{"$schema":"https://wellknown.network/schemas/agent-record-v1.json","schemaVersion":"1","id":"ag_p89vjrr6uauh","handle":"com-medigami-mcp","url":"https://wellknown.network/agents/com-medigami-mcp","links":{"self":"https://wellknown.network/agents/com-medigami-mcp/record.json","html":"https://wellknown.network/agents/com-medigami-mcp","markdown":"https://wellknown.network/agents/com-medigami-mcp/record.md","api":"https://wellknown.network/api/v1/agents/com-medigami-mcp","status":"https://wellknown.network/api/v1/agents/com-medigami-mcp/status","claim":"https://wellknown.network/agents/com-medigami-mcp/claim","claimApi":"https://wellknown.network/api/v1/claims","claimDescriptor":"https://wellknown.network/agents/com-medigami-mcp/claim.json","badge":"https://wellknown.network/agents/com-medigami-mcp/badge.svg","openapi":"https://wellknown.network/openapi.json","history":"https://wellknown.network/api/v1/agents/com-medigami-mcp/history","tools":"https://wellknown.network/api/v1/agents/com-medigami-mcp/tools"},"ard":{"identifier":"urn:air:mcp.medigami.com:server:com-medigami-mcp","type":"application/mcp-server-card+json"},"kind":"mcp_server","declared":{"name":"mcp","summary":"Medigami: medical bill error scan, denial decoding, appeal deadlines, hospital price lookup","description":"Medigami: medical bill error scan, denial decoding, appeal deadlines, hospital price lookup","publisher":{"name":"com.medigami","url":null},"homepage":"https://medigami.com/mcp","repository":null,"version":"1.0.0","license":null,"protocols":["mcp"],"tags":[],"pricing":null,"endpoints":[{"url":"https://mcp.medigami.com/public/mcp","type":"mcp_streamable_http","auth":null,"probeable":true}],"skills":null,"tools":null,"extra":{"updatedAt":"2026-09-07T19:58:15.116788Z","publishedAt":"2026-09-07T19:58:15.116788Z","registryName":"com.medigami/mcp"},"attribution":{"kind":"mcp_registry","name":"mcp_registry","summary":"mcp_registry","version":"mcp_registry","description":"mcp_registry","homepageUrl":"mcp_registry","publisherName":"mcp_registry"}},"derived":{"capabilities":[{"slug":"commerce.pricing","name":"Pricing & Quotes","confidence":1,"provenance":"derived"},{"slug":"finance.banking","name":"Banking","confidence":0.583,"provenance":"derived"},{"slug":"security.identity","name":"Identity & Access","confidence":0.583,"provenance":"derived"},{"slug":"code.execution","name":"Code Execution","confidence":0.569,"provenance":"derived"},{"slug":"dev.docs-lookup","name":"Documentation Lookup","confidence":0.54,"provenance":"derived"},{"slug":"ai.evaluation","name":"Evaluation & Benchmarks","confidence":0.54,"provenance":"derived"},{"slug":"documents.contracts","name":"Contracts & Legal","confidence":0.525,"provenance":"derived"},{"slug":"data.weather","name":"Weather","confidence":0.525,"provenance":"derived"}],"categories":["ai","code","commerce","data","dev","documents","finance","security"],"language":"es"},"observed":{"status":"live","statusReason":"Responded 4h ago.","lastOkAt":"2026-10-09T23:28:45.939Z","lastProbedAt":"2026-10-09T23:28:45.939Z","statusComputedAt":"2026-10-09T23:31:02.816Z","reliability30d":{"probes":109,"successRate":1,"p50Ms":236,"basis":"service","measures":{"availability":"availability","latency":"response time","tools":"tool surface observed","summary":"Checks reached the service itself."},"checks":{"total":108,"ok":108,"authBoundaryOk":0,"serviceOk":108,"note":"Counted from the observation rows for the window, checks of the server only (HTTP, A2A card, MCP initialize). ok = authBoundaryOk + serviceOk. `probes` is the sum of daily rollups and includes registry checks, so it can differ from `total`."}},"latestObservations":[{"at":"2026-10-09T23:28:45.939Z","kind":"mcp_initialize","ok":true,"httpStatus":200,"latencyMs":193,"error":null,"detail":{"tools":[{"name":"scan_bill_for_errors","description":"Scan a medical bill or EOB text for errors: duplicate charges, CPT unbundling, upcoding, facility-fee overcharges. Returns flagged anomalies with estimated doll"},{"name":"generate_appeal_letter","description":"Generate a legally-grounded insurance appeal letter for a denied claim. Returns the letter as a template with [PATIENT NAME] and [PROVIDER NAME] placeholders (s"},{"name":"optimize_prescription","description":"Find the lowest-cost path for a prescription: generics, biosimilars, GoodRx coupons, manufacturer assistance, 90-day fills, and mail-order vs retail comparison."},{"name":"analyze_glp1_pathways","description":"Find all access pathways for a GLP-1 drug (Ozempic, Wegovy, Mounjaro, Zepbound) given patient eligibility factors. Ranks pathways by monthly cost, flags prior-a"},{"name":"verify_attestation","description":"Verify an Ed25519-signed Medigami MCP response envelope — confirm a medical-bill / appeal / denial / rate answer came from Medigami and hasn't been tampered wit"},{"name":"watch_appeal_outcome","description":"Subscribe to an appeal outcome by tracking_id. Blocks up to `timeout_seconds` (default 300). Returns the outcome payload as soon as it's recorded, or {status: '"},{"name":"watch_claim_denial","description":"Subscribe to a claim denial event for a given scan_id. Blocks up to `timeout_seconds`. Returns {status: 'denied', ...} as soon as the payer marks the claim deni"},{"name":"format_citation","description":"Format an LLM-citable reference to a previously-attested Medigami MCP response. Input: either the full signed envelope that an earlier attested tool returned, O"},{"name":"submit_denial_letter","description":"Submit a medical-claim denial letter to the Medigami Denial Common Crawl (public aggregate dataset). Consent-gated — caller must pass consent=true to attest the"},{"name":"verify_mcp_response","description":"DEPRECATED ALIAS of verify_attestation — kept for backward compatibility with v0.1.7 clients. New code should call verify_attestation directly.\n\nWHEN TO USE: Re"},{"name":"format_medigami_citation","description":"DEPRECATED ALIAS of format_citation — kept for backward compatibility with v0.1.7 clients. New code should call format_citation directly.\n\nWHEN TO USE: Referenc"},{"name":"estimate_appeal_success","description":"Probability an appeal will be approved, derived from outcome-labeled data weighted by label provenance (IRO determinations, EOB reversals, physician confirmatio"},{"name":"resolve_denial","description":"End-to-end denial resolution: returns appeal probability + confidence interval + a drafted letter template grounded in aggregate outcome data + plan-context fla"},{"name":"maximize_recovery","description":"Given a prior scan_id, returns a prioritized action list: anomalies ranked by (expected overcharge x recovery probability), with the next steps to pursue each. "},{"name":"explain_appeal_success","description":"Human-readable rationale for an appeal probability. Returns {probability, tier, recommended_posture, rationale, expected_days_to_resolution, tracking_id} ground"},{"name":"negotiate_bill_script","description":"Generate a phone script the user can read when negotiating a medical bill directly with the provider. Combines DP-noised commercial rate benchmarks + the caller"},{"name":"batch_scan_bills","description":"Scan multiple medical bills in one call. Returns per-bill anomaly lists + total recovery estimate across the batch. Input is a list of {bill_text, provider?, in"},{"name":"lookup_icd10","description":"Look up an ICD-10-CM diagnosis code or search by keyword. Input is either an exact code (e.g. 'E11.21') or a free-text description phrase ('type 2 diabetes with"},{"name":"lookup_cpt","description":"Look up a CPT or HCPCS-J code or search by keyword. Covers the most common outpatient billing codes (E/M, preventive, lab, imaging, procedure, cardiology, thera"},{"name":"lookup_npi","description":"Look up a provider in the CMS NPPES National Provider Identifier registry. Accepts a 10-digit NPI number OR a provider name (optionally narrowed by 2-char state"},{"name":"verify_dea_authorization","description":"Validate the format + checksum of a DEA registration number (format: [A-Z][A-Z9][0-9]{7}; public checksum algorithm). Useful as a sanity check on a DEA number y"},{"name":"lookup_provider_taxonomy","description":"Look up a NUCC provider taxonomy code (the specialty codes used on HIPAA transactions + NPI registrations) or search by keyword. Returns classification + type +"},{"name":"resolve_codes","description":"[Taxonomy A.1 — baseline response (public data only)] Unified code resolver — free-form query or clinical description → ranked ICD-10-CM, CPT, and HCPCS codes w"},{"name":"code_conflict_detector","description":"[Taxonomy A.5 — delegates to scan_bill_for_errors] Detect CPT unbundling, mutually exclusive code pairs, and NCCI edit violations in a set of codes. Implemented"},{"name":"fair_price_estimator","description":"[Taxonomy B.8 — delegates to benchmark_payer_rate] Fair-market price distribution for a service: DP-noised percentiles (p10, p25, p50, p75, p90) for the given C"},{"name":"price_variance_analyzer","description":"[Taxonomy B.9 — baseline response (public data only)] Given a target price and a CPT+region, return how many standard deviations above/below the market the targ"},{"name":"claim_consistency_checker","description":"[Taxonomy C.14 — delegates to scan_bill_for_errors] Detect internal contradictions in a claim: time mismatches, mutually exclusive codes, missing required field"},{"name":"bundling_violation_detector","description":"[Taxonomy C.16 — delegates to scan_bill_for_errors] Detect CPT unbundling (billing components of a procedure separately to inflate the claim). Uses the CMS NCCI"},{"name":"appeal_success_predictor","description":"[Taxonomy E.25 — delegates to estimate_appeal_success] Given a denial, predict the probability of a successful appeal. Returns probability with 95% CI, sample s"},{"name":"generate_appeal_letter_v2","description":"[Taxonomy F.28 — delegates to generate_appeal_letter] [Taxonomy alias] Generate a state-specific insurance appeal letter with UPL-safe disclaimers for 19 US sta"},{"name":"negotiation_strategy_generator","description":"[Taxonomy F.30 — baseline response (public data only)] Given a bill + patient situation, generate a ranked negotiation strategy: hardship appeal, charity-care a"},{"name":"insurance_response_interpreter","description":"[Taxonomy F.31 — baseline response (public data only)] Parse an insurer's response letter or EOB into structured fields: denial reason codes, appeal rights, dea"},{"name":"settlement_optimizer","description":"[Taxonomy F.32 — baseline response (public data only)] For a disputed bill, compute the optimal settlement target price balancing probability of acceptance agai"},{"name":"patient_cost_forecaster","description":"[Taxonomy H.38 — baseline response (public data only)] Given a patient's plan + predicted care needs, forecast annual out-of-pocket spend across expected claims"},{"name":"insurance_plan_optimizer","description":"[Taxonomy H.39 — baseline response (public data only)] Given a patient's historical claim patterns, rank available insurance plans by expected annual cost.