bypass for topiramate/valproate.
Pediatric migraine (.vaultpeds-acute, .vaultpeds-prevent) — off-label CGRP documentation, reduced step therapy justification, injection phobia bypass.
Cluster headache (.vaultcluster-dx, .vaultcluster-O2) — diagnosis documentation and home high-flow oxygen DME authorization. The oxygen phrase addresses a specific claim failure: high-flow oxygen is a DME benefit (HCPCS codes E0439/E1392), not a pharmacy benefit. Wrong pathway = denial unrelated to medical necessity.
How to use the phrases
Each phrase is identified by a dot-prefix name (e.g., .vaultbehavioral) and designed for direct import into Epic, Cerner, or any EHR supporting text expansion. Bracketed fields [like this] indicate clinician-completed data.
Ready to run a PA?
The PA Engine applies this guidance automatically — paste a clinical note and get a complete, payer-specific PA letter in under a minute. Free, no account required.
Run a PA — free →Citations: Headache Vault Smart Phrase Library, Core + Volume 2 (2026). Full library available to registered providers.