\n\nWHE"},{"name":"cash_vs_insurance_optimizer","description":"[Taxonomy H.41 — baseline response (public data only)] For a given service + patient plan, determine whether cash-pay + charity-care beats insurance billing.\n\nW"},{"name":"financial_risk_exposure_model","description":"[Taxonomy H.42 — baseline response (public data only)] Quantify a patient's financial exposure to medical-debt risk given current plan, health status, and histo"},{"name":"cpt_to_icd_mapper","description":"[Taxonomy II.21 — baseline response (public data only)] For a given CPT, surface the ICD-10 codes typically paired with it for medical-necessity support.\n\nWHEN "},{"name":"icd_to_cpt_mapper","description":"[Taxonomy II.22 — baseline response (public data only)] For a given ICD-10, surface the CPT codes typically billed for that diagnosis.\n\nWHEN TO USE: User has an"},{"name":"code_bundle_validator","description":"[Taxonomy II.25 — baseline response (public data only)] Check a set of CPT codes against NCCI bundling rules (distinct from modifier-based unbundling).\n\nWHEN TO"},{"name":"unbundling_detector","description":"[Taxonomy II.26 — delegates to scan_bill_for_errors] Detect CPT unbundling patterns in a claim. Alias of scan_bill_for_errors.\n\nWHEN TO USE: User asks about med"},{"name":"cash_price_estimator","description":"[Taxonomy III.39 — baseline response (public data only)] Estimate a fair cash price for a service in a given region (no-insurance path).\n\nWHEN TO USE: Uninsured"},{"name":"zip_based_price_variance","description":"[Taxonomy III.41 — baseline response (public data only)] Report price variance for a CPT across ZIP3 regions with DP noise.\n\nWHEN TO USE: User wants to understa"},{"name":"regional_price_benchmark","description":"[Taxonomy III.43 — baseline response (public data only)] Regional price benchmark for a CPT at state/metro/ZIP3 granularity.\n\nWHEN TO USE: User wants to underst"},{"name":"specialty_price_benchmark","description":"[Taxonomy III.44 — baseline response (public data only)] Price benchmark for a CPT within a specific provider specialty.\n\nWHEN TO USE: User wants to understand "},{"name":"inflation_adjusted_price_model","description":"[Taxonomy III.46 — baseline response (public data only)] Inflation-adjusted price comparison across years for a CPT.\n\nWHEN TO USE: User has a historical dollar "},{"name":"deductible_impact_calculator","description":"[Taxonomy III.48 — baseline response (public data only)] Estimate how a planned service will draw against the member's deductible.\n\nWHEN TO USE: User wants to k"},{"name":"coinsurance_simulator","description":"[Taxonomy III.49 — baseline response (public data only)] Simulate member coinsurance exposure across plan-design variants.\n\nWHEN TO USE: User wants to model the"},{"name":"copay_model","description":"[Taxonomy III.50 — baseline response (public data only)] Model member copay for a service by plan-design class.\n\nWHEN TO USE: User wants the typical copay for a"},{"name":"billing_charge_vs_allowed_delta","description":"[Taxonomy III.51 — baseline response (public data only)] Delta between billed charge and payer-allowed amount for a claim line.\n\nWHEN TO USE: User wants to unde"},{"name":"price_anomaly_detector","description":"[Taxonomy III.52 — baseline response (public data only)] Detect service-line prices statistically anomalous versus market.\n\nWHEN TO USE: User wants to understan"},{"name":"overpriced_service_detector","description":"[Taxonomy III.53 — baseline response (public data only)] Flag services billed materially above market percentile thresholds.\n\nWHEN TO USE: User wants to underst"},{"name":"market_price_distribution_model","description":"[Taxonomy III.55 — baseline response (public data only)] Full DP-noised market price distribution for a CPT+region pair.\n\nWHEN TO USE: User wants to understand "},{"name":"price_outlier_detector","description":"[Taxonomy III.56 — baseline response (public data only)] Detect claim-line outliers relative to a learned market distribution.\n\nWHEN TO USE: User wants to under"},{"name":"procedure_cost_decomposition","description":"[Taxonomy III.57 — baseline response (public data only)] Decompose the cost of a procedure into component services + facility + professional fees.\n\nWHEN TO USE:"},{"name":"price_recommendation_engine","description":"[Taxonomy III.58 — baseline response (public data only)] Recommend a reasonable price to propose to a provider for a service (self-pay or negotiation).\n\nWHEN TO"},{"name":"claim_duplicate_line_detector","description":"[Taxonomy IV.75 — baseline response (public data only)] Detect duplicated service lines within a single claim.\n\nWHEN TO USE: Caller is building or validating a "},{"name":"denial_reason_classifier","description":"[Taxonomy VI.106 — baseline response (public data only)] Classify a denial letter or remittance advice into normalized denial-reason categories.\n\nWHEN TO USE: U"},{"name":"appeal_argument_generator","description":"[Taxonomy VII.120 — baseline response (public data only)] Generate component arguments for an appeal letter: medical-necessity, contract, policy.\n\nWHEN TO USE: "},{"name":"denial_response_builder","description":"[Taxonomy VII.121 — baseline response (public data only)] Build a denial-response package tailored to the denial reason code.\n\nWHEN TO USE: User has a denied cl"},{"name":"dispute_case_builder","description":"[Taxonomy VII.123 — baseline response (public data only)] Assemble a complete dispute case file including claim, denial, evidence, and timeline.\n\nWHEN TO USE: U"},{"name":"evidence_pack_generator","description":"[Taxonomy VII.124 — baseline response (public data only)] Generate an evidence package supporting a claim or appeal (references, studies, policies).\n\nWHEN TO US"},{"name":"claim_rebuttal_generator","description":"[Taxonomy VII.128 — baseline response (public data only)] Generate a rebuttal to a payer's denial rationale point-by-point.\n\nWHEN TO USE: User has a denied clai"},{"name":"appeal_escalation_path_finder","description":"[Taxonomy VII.129 — baseline response (public data only)] Find the correct escalation path for a denied claim (internal appeal → external review → DOI).\n\nWHEN T"},{"name":"payer_specific_appeal_templates","description":"[Taxonomy VII.130 — baseline response (public data only)] Return payer-specific appeal templates known to perform well.\n\nWHEN TO USE: User has a denied claim an"},{"name":"denial_code_explainer","description":"[Taxonomy VII.131 — baseline response (public data only)] Explain a CARC/RARC denial code in plain language with common causes.\n\nWHEN TO USE: User asks 'what do"},{"name":"claim_reconsideration_builder","description":"[Taxonomy VII.132 — baseline response (public data only)] Build a claim reconsideration request (lighter-weight than a formal appeal).\n\nWHEN TO USE: User has a "},{"name":"supporting_document_selector","description":"[Taxonomy VII.135 — baseline response (public data only)] Select optimal supporting documents for an appeal from an available document pool.\n\nWHEN TO USE: User "},{"name":"out_of_pocket_optimizer","description":"[Taxonomy X.174 — baseline response (public data only)] Optimize out-of-pocket spend across a sequence of planned services.\n\nWHEN TO USE: User is planning for a"},{"name":"financial_exposure_model","description":"[Taxonomy X.176 — delegates to financial_risk_exposure_model] Model a member's financial exposure. Alias of financial_risk_exposure_model.\n\nWHEN TO USE: User is"},{"name":"procedure_affordability_ranker","description":"[Taxonomy X.177 — baseline response (public data only)] Rank a set of procedures by affordability for a given member.\n\nWHEN TO USE: User is planning for a medic"},{"name":"treatment_cost_comparator","description":"[Taxonomy X.178 — baseline response (public data only)] Compare expected costs across treatment alternatives for a condition.\n\nWHEN TO USE: User is planning for"},{"name":"bill_shock_predictor","description":"[Taxonomy X.179 — baseline response (public data only)] Predict risk that a planned service will trigger an unexpected large bill.\n\nWHEN TO USE: User planning a"},{"name":"payment_plan_optimizer","description":"[Taxonomy X.180 — baseline response (public data only)] Optimize a payment plan structure for a patient balance.\n\nWHEN TO USE: User has a balance and wants to s"},{"name":"financial_assistance_finder","description":"[Taxonomy X.181 — baseline response (public data only)] Find applicable financial-assistance programs (hospital charity, 340B, state, pharma).\n\nWHEN TO USE: Use"},{"name":"patient_cost_explainer","description":"[Taxonomy X.182 — baseline response (public data only)] Explain why a specific charge appears on a bill in plain language.\n\nWHEN TO USE: User is planning for a "},{"name":"healthcare_budget_forecaster","description":"[Taxonomy X.183 — baseline response (public data only)] Forecast a household's annual healthcare spend based on plan + utilization.\n\nWHEN TO USE: User planning "},{"name":"medical_spending_analyzer","description":"[Taxonomy X.184 — baseline response (public data only)] Analyze a patient's medical spending over a period and surface optimization opportunities.\n\nWHEN TO USE:"},{"name":"insurance_value_optimizer","description":"[Taxonomy X.185 — baseline response (public data only)] Recommend insurance-plan selections to maximize value given projected utilization.\n\nWHEN TO USE: User is"},{"name":"patient_financial_risk_score","description":"[Taxonomy X.186 — baseline response (public data only)] Score a patient's financial risk exposure from planned or ongoing care.\n\nWHEN TO USE: User is planning f"},{"name":"decode_denial","description":"Decode a CARC (Claim Adjustment Reason Code) denial code into plain English. Returns meaning, category, whether it's typically reversible on appeal, and appeal "},{"name":"get_appeal_deadline","description":"External-review filing deadline for a state + the date of the FINAL adverse determination. Returns the deadline date, the statutory window label + citation, and"},{"name":"get_venue","description":"Where and how to file an external review for a given state — the venue name, filing channel (portal/mail/fax), portal URL, and whether expedited review is avail"},{"name":"medigami_odds","description":"Historical external-review overturn rate published by the state regulator for the insurer you name, in a regulated venue (CA/NY/MD/NJ/MI/OH/NC). Returns one ins"},{"name":"medigami_roast","description":"Compare a billed charge against a hospital's own MRF-published negotiated rate for a CPT code; returns the markup multiple. Public regulator data, k-anonymity f"},{"name":"medigami_deadline","description":"Federal appeal-deadline window (ERISA §503 internal-appeal / ACA §2719 external-review / NSA IDR) for a plan type. Public regulator data, k-anonymity floored, n"},{"name":"medigami_rate","description":"A hospital's own MRF-published negotiated rate for a CPT code (no billed-amount comparison — use medigami_roast for that). Public regulator data, k-anonymity fl"}],"toolCount":87,"toolsHash":"c7d83d3598bc9743ce42bdba887f50436a00b4a82ff6989e4da5034fecd0402d","serverName":"medigami-public","capabilities":["experimental","resources","tools"],"serverVersion":"1.28.1","protocolVersion":"2025-06-18"}},{"at":"2026-10-09T16:33:19.775Z","kind":"mcp_initialize","ok":true,"httpStatus":200,"latencyMs":186,"error":null,"detail":{"tools":[{"name":"scan_bill_for_errors","description":"Scan a medical bill or EOB text for errors: duplicate charges, CPT unbundling, upcoding, facility-fee overcharges. Returns flagged anomalies with estimated doll"},{"name":"generate_appeal_letter","description":"Generate a legally-grounded insurance appeal letter for a denied claim. Returns the letter as a template with [PATIENT NAME] and [PROVIDER NAME] placeholders (s"},{"name":"optimize_prescription","description":"Find the lowest-cost path for a prescription: generics, biosimilars, GoodRx coupons, manufacturer assistance, 90-day fills, and mail-order vs retail comparison."},{"name":"analyze_glp1_pathways","description":"Find all access pathways for a GLP-1 drug (Ozempic, Wegovy, Mounjaro, Zepbound) given patient eligibility factors. Ranks pathways by monthly cost, flags prior-a"},{"name":"verify_attestation","description":"Verify an Ed25519-signed Medigami MCP response envelope — confirm a medical-bill / appeal / denial / rate answer came from Medigami and hasn't been tampered wit"},{"name":"watch_appeal_outcome","description":"Subscribe to an appeal outcome by tracking_id. Blocks up to `timeout_seconds` (default 300). Returns the outcome payload as soon as it's recorded, or {status: '"},{"name":"watch_claim_denial","description":"Subscribe to a claim denial event for a given scan_id. Blocks up to `timeout_seconds`. Returns {status: 'denied', ...} as soon as the payer marks the claim deni"},{"name":"format_citation","description":"Format an LLM-citable reference to a previously-attested Medigami MCP response. Input: either the full signed envelope that an earlier attested tool returned, O"},{"name":"submit_denial_letter","description":"Submit a medical-claim denial letter to the Medigami Denial Common Crawl (public aggregate dataset). Consent-gated — caller must pass consent=true to attest the"},{"name":"verify_mcp_response","description":"DEPRECATED ALIAS of verify_attestation — kept for backward compatibility with v0.1.7 clients. New code should call verify_attestation directly.\n\nWHEN TO USE: Re"},{"name":"format_medigami_citation","description":"DEPRECATED ALIAS of format_citation — kept for backward compatibility with v0.1.7 clients. New code should call format_citation directly.\n\nWHEN TO USE: Referenc"},{"name":"estimate_appeal_success","description":"Probability an appeal will be approved, derived from outcome-labeled data weighted by label provenance (IRO determinations, EOB reversals, physician confirmatio"},{"name":"resolve_denial","description":"End-to-end denial resolution: returns appeal probability + confidence interval + a drafted letter template grounded in aggregate outcome data + plan-context fla"},{"name":"maximize_recovery","description":"Given a prior scan_id, returns a prioritized action list: anomalies ranked by (expected overcharge x recovery probability), with the next steps to pursue each. "},{"name":"explain_appeal_success","description":"Human-readable rationale for an appeal probability. Returns {probability, tier, recommended_posture, rationale, expected_days_to_resolution, tracking_id} ground"},{"name":"negotiate_bill_script","description":"Generate a phone script the user can read when negotiating a medical bill directly with the provider. Combines DP-noised commercial rate benchmarks + the caller"},{"name":"batch_scan_bills","description":"Scan multiple medical bills in one call. Returns per-bill anomaly lists + total recovery estimate across the batch. Input is a list of {bill_text, provider?, in"},{"name":"lookup_icd10","description":"Look up an ICD-10-CM diagnosis code or search by keyword. Input is either an exact code (e.g. 'E11.21') or a free-text description phrase ('type 2 diabetes with"},{"name":"lookup_cpt","description":"Look up a CPT or HCPCS-J code or search by keyword. Covers the most common outpatient billing codes (E/M, preventive, lab, imaging, procedure, cardiology, thera"},{"name":"lookup_npi","description":"Look up a provider in the CMS NPPES National Provider Identifier registry. Accepts a 10-digit NPI number OR a provider name (optionally narrowed by 2-char state"},{"name":"verify_dea_authorization","description":"Validate the format + checksum of a DEA registration number (format: [A-Z][A-Z9][0-9]{7}; public checksum algorithm). Useful as a sanity check on a DEA number y"},{"name":"lookup_provider_taxonomy","description":"Look up a NUCC provider taxonomy code (the specialty codes used on HIPAA transactions + NPI registrations) or search by keyword. Returns classification + type +"},{"name":"resolve_codes","description":"[Taxonomy A.1 — baseline response (public data only)] Unified code resolver — free-form query or clinical description → ranked ICD-10-CM, CPT, and HCPCS codes w"},{"name":"code_conflict_detector","description":"[Taxonomy A.5 — delegates to scan_bill_for_errors] Detect CPT unbundling, mutually exclusive code pairs, and NCCI edit violations in a set of codes. Implemented"},{"name":"fair_price_estimator","description":"[Taxonomy B.8 — delegates to benchmark_payer_rate] Fair-market price distribution for a service: DP-noised percentiles (p10, p25, p50, p75, p90) for the given C"},{"name":"price_variance_analyzer","description":"[Taxonomy B.9 — baseline response (public data only)] Given a target price and a CPT+region, return how many standard deviations above/below the market the targ"},{"name":"claim_consistency_checker","description":"[Taxonomy C.14 — delegates to scan_bill_for_errors] Detect internal contradictions in a claim: time mismatches, mutually exclusive codes, missing required field"},{"name":"bundling_violation_detector","description":"[Taxonomy C.16 — delegates to scan_bill_for_errors] Detect CPT unbundling (billing components of a procedure separately to inflate the claim). Uses the CMS NCCI"},{"name":"appeal_success_predictor","description":"[Taxonomy E.25 — delegates to estimate_appeal_success] Given a denial, predict the probability of a successful appeal. Returns probability with 95% CI, sample s"},{"name":"generate_appeal_letter_v2","description":"[Taxonomy F.28 — delegates to generate_appeal_letter] [Taxonomy alias] Generate a state-specific insurance appeal letter with UPL-safe disclaimers for 19 US sta"},{"name":"negotiation_strategy_generator","description":"[Taxonomy F.30 — baseline response (public data only)] Given a bill + patient situation, generate a ranked negotiation strategy: hardship appeal, charity-care a"},{"name":"insurance_response_interpreter","description":"[Taxonomy F.31 — baseline response (public data only)] Parse an insurer's response letter or EOB into structured fields: denial reason codes, appeal rights, dea"},{"name":"settlement_optimizer","description":"[Taxonomy F.32 — baseline response (public data only)] For a disputed bill, compute the optimal settlement target price balancing probability of acceptance agai"},{"name":"patient_cost_forecaster","description":"[Taxonomy H.38 — baseline response (public data only)] Given a patient's plan + predicted care needs, forecast annual out-of-pocket spend across expected claims"},{"name":"insurance_plan_optimizer","description":"[Taxonomy H.39 — baseline response (public data only)] Given a patient's historical claim patterns, rank available insurance plans by expected annual cost.\n\nWHE"},{"name":"cash_vs_insurance_optimizer","description":"[Taxonomy H.41 — baseline response (public data only)] For a given service + patient plan, determine whether cash-pay + charity-care beats insurance billing.\n\nW"},{"name":"financial_risk_exposure_model","description":"[Taxonomy H.42 — baseline response (public data only)] Quantify a patient's financial exposure to medical-debt risk given current plan, health status, and histo"},{"name":"cpt_to_icd_mapper","description":"[Taxonomy II.21 — baseline response (public data only)] For a given CPT, surface the ICD-10 codes typically paired with it for medical-necessity support.\n\nWHEN "},{"name":"icd_to_cpt_mapper","description":"[Taxonomy II.22 — baseline response (public data only)] For a given ICD-10, surface the CPT codes typically billed for that diagnosis.\n\nWHEN TO USE: User has an"},{"name":"code_bundle_validator","description":"[Taxonomy II.25 — baseline response (public data only)] Check a set of CPT codes against NCCI bundling rules (distinct from modifier-based unbundling).\n\nWHEN TO"},{"name":"unbundling_detector","description":"[Taxonomy II.26 — delegates to scan_bill_for_errors] Detect CPT unbundling patterns in a claim. Alias of scan_bill_for_errors.\n\nWHEN TO USE: User asks about med"},{"name":"cash_price_estimator","description":"[Taxonomy III.39 — baseline response (public data only)] Estimate a fair cash price for a service in a given region (no-insurance path).\n\nWHEN TO USE: Uninsured"},{"name":"zip_based_price_variance","description":"[Taxonomy III.41 — baseline response (public data only)] Report price variance for a CPT across ZIP3 regions with DP noise.\n\nWHEN TO USE: User wants to understa"},{"name":"regional_price_benchmark","description":"[Taxonomy III.43 — baseline response (public data only)] Regional price benchmark for a CPT at state/metro/ZIP3 granularity.\n\nWHEN TO USE: User wants to underst"},{"name":"specialty_price_benchmark","description":"[Taxonomy III.44 — baseline response (public data only)] Price benchmark for a CPT within a specific provider specialty.\n\nWHEN TO USE: User wants to understand "},{"name":"inflation_adjusted_price_model","description":"[Taxonomy III.46 — baseline response (public data only)] Inflation-adjusted price comparison across years for a CPT.\n\nWHEN TO USE: User has a historical dollar "},{"name":"deductible_impact_calculator","description":"[Taxonomy III.48 — baseline response (public data only)] Estimate how a planned service will draw against the member's deductible.\n\nWHEN TO USE: User wants to k"},{"name":"coinsurance_simulator","description":"[Taxonomy III.49 — baseline response (public data only)] Simulate member coinsurance exposure across plan-design variants.\n\nWHEN TO USE: User wants to model the"},{"name":"copay_model","description":"[Taxonomy III.50 — baseline response (public data only)] Model member copay for a service by plan-design class.\n\nWHEN TO USE: User wants the typical copay for a"},{"name":"billing_charge_vs_allowed_delta","description":"[Taxonomy III.51 — baseline response (public data only)] Delta between billed charge and payer-allowed amount for a claim line.\n\nWHEN TO USE: User wants to unde"},{"name":"price_anomaly_detector","description":"[Taxonomy III.52 — baseline response (public data only)] Detect service-line prices statistically anomalous versus market.\n\nWHEN TO USE: User wants to understan"},{"name":"overpriced_service_detector","description":"[Taxonomy III.53 — baseline response (public data only)] Flag services billed materially above market percentile thresholds.\n\nWHEN TO USE: User wants to underst"},{"name":"market_price_distribution_model","description":"[Taxonomy III.55 — baseline response (public data only)] Full DP-noised market price distribution for a CPT+region pair.\n\nWHEN TO USE: User wants to understand "},{"name":"price_outlier_detector","description":"[Taxonomy III.56 — baseline response (public data only)] Detect claim-line outliers relative to a learned market distribution.\n\nWHEN TO USE: User wants to under"},{"name":"procedure_cost_decomposition","description":"[Taxonomy III.57 — baseline response (public data only)] Decompose the cost of a procedure into component services + facility + professional fees.\n\nWHEN TO USE:"},{"name":"price_recommendation_engine","description":"[Taxonomy III.58 — baseline response (public data only)] Recommend a reasonable price to propose to a provider for a service (self-pay or negotiation).\n\nWHEN TO"},{"name":"claim_duplicate_line_detector","description":"[Taxonomy IV.75 — baseline response (public data only)] Detect duplicated service lines within a single claim.\n\nWHEN TO USE: Caller is building or validating a "},{"name":"denial_reason_classifier","description":"[Taxonomy VI.106 — baseline response (public data only)] Classify a denial letter or remittance advice into normalized denial-reason categories.\n\nWHEN TO USE: U"},{"name":"appeal_argument_generator","description":"[Taxonomy VII.120 — baseline response (public data only)] Generate component arguments for an appeal letter: medical-necessity, contract, policy.\n\nWHEN TO USE: "},{"name":"denial_response_builder","description":"[Taxonomy VII.121 — baseline response (public data only)] Build a denial-response package tailored to the denial reason code.\n\nWHEN TO USE: User has a denied cl"},{"name":"dispute_case_builder","description":"[Taxonomy VII.123 — baseline response (public data only)] Assemble a complete dispute case file including claim, denial, evidence, and timeline.\n\nWHEN TO USE: U"},{"name":"evidence_pack_generator","description":"[Taxonomy VII.124 — baseline response (public data only)] Generate an evidence package supporting a claim or appeal (references, studies, policies).\n\nWHEN TO US"},{"name":"claim_rebuttal_generator","description":"[Taxonomy VII.128 — baseline response (public data only)] Generate a rebuttal to a payer's denial rationale point-by-point.\n\nWHEN TO USE: User has a denied clai"},{"name":"appeal_escalation_path_finder","description":"[Taxonomy VII.129 — baseline response (public data only)] Find the correct escalation path for a denied claim (internal appeal → external review → DOI).\n\nWHEN T"},{"name":"payer_specific_appeal_templates","description":"[Taxonomy VII.130 — baseline response (public data only)] Return payer-specific appeal templates known to perform well.\n\nWHEN TO USE: User has a denied claim an"},{"name":"denial_code_explainer","description":"[Taxonomy VII.131 — baseline response (public data only)] Explain a CARC/RARC denial code in plain language with common causes.\n\nWHEN TO USE: User asks 'what do"},{"name":"claim_reconsideration_builder","description":"[Taxonomy VII.132 — baseline response (public data only)] Build a claim reconsideration request (lighter-weight than a formal appeal).\n\nWHEN TO USE: User has a "},{"name":"supporting_document_selector","description":"[Taxonomy VII.135 — baseline response (public data only)] Select optimal supporting documents for an appeal from an available document pool.\n\nWHEN TO USE: User "},{"name":"out_of_pocket_optimizer","description":"[Taxonomy X.174 — baseline response (public data only)] Optimize out-of-pocket spend across a sequence of planned services.\n\nWHEN TO USE: User is planning for a"},{"name":"financial_exposure_model","description":"[Taxonomy X.176 — delegates to financial_risk_exposure_model] Model a member's financial exposure. Alias of financial_risk_exposure_model.\n\nWHEN TO USE: User is"},{"name":"procedure_affordability_ranker","description":"[Taxonomy X.177 — baseline response (public data only)] Rank a set of procedures by affordability for a given member.\n\nWHEN TO USE: User is planning for a medic"},{"name":"treatment_cost_comparator","description":"[Taxonomy X.178 — baseline response (public data only)] Compare expected costs across treatment alternatives for a condition.\n\nWHEN TO USE: User is planning for"},{"name":"bill_shock_predictor","description":"[Taxonomy X.179 — baseline response (public data only)] Predict risk that a planned service will trigger an unexpected large bill.\n\nWHEN TO USE: User planning a"},{"name":"payment_plan_optimizer","description":"[Taxonomy X.180 — baseline response (public data only)] Optimize a payment plan structure for a patient balance.\n\nWHEN TO USE: User has a balance and wants to s"},{"name":"financial_assistance_finder","description":"[Taxonomy X.181 — baseline response (public data only)] Find applicable financial-assistance programs (hospital charity, 340B, state, pharma).\n\nWHEN TO USE: Use"},{"name":"patient_cost_explainer","description":"[Taxonomy X.182 — baseline response (public data only)] Explain why a specific charge appears on a bill in plain language.\n\nWHEN TO USE: User is planning for a "},{"name":"healthcare_budget_forecaster","description":"[Taxonomy X.183 — baseline response (public data only)] Forecast a household's annual healthcare spend based on plan + utilization.\n\nWHEN TO USE: User planning "},{"name":"medical_spending_analyzer","description":"[Taxonomy X.184 — baseline response (public data only)] Analyze a patient's medical spending over a period and surface optimization opportunities.\n\nWHEN TO USE:"},{"name":"insurance_value_optimizer","description":"[Taxonomy X.185 — baseline response (public data only)] Recommend insurance-plan selections to maximize value given projected utilization.\n\nWHEN TO USE: User is"},{"name":"patient_financial_risk_score","description":"[Taxonomy X.186 — baseline response (public data only)] Score a patient's financial risk exposure from planned or ongoing care.\n\nWHEN TO USE: User is planning f"},{"name":"decode_denial","description":"Decode a CARC (Claim Adjustment Reason Code) denial code into plain English. Returns meaning, category, whether it's typically reversible on appeal, and appeal "},{"name":"get_appeal_deadline","description":"External-review filing deadline for a state + the date of the FINAL adverse determination. Returns the deadline date, the statutory window label + citation, and"},{"name":"get_venue","description":"Where and how to file an external review for a given state — the venue name, filing channel (portal/mail/fax), portal URL, and whether expedited review is avail"},{"name":"medigami_odds","description":"Historical external-review overturn rate published by the state regulator for the insurer you name, in a regulated venue (CA/NY/MD/NJ/MI/OH/NC). Returns one ins"},{"name":"medigami_roast","description":"Compare a billed charge against a hospital's own MRF-published negotiated rate for a CPT code; returns the markup multiple. Public regulator data, k-anonymity f"},{"name":"medigami_deadline","description":"Federal appeal-deadline window (ERISA §503 internal-appeal / ACA §2719 external-review / NSA IDR) for a plan type. Public regulator data, k-anonymity floored, n"},{"name":"medigami_rate","description":"A hospital's own MRF-published negotiated rate for a CPT code (no billed-amount comparison — use medigami_roast for that). Public regulator data, k-anonymity fl"}],"toolCount":87,"toolsHash":"c7d83d3598bc9743ce42bdba887f50436a00b4a82ff6989e4da5034fecd0402d","serverName":"medigami-public","capabilities":["experimental","resources","tools"],"serverVersion":"1.28.1","protocolVersion":"2025-06-18"}},{"at":"2026-10-09T10:23:03.494Z","kind":"mcp_initialize","ok":true,"httpStatus":200,"latencyMs":194,"error":null,"detail":{"tools":[{"name":"scan_bill_for_errors","description":"Scan a medical bill or EOB text for errors: duplicate charges, CPT unbundling, upcoding, facility-fee overcharges. Returns flagged anomalies with estimated doll"},{"name":"generate_appeal_letter","description":"Generate a legally-grounded insurance appeal letter for a denied claim. Returns the letter as a template with [PATIENT NAME] and [PROVIDER NAME] placeholders (s"},{"name":"optimize_prescription","description":"Find the lowest-cost path for a prescription: generics, biosimilars, GoodRx coupons, manufacturer assistance, 90-day fills, and mail-order vs retail comparison."},{"name":"analyze_glp1_pathways","description":"Find all access pathways for a GLP-1 drug (Ozempic, Wegovy, Mounjaro, Zepbound) given patient eligibility factors. Ranks pathways by monthly cost, flags prior-a"},{"name":"verify_attestation","description":"Verify an Ed25519-signed Medigami MCP response envelope — confirm a medical-bill / appeal / denial / rate answer came from Medigami and hasn't been tampered wit"},{"name":"watch_appeal_outcome","description":"Subscribe to an appeal outcome by tracking_id. Blocks up to `timeout_seconds` (default 300). Returns the outcome payload as soon as it's recorded, or {status: '"},{"name":"watch_claim_denial","description":"Subscribe to a claim denial event for a given scan_id. Blocks up to `timeout_seconds`. Returns {status: 'denied', ...} as soon as the payer marks the claim deni"},{"name":"format_citation","description":"Format an LLM-citable reference to a previously-attested Medigami MCP response. Input: either the full signed envelope that an earlier attested tool returned, O"},{"name":"submit_denial_letter","description":"Submit a medical-claim denial letter to the Medigami Denial Common Crawl (public aggregate dataset). Consent-gated — caller must pass consent=true to attest the"},{"name":"verify_mcp_response","description":"DEPRECATED ALIAS of verify_attestation — kept for backward compatibility with v0.1.7 clients. New code should call verify_attestation directly.\n\nWHEN TO USE: Re"},{"name":"format_medigami_citation","description":"DEPRECATED ALIAS of format_citation — kept for backward compatibility with v0.1.7 clients. New code should call format_citation directly.\n\nWHEN TO USE: Referenc"},{"name":"estimate_appeal_success","description":"Probability an appeal will be approved, derived from outcome-labeled data weighted by label provenance (IRO determinations, EOB reversals, physician confirmatio"},{"name":"resolve_denial","description":"End-to-end denial resolution: returns appeal probability + confidence interval + a drafted letter template grounded in aggregate outcome data + plan-context fla"},{"name":"maximize_recovery","description":"Given a prior scan_id, returns a prioritized action list: anomalies ranked by (expected overcharge x recovery probability), with the next steps to pursue each. "},{"name":"explain_appeal_success","description":"Human-readable rationale for an appeal probability. Returns {probability, tier, recommended_posture, rationale, expected_days_to_resolution, tracking_id} ground"},{"name":"negotiate_bill_script","description":"Generate a phone script the user can read when negotiating a medical bill directly with the provider. Combines DP-noised commercial rate benchmarks + the caller"},{"name":"batch_scan_bills","description":"Scan multiple medical bills in one call. Returns per-bill anomaly lists + total recovery estimate across the batch. Input is a list of {bill_text, provider?, in"},{"name":"lookup_icd10","description":"Look up an ICD-10-CM diagnosis code or search by keyword. Input is either an exact code (e.g. 'E11.21') or a free-text description phrase ('type 2 diabetes with"},{"name":"lookup_cpt","description":"Look up a CPT or HCPCS-J code or search by keyword. Covers the most common outpatient billing codes (E/M, preventive, lab, imaging, procedure, cardiology, thera"},{"name":"lookup_npi","description":"Look up a provider in the CMS NPPES National Provider Identifier registry. Accepts a 10-digit NPI number OR a provider name (optionally narrowed by 2-char state"},{"name":"verify_dea_authorization","description":"Validate the format + checksum of a DEA registration number (format: [A-Z][A-Z9][0-9]{7}; public checksum algorithm). Useful as a sanity check on a DEA number y"},{"name":"lookup_provider_taxonomy","description":"Look up a NUCC provider taxonomy code (the specialty codes used on HIPAA transactions + NPI registrations) or search by keyword. Returns classification + type +"},{"name":"resolve_codes","description":"[Taxonomy A.1 — baseline response (public data only)] Unified code resolver — free-form query or clinical description → ranked ICD-10-CM, CPT, and HCPCS codes w"},{"name":"code_conflict_detector","description":"[Taxonomy A.5 — delegates to scan_bill_for_errors] Detect CPT unbundling, mutually exclusive code pairs, and NCCI edit violations in a set of codes. Implemented"},{"name":"fair_price_estimator","description":"[Taxonomy B.8 — delegates to benchmark_payer_rate] Fair-market price distribution for a service: DP-noised percentiles (p10, p25, p50, p75, p90) for the given C"},{"name":"price_variance_analyzer","description":"[Taxonomy B.9 — baseline response (public data only)] Given a target price and a CPT+region, return how many standard deviations above/below the market the targ"},{"name":"claim_consistency_checker","description":"[Taxonomy C.14 — delegates to scan_bill_for_errors] Detect internal contradictions in a claim: time mismatches, mutually exclusive codes, missing required field"},{"name":"bundling_violation_detector","description":"[Taxonomy C.16 — delegates to scan_bill_for_errors] Detect CPT unbundling (billing components of a procedure separately to inflate the claim). Uses the CMS NCCI"},{"name":"appeal_success_predictor","description":"[Taxonomy E.25 — delegates to estimate_appeal_success] Given a denial, predict the probability of a successful appeal. Returns probability with 95% CI, sample s"},{"name":"generate_appeal_letter_v2","description":"[Taxonomy F.28 — delegates to generate_appeal_letter] [Taxonomy alias] Generate a state-specific insurance appeal letter with UPL-safe disclaimers for 19 US sta"},{"name":"negotiation_strategy_generator","description":"[Taxonomy F.30 — baseline response (public data only)] Given a bill + patient situation, generate a ranked negotiation strategy: hardship appeal, charity-care a"},{"name":"insurance_response_interpreter","description":"[Taxonomy F.31 — baseline response (public data only)] Parse an insurer's response letter or EOB into structured fields: denial reason codes, appeal rights, dea"},{"name":"settlement_optimizer","description":"[Taxonomy F.32 — baseline response (public data only)] For a disputed bill, compute the optimal settlement target price balancing probability of acceptance agai"},{"name":"patient_cost_forecaster","description":"[Taxonomy H.38 — baseline response (public data only)] Given a patient's plan + predicted care needs, forecast annual out-of-pocket spend across expected claims"},{"name":"insurance_plan_optimizer","description":"[Taxonomy H.39 — baseline response (public data only)] Given a patient's historical claim patterns, rank available insurance plans by expected annual cost.\n\nWHE"},{"name":"cash_vs_insurance_optimizer","description":"[Taxonomy H.41 — baseline response (public data only)] For a given service + patient plan, determine whether cash-pay + charity-care beats insurance billing.\n\nW"},{"name":"financial_risk_exposure_model","description":"[Taxonomy H.42 — baseline response (public data only)] Quantify a patient's financial exposure to medical-debt risk given current plan, health status, and histo"},{"name":"cpt_to_icd_mapper","description":"[Taxonomy II.21 — baseline response (public data only)] For a given CPT, surface the ICD-10 codes typically paired with it for medical-necessity support.\n\nWHEN "},{"name":"icd_to_cpt_mapper","description":"[Taxonomy II.22 — baseline response (public data only)] For a given ICD-10, surface the CPT codes typically billed for that diagnosis.\n\nWHEN TO USE: User has an"},{"name":"code_bundle_validator","description":"[Taxonomy II.25 — baseline response (public data only)] Check a set of CPT codes against NCCI bundling rules (distinct from modifier-based unbundling).\n\nWHEN TO"},{"name":"unbundling_detector","description":"[Taxonomy II.26 — delegates to scan_bill_for_errors] Detect CPT unbundling patterns in a claim. Alias of scan_bill_for_errors.\n\nWHEN TO USE: User asks about med"},{"name":"cash_price_estimator","description":"[Taxonomy III.39 — baseline response (public data only)] Estimate a fair cash price for a service in a given region (no-insurance path).\n\nWHEN TO USE: Uninsured"},{"name":"zip_based_price_variance","description":"[Taxonomy III.41 — baseline response (public data only)] Report price variance for a CPT across ZIP3 regions with DP noise.\n\nWHEN TO USE: User wants to understa"},{"name":"regional_price_benchmark","description":"[Taxonomy III.43 — baseline response (public data only)] Regional price benchmark for a CPT at state/metro/ZIP3 granularity.\n\nWHEN TO USE: User wants to underst"},{"name":"specialty_price_benchmark","description":"[Taxonomy III.44 — baseline response (public data only)] Price benchmark for a CPT within a specific provider specialty.\n\nWHEN TO USE: User wants to understand "},{"name":"inflation_adjusted_price_model","description":"[Taxonomy III.46 — baseline response (public data only)] Inflation-adjusted price comparison across years for a CPT.\n\nWHEN TO USE: User has a historical dollar "},{"name":"deductible_impact_calculator","description":"[Taxonomy III.48 — baseline response (public data only)] Estimate how a planned service will draw against the member's deductible.\n\nWHEN TO USE: User wants to k"},{"name":"coinsurance_simulator","description":"[Taxonomy III.49 — baseline response (public data only)] Simulate member coinsurance exposure across plan-design variants.\n\nWHEN TO USE: User wants to model the"},{"name":"copay_model","description":"[Taxonomy III.50 — baseline response (public data only)] Model member copay for a service by plan-design class.\n\nWHEN TO USE: User wants the typical copay for a"},{"name":"billing_charge_vs_allowed_delta","description":"[Taxonomy III.51 — baseline response (public data only)] Delta between billed charge and payer-allowed amount for a claim line.\n\nWHEN TO USE: User wants to unde"},{"name":"price_anomaly_detector","description":"[Taxonomy III.52 — baseline response (public data only)] Detect service-line prices statistically anomalous versus market.\n\nWHEN TO USE: User wants to understan"},{"name":"overpriced_service_detector","description":"[Taxonomy III.53 — baseline response (public data only)] Flag services billed materially above market percentile thresholds.\n\nWHEN TO USE: User wants to underst"},{"name":"market_price_distribution_model","description":"[Taxonomy III.55 — baseline response (public data only)] Full DP-noised market price distribution for a CPT+region pair.\n\nWHEN TO USE: User wants to understand "},{"name":"price_outlier_detector","description":"[Taxonomy III.56 — baseline response (public data only)] Detect claim-line outliers relative to a learned market distribution.\n\nWHEN TO USE: User wants to under"},{"name":"procedure_cost_decomposition","description":"[Taxonomy III.57 — baseline response (public data only)] Decompose the cost of a procedure into component services + facility + professional fees.\n\nWHEN TO USE:"},{"name":"price_recommendation_engine","description":"[Taxonomy III.58 — baseline response (public data only)] Recommend a reasonable price to propose to a provider for a service (self-pay or negotiation).\n\nWHEN TO"},{"name":"claim_duplicate_line_detector","description":"[Taxonomy IV.75 — baseline response (public data only)] Detect duplicated service lines within a single claim.\n\nWHEN TO USE: Caller is building or validating a "},{"name":"denial_reason_classifier","description":"[Taxonomy VI.106 — baseline response (public data only)] Classify a denial letter or remittance advice into normalized denial-reason categories.\n\nWHEN TO USE: U"},{"name":"appeal_argument_generator","description":"[Taxonomy VII.120 — baseline response (public data only)] Generate component arguments for an appeal letter: medical-necessity, contract, policy.\n\nWHEN TO USE: "},{"name":"denial_response_builder","description":"[Taxonomy VII.121 — baseline response (public data only)] Build a denial-response package tailored to the denial reason code.\n\nWHEN TO USE: User has a denied cl"},{"name":"dispute_case_builder","description":"[Taxonomy VII.123 — baseline response (public data only)] Assemble a complete dispute case file including claim, denial, evidence, and timeline.\n\nWHEN TO USE: U"},{"name":"evidence_pack_generator","description":"[Taxonomy VII.124 — baseline response (public data only)] Generate an evidence package supporting a claim or appeal (references, studies, policies).\n\nWHEN TO US"},{"name":"claim_rebuttal_generator","description":"[Taxonomy VII.128 — baseline response (public data only)] Generate a rebuttal to a payer's denial rationale point-by-point.\n\nWHEN TO USE: User has a denied clai"},{"name":"appeal_escalation_path_finder","description":"[Taxonomy VII.129 — baseline response (public data only)] Find the correct escalation path for a denied claim (internal appeal → external review → DOI).\n\nWHEN T"},{"name":"payer_specific_appeal_templates","description":"[Taxonomy VII.130 — baseline response (public data only)] Return payer-specific appeal templates known to perform well.\n\nWHEN TO USE: User has a denied claim an"},{"name":"denial_code_explainer","description":"[Taxonomy VII.131 — baseline response (public data only)] Explain a CARC/RARC denial code in plain language with common causes.\n\nWHEN TO USE: User asks 'what do"},{"name":"claim_reconsideration_builder","description":"[Taxonomy VII.132 — baseline response (public data only)] Build a claim reconsideration request (lighter-weight than a formal appeal).\n\nWHEN TO USE: User has a "},{"name":"supporting_document_selector","description":"[Taxonomy VII.135 — baseline response (public data only)] Select optimal supporting documents for an appeal from an available document pool.\n\nWHEN TO USE: User "},{"name":"out_of_pocket_optimizer","description":"[Taxonomy X.174 — baseline response (public data only)] Optimize out-of-pocket spend across a sequence of planned services.\n\nWHEN TO USE: User is planning for a"},{"name":"financial_exposure_model","description":"[Taxonomy X.176 — delegates to financial_risk_exposure_model] Model a member's financial exposure. Alias of financial_risk_exposure_model.\n\nWHEN TO USE: User is"},{"name":"procedure_affordability_ranker","description":"[Taxonomy X.177 — baseline response (public data only)] Rank a set of procedures by affordability for a given member.\n\nWHEN TO USE: User is planning for a medic"},{"name":"treatment_cost_comparator","description":"[Taxonomy X.178 — baseline response (public data only)] Compare expected costs across treatment alternatives for a condition.\n\nWHEN TO USE: User is planning for"},{"name":"bill_shock_predictor","description":"[Taxonomy X.179 — baseline response (public data only)] Predict risk that a planned service will trigger an unexpected large bill.\n\nWHEN TO USE: User planning a"},{"name":"payment_plan_optimizer","description":"[Taxonomy X.180 — baseline response (public data only)] Optimize a payment plan structure for a patient balance.\n\nWHEN TO USE: User has a balance and wants to s"},{"name":"financial_assistance_finder","description":"[Taxonomy X.181 — baseline response (public data only)] Find applicable financial-assistance programs (hospital charity, 340B, state, pharma).\n\nWHEN TO USE: Use"},{"name":"patient_cost_explainer","description":"[Taxonomy X.182 — baseline response (public data only)] Explain why a specific charge appears on a bill in plain language.\n\nWHEN TO USE: User is planning for a "},{"name":"healthcare_budget_forecaster","description":"[Taxonomy X.183 — baseline response (public data only)] Forecast a household's annual healthcare spend based on plan + utilization.\n\nWHEN TO USE: User planning "},{"name":"medical_spending_analyzer","description":"[Taxonomy X.184 — baseline response (public data only)] Analyze a patient's medical spending over a period and surface optimization opportunities.\n\nWHEN TO USE:"},{"name":"insurance_value_optimizer","description":"[Taxonomy X.185 — baseline response (public data only)] Recommend insurance-plan selections to maximize value given projected utilization.\n\nWHEN TO USE: User is"},{"name":"patient_financial_risk_score","description":"[Taxonomy X.186 — baseline response (public data only)] Score a patient's financial risk exposure from planned or ongoing care.\n\nWHEN TO USE: User is planning f"},{"name":"decode_denial","description":"Decode a CARC (Claim Adjustment Reason Code) denial code into plain English. Returns meaning, category, whether it's typically reversible on appeal, and appeal "},{"name":"get_appeal_deadline","description":"External-review filing deadline for a state + the date of the FINAL adverse determination. Returns the deadline date, the statutory window label + citation, and"},{"name":"get_venue","description":"Where and how to file an external review for a given state — the venue name, filing channel (portal/mail/fax), portal URL, and whether expedited review is avail"},{"name":"medigami_odds","description":"Historical external-review overturn rate published by the state regulator for the insurer you name, in a regulated venue (CA/NY/MD/NJ/MI/OH/NC). Returns one ins"},{"name":"medigami_roast","description":"Compare a billed charge against a hospital's own MRF-published negotiated rate for a CPT code; returns the markup multiple. Public regulator data, k-anonymity f"},{"name":"medigami_deadline","description":"Federal appeal-deadline window (ERISA §503 internal-appeal / ACA §2719 external-review / NSA IDR) for a plan type. Public regulator data, k-anonymity floored, n"},{"name":"medigami_rate","description":"A hospital's own MRF-published negotiated rate for a CPT code (no billed-amount comparison — use medigami_roast for that). Public regulator data, k-anonymity fl"}],"toolCount":87,"toolsHash":"c7d83d3598bc9743ce42bdba887f50436a00b4a82ff6989e4da5034fecd0402d","serverName":"medigami-public","capabilities":["experimental","resources","tools"],"serverVersion":"1.28.1","protocolVersion":"2025-06-18"}},{"at":"2026-10-09T04:28:37.027Z","kind":"mcp_initialize","ok":true,"httpStatus":200,"latencyMs":228,"error":null,"detail":{"tools":[{"name":"scan_bill_for_errors","description":"Scan a medical bill or EOB text for errors: duplicate charges, CPT unbundling, upcoding, facility-fee overcharges. Returns flagged anomalies with estimated doll"},{"name":"generate_appeal_letter","description":"Generate a legally-grounded insurance appeal letter for a denied claim. Returns the letter as a template with [PATIENT NAME] and [PROVIDER NAME] placeholders (s"},{"name":"optimize_prescription","description":"Find the lowest-cost path for a prescription: generics, biosimilars, GoodRx coupons, manufacturer assistance, 90-day fills, and mail-order vs retail comparison."},{"name":"analyze_glp1_pathways","description":"Find all access pathways for a GLP-1 drug (Ozempic, Wegovy, Mounjaro, Zepbound) given patient eligibility factors. Ranks pathways by monthly cost, flags prior-a"},{"name":"verify_attestation","description":"Verify an Ed25519-signed Medigami MCP response envelope — confirm a medical-bill / appeal / denial / rate answer came from Medigami and hasn't been tampered wit"},{"name":"watch_appeal_outcome","description":"Subscribe to an appeal outcome by tracking_id. Blocks up to `timeout_seconds` (default 300). Returns the outcome payload as soon as it's recorded, or {status: '"},{"name":"watch_claim_denial","description":"Subscribe to a claim denial event for a given scan_id. Blocks up to `timeout_seconds`. Returns {status: 'denied', ...} as soon as the payer marks the claim deni"},{"name":"format_citation","description":"Format an LLM-citable reference to a previously-attested Medigami MCP response. Input: either the full signed envelope that an earlier attested tool returned, O"},{"name":"submit_denial_letter","description":"Submit a medical-claim denial letter to the Medigami Denial Common Crawl (public aggregate dataset). Consent-gated — caller must pass consent=true to attest the"},{"name":"verify_mcp_response","description":"DEPRECATED ALIAS of verify_attestation — kept for backward compatibility with v0.1.7 clients. New code should call verify_attestation directly.\n\nWHEN TO USE: Re"},{"name":"format_medigami_citation","description":"DEPRECATED ALIAS of format_citation — kept for backward compatibility with v0.1.7 clients. New code should call format_citation directly.\n\nWHEN TO USE: Referenc"},{"name":"estimate_appeal_success","description":"Probability an appeal will be approved, derived from outcome-labeled data weighted by label provenance (IRO determinations, EOB reversals, physician confirmatio"},{"name":"resolve_denial","description":"End-to-end denial resolution: returns appeal probability + confidence interval + a drafted letter template grounded in aggregate outcome data + plan-context fla"},{"name":"maximize_recovery","description":"Given a prior scan_id, returns a prioritized action list: anomalies ranked by (expected overcharge x recovery probability), with the next steps to pursue each. "},{"name":"explain_appeal_success","description":"Human-readable rationale for an appeal probability. Returns {probability, tier, recommended_posture, rationale, expected_days_to_resolution, tracking_id} ground"},{"name":"negotiate_bill_script","description":"Generate a phone script the user can read when negotiating a medical bill directly with the provider. Combines DP-noised commercial rate benchmarks + the caller"},{"name":"batch_scan_bills","description":"Scan multiple medical bills in one call. Returns per-bill anomaly lists + total recovery estimate across the batch. Input is a list of {bill_text, provider?, in"},{"name":"lookup_icd10","description":"Look up an ICD-10-CM diagnosis code or search by keyword. Input is either an exact code (e.g. 'E11.21') or a free-text description phrase ('type 2 diabetes with"},{"name":"lookup_cpt","description":"Look up a CPT or HCPCS-J code or search by keyword. Covers the most common outpatient billing codes (E/M, preventive, lab, imaging, procedure, cardiology, thera"},{"name":"lookup_npi","description":"Look up a provider in the CMS NPPES National Provider Identifier registry. Accepts a 10-digit NPI number OR a provider name (optionally narrowed by 2-char state"},{"name":"verify_dea_authorization","description":"Validate the format + checksum of a DEA registration number (format: [A-Z][A-Z9][0-9]{7}; public checksum algorithm). Useful as a sanity check on a DEA number y"},{"name":"lookup_provider_taxonomy","description":"Look up a NUCC provider taxonomy code (the specialty codes used on HIPAA transactions + NPI registrations) or search by keyword. Returns classification + type +"},{"name":"resolve_codes","description":"[Taxonomy A.1 — baseline response (public data only)] Unified code resolver — free-form query or clinical description → ranked ICD-10-CM, CPT, and HCPCS codes w"},{"name":"code_conflict_detector","description":"[Taxonomy A.5 — delegates to scan_bill_for_errors] Detect CPT unbundling, mutually exclusive code pairs, and NCCI edit violations in a set of codes. Implemented"},{"name":"fair_price_estimator","description":"[Taxonomy B.8 — delegates to benchmark_payer_rate] Fair-market price distribution for a service: DP-noised percentiles (p10, p25, p50, p75, p90) for the given C"},{"name":"price_variance_analyzer","description":"[Taxonomy B.9 — baseline response (public data only)] Given a target price and a CPT+region, return how many standard deviations above/below the market the targ"},{"name":"claim_consistency_checker","description":"[Taxonomy C.14 — delegates to scan_bill_for_errors] Detect internal contradictions in a claim: time mismatches, mutually exclusive codes, missing required field"},{"name":"bundling_violation_detector","description":"[Taxonomy C.16 — delegates to scan_bill_for_errors] Detect CPT unbundling (billing components of a procedure separately to inflate the claim). Uses the CMS NCCI"},{"name":"appeal_success_predictor","description":"[Taxonomy E.25 — delegates to estimate_appeal_success] Given a denial, predict the probability of a successful appeal. Returns probability with 95% CI, sample s"},{"name":"generate_appeal_letter_v2","description":"[Taxonomy F.28 — delegates to generate_appeal_letter] [Taxonomy alias] Generate a state-specific insurance appeal letter with UPL-safe disclaimers for 19 US sta"},{"name":"negotiation_strategy_generator","description":"[Taxonomy F.30 — baseline response (public data only)] Given a bill + patient situation, generate a ranked negotiation strategy: hardship appeal, charity-care a"},{"name":"insurance_response_interpreter","description":"[Taxonomy F.31 — baseline response (public data only)] Parse an insurer's response letter or EOB into structured fields: denial reason codes, appeal rights, dea"},{"name":"settlement_optimizer","description":"[Taxonomy F.32 — baseline response (public data only)] For a disputed bill, compute the optimal settlement target price balancing probability of acceptance agai"},{"name":"patient_cost_forecaster","description":"[Taxonomy H.38 — baseline response (public data only)] Given a patient's plan + predicted care needs, forecast annual out-of-pocket spend across expected claims"},{"name":"insurance_plan_optimizer","description":"[Taxonomy H.39 — baseline response (public data only)] Given a patient's historical claim patterns, rank available insurance plans by expected annual cost.\n\nWHE"},{"name":"cash_vs_insurance_optimizer","description":"[Taxonomy H.41 — baseline response (public data only)] For a given service + patient plan, determine whether cash-pay + charity-care beats insurance billing.\n\nW"},{"name":"financial_risk_exposure_model","description":"[Taxonomy H.42 — baseline response (public data only)] Quantify a patient's financial exposure to medical-debt risk given current plan, health status, and histo"},{"name":"cpt_to_icd_mapper","description":"[Taxonomy II.21 — baseline response (public data only)] For a given CPT, surface the ICD-10 codes typically paired with it for medical-necessity support.\n\nWHEN "},{"name":"icd_to_cpt_mapper","description":"[Taxonomy II.22 — baseline response (public data only)] For a given ICD-10, surface the CPT codes typically billed for that diagnosis.\n\nWHEN TO USE: User has an"},{"name":"code_bundle_validator","description":"[Taxonomy II.25 — baseline response (public data only)] Check a set of CPT codes against NCCI bundling rules (distinct from modifier-based unbundling).\n\nWHEN TO"},{"name":"unbundling_detector","description":"[Taxonomy II.26 — delegates to scan_bill_for_errors] Detect CPT unbundling patterns in a claim. Alias of scan_bill_for_errors.\n\nWHEN TO USE: User asks about med"},{"name":"cash_price_estimator","description":"[Taxonomy III.39 — baseline response (public data only)] Estimate a fair cash price for a service in a given region (no-insurance path).\n\nWHEN TO USE: Uninsured"},{"name":"zip_based_price_variance","description":"[Taxonomy III.41 — baseline response (public data only)] Report price variance for a CPT across ZIP3 regions with DP noise.\n\nWHEN TO USE: User wants to understa"},{"name":"regional_price_benchmark","description":"[Taxonomy III.43 — baseline response (public data only)] Regional price benchmark for a CPT at state/metro/ZIP3 granularity.\n\nWHEN TO USE: User wants to underst"},{"name":"specialty_price_benchmark","description":"[Taxonomy III.44 — baseline response (public data only)] Price benchmark for a CPT within a specific provider specialty.\n\nWHEN TO USE: User wants to understand "},{"name":"inflation_adjusted_price_model","description":"[Taxonomy III.46 — baseline response (public data only)] Inflation-adjusted price comparison across years for a CPT.\n\nWHEN TO USE: User has a historical dollar "},{"name":"deductible_impact_calculator","description":"[Taxonomy III.48 — baseline response (public data only)] Estimate how a planned service will draw against the member's deductible.\n\nWHEN TO USE: User wants to k"},{"name":"coinsurance_simulator","description":"[Taxonomy III.49 — baseline response (public data only)] Simulate member coinsurance exposure across plan-design variants.\n\nWHEN TO USE: User wants to model the"},{"name":"copay_model","description":"[Taxonomy III.50 — baseline response (public data only)] Model member copay for a service by plan-design class.\n\nWHEN TO USE: User wants the typical copay for a"},{"name":"billing_charge_vs_allowed_delta","description":"[Taxonomy III.51 — baseline response (public data only)] Delta between billed charge and payer-allowed amount for a claim line.\n\nWHEN TO USE: User wants to unde"},{"name":"price_anomaly_detector","description":"[Taxonomy III.52 — baseline response (public data only)] Detect service-line prices statistically anomalous versus market.\n\nWHEN TO USE: User wants to understan"},{"name":"overpriced_service_detector","description":"[Taxonomy III.53 — baseline response (public data only)] Flag services billed materially above market percentile thresholds.\n\nWHEN TO USE: User wants to underst"},{"name":"market_price_distribution_model","description":"[Taxonomy III.55 — baseline response (public data only)] Full DP-noised market price distribution for a CPT+region pair.\n\nWHEN TO USE: User wants to understand "},{"name":"price_outlier_detector","description":"[Taxonomy III.56 — baseline response (public data only)] Detect claim-line outliers relative to a learned market distribution.\n\nWHEN TO USE: User wants to under"},{"name":"procedure_cost_decomposition","description":"[Taxonomy III.57 — baseline response (public data only)] Decompose the cost of a procedure into component services + facility + professional fees.\n\nWHEN TO USE:"},{"name":"price_recommendation_engine","description":"[Taxonomy III.58 — baseline response (public data only)] Recommend a reasonable price to propose to a provider for a service (self-pay or negotiation).\n\nWHEN TO"},{"name":"claim_duplicate_line_detector","description":"[Taxonomy IV.75 — baseline response (public data only)] Detect duplicated service lines within a single claim.\n\nWHEN TO USE: Caller is building or validating a "},{"name":"denial_reason_classifier","description":"[Taxonomy VI.106 — baseline response (public data only)] Classify a denial letter or remittance advice into normalized denial-reason categories.\n\nWHEN TO USE: U"},{"name":"appeal_argument_generator","description":"[Taxonomy VII.120 — baseline response (public data only)] Generate component arguments for an appeal letter: medical-necessity, contract, policy.\n\nWHEN TO USE: "},{"name":"denial_response_builder","description":"[Taxonomy VII.121 — baseline response (public data only)] Build a denial-response package tailored to the denial reason code.\n\nWHEN TO USE: User has a denied cl"},{"name":"dispute_case_builder","description":"[Taxonomy VII.123 — baseline response (public data only)] Assemble a complete dispute case file including claim, denial, evidence, and timeline.\n\nWHEN TO USE: U"},{"name":"evidence_pack_generator","description":"[Taxonomy VII.124 — baseline response (public data only)] Generate an evidence package supporting a claim or appeal (references, studies, policies).\n\nWHEN TO US"},{"name":"claim_rebuttal_generator","description":"[Taxonomy VII.128 — baseline response (public data only)] Generate a rebuttal to a payer's denial rationale point-by-point.\n\nWHEN TO USE: User has a denied clai"},{"name":"appeal_escalation_path_finder","description":"[Taxonomy VII.129 — baseline response (public data only)] Find the correct escalation path for a denied claim (internal appeal → external review → DOI).\n\nWHEN T"},{"name":"payer_specific_appeal_templates","description":"[Taxonomy VII.130 — baseline response (public data only)] Return payer-specific appeal templates known to perform well.\n\nWHEN TO USE: User has a denied claim an"},{"name":"denial_code_explainer","description":"[Taxonomy VII.131 — baseline response (public data only)] Explain a CARC/RARC denial code in plain language with common causes.\n\nWHEN TO USE: User asks 'what do"},{"name":"claim_reconsideration_builder","description":"[Taxonomy VII.132 — baseline response (public data only)] Build a claim reconsideration request (lighter-weight than a formal appeal).\n\nWHEN TO USE: User has a "},{"name":"supporting_document_selector","description":"[Taxonomy VII.135 — baseline response (public data only)] Select optimal supporting documents for an appeal from an available document pool.\n\nWHEN TO USE: User "},{"name":"out_of_pocket_optimizer","description":"[Taxonomy X.174 — baseline response (public data only)] Optimize out-of-pocket spend across a sequence of planned services.\n\nWHEN TO USE: User is planning for a"},{"name":"financial_exposure_model","description":"[Taxonomy X.176 — delegates to financial_risk_exposure_model] Model a member's financial exposure. Alias of financial_risk_exposure_model.\n\nWHEN TO USE: User is"},{"name":"procedure_affordability_ranker","description":"[Taxonomy X.177 — baseline response (public data only)] Rank a set of procedures by affordability for a given member.\n\nWHEN TO USE: User is planning for a medic"},{"name":"treatment_cost_comparator","description":"[Taxonomy X.178 — baseline response (public data only)] Compare expected costs across treatment alternatives for a condition.\n\nWHEN TO USE: User is planning for"},{"name":"bill_shock_predictor","description":"[Taxonomy X.179 — baseline response (public data only)] Predict risk that a planned service will trigger an unexpected large bill.\n\nWHEN TO USE: User planning a"},{"name":"payment_plan_optimizer","description":"[Taxonomy X.180 — baseline response (public data only)] Optimize a payment plan structure for a patient balance.\n\nWHEN TO USE: User has a balance and wants to s"},{"name":"financial_assistance_finder","description":"[Taxonomy X.181 — baseline response (public data only)] Find applicable financial-assistance programs (hospital charity, 340B, state, pharma).\n\nWHEN TO USE: Use"},{"name":"patient_cost_explainer","description":"[Taxonomy X.182 — baseline response (public data only)] Explain why a specific charge appears on a bill in plain language.\n\nWHEN TO USE: User is planning for a "},{"name":"healthcare_budget_forecaster","description":"[Taxonomy X.183 — baseline response (public data only)] Forecast a household's annual healthcare spend based on plan + utilization.\n\nWHEN TO USE: User planning "},{"name":"medical_spending_analyzer","description":"[Taxonomy X.184 — baseline response (public data only)] Analyze a patient's medical spending over a period and surface optimization opportunities.\n\nWHEN TO USE:"},{"name":"insurance_value_optimizer","description":"[Taxonomy X.185 — baseline response (public data only)] Recommend insurance-plan selections to maximize value given projected utilization.\n\nWHEN TO USE: User is"},{"name":"patient_financial_risk_score","description":"[Taxonomy X.186 — baseline response (public data only)] Score a patient's financial risk exposure from planned or ongoing care.\n\nWHEN TO USE: User is planning f"},{"name":"decode_denial","description":"Decode a CARC (Claim Adjustment Reason Code) denial code into plain English. Returns meaning, category, whether it's typically reversible on appeal, and appeal "},{"name":"get_appeal_deadline","description":"External-review filing deadline for a state + the date of the FINAL adverse determination. Returns the deadline date, the statutory window label + citation, and"},{"name":"get_venue","description":"Where and how to file an external review for a given state — the venue name, filing channel (portal/mail/fax), portal URL, and whether expedited review is avail"},{"name":"medigami_odds","description":"Historical external-review overturn rate published by the state regulator for the insurer you name, in a regulated venue (CA/NY/MD/NJ/MI/OH/NC). Returns one ins"},{"name":"medigami_roast","description":"Compare a billed charge against a hospital's own MRF-published negotiated rate for a CPT code; returns the markup multiple. Public regulator data, k-anonymity f"},{"name":"medigami_deadline","description":"Federal appeal-deadline window (ERISA §503 internal-appeal / ACA §2719 external-review / NSA IDR) for a plan type. Public regulator data, k-anonymity floored, n"},{"name":"medigami_rate","description":"A hospital's own MRF-published negotiated rate for a CPT code (no billed-amount comparison — use medigami_roast for that). Public regulator data, k-anonymity fl"}],"toolCount":87,"toolsHash":"c7d83d3598bc9743ce42bdba887f50436a00b4a82ff6989e4da5034fecd0402d","serverName":"medigami-public","capabilities":["experimental","resources","tools"],"serverVersion":"1.28.1","protocolVersion":"2025-06-18"}},{"at":"2026-10-08T21:23:38.619Z","kind":"mcp_initialize","ok":true,"httpStatus":200,"latencyMs":193,"error":null,"detail":{"tools":[{"name":"scan_bill_for_errors","description":"Scan a medical bill or EOB text for errors: duplicate charges, CPT unbundling, upcoding, facility-fee overcharges. Returns flagged anomalies with estimated doll"},{"name":"generate_appeal_letter","description":"Generate a legally-grounded insurance appeal letter for a denied claim. Returns the letter as a template with [PATIENT NAME] and [PROVIDER NAME] placeholders (s"},{"name":"optimize_prescription","description":"Find the lowest-cost path for a prescription: generics, biosimilars, GoodRx coupons, manufacturer assistance, 90-day fills, and mail-order vs retail comparison."},{"name":"analyze_glp1_pathways","description":"Find all access pathways for a GLP-1 drug (Ozempic, Wegovy, Mounjaro, Zepbound) given patient eligibility factors. Ranks pathways by monthly cost, flags prior-a"},{"name":"verify_attestation","description":"Verify an Ed25519-signed Medigami MCP response envelope — confirm a medical-bill / appeal / denial / rate answer came from Medigami and hasn't been tampered wit"},{"name":"watch_appeal_outcome","description":"Subscribe to an appeal outcome by tracking_id. Blocks up to `timeout_seconds` (default 300). Returns the outcome payload as soon as it's recorded, or {status: '"},{"name":"watch_claim_denial","description":"Subscribe to a claim denial event for a given scan_id. Blocks up to `timeout_seconds`. Returns {status: 'denied', ...} as soon as the payer marks the claim deni"},{"name":"format_citation","description":"Format an LLM-citable reference to a previously-attested Medigami MCP response. Input: either the full signed envelope that an earlier attested tool returned, O"},{"name":"submit_denial_letter","description":"Submit a medical-claim denial letter to the Medigami Denial Common Crawl (public aggregate dataset). Consent-gated — caller must pass consent=true to attest the"},{"name":"verify_mcp_response","description":"DEPRECATED ALIAS of verify_attestation — kept for backward compatibility with v0.1.7 clients. New code should call verify_attestation directly.\n\nWHEN TO USE: Re"},{"name":"format_medigami_citation","description":"DEPRECATED ALIAS of format_citation — kept for backward compatibility with v0.1.7 clients. New code should call format_citation directly.\n\nWHEN TO USE: Referenc"},{"name":"estimate_appeal_success","description":"Probability an appeal will be approved, derived from outcome-labeled data weighted by label provenance (IRO determinations, EOB reversals, physician confirmatio"},{"name":"resolve_denial","description":"End-to-end denial resolution: returns appeal probability + confidence interval + a drafted letter template grounded in aggregate outcome data + plan-context fla"},{"name":"maximize_recovery","description":"Given a prior scan_id, returns a prioritized action list: anomalies ranked by (expected overcharge x recovery probability), with the next steps to pursue each. "},{"name":"explain_appeal_success","description":"Human-readable rationale for an appeal probability. Returns {probability, tier, recommended_posture, rationale, expected_days_to_resolution, tracking_id} ground"},{"name":"negotiate_bill_script","description":"Generate a phone script the user can read when negotiating a medical bill directly with the provider. Combines DP-noised commercial rate benchmarks + the caller"},{"name":"batch_scan_bills","description":"Scan multiple medical bills in one call. Returns per-bill anomaly lists + total recovery estimate across the batch. Input is a list of {bill_text, provider?, in"},{"name":"lookup_icd10","description":"Look up an ICD-10-CM diagnosis code or search by keyword. Input is either an exact code (e.g. 'E11.21') or a free-text description phrase ('type 2 diabetes with"},{"name":"lookup_cpt","description":"Look up a CPT or HCPCS-J code or search by keyword. Covers the most common outpatient billing codes (E/M, preventive, lab, imaging, procedure, cardiology, thera"},{"name":"lookup_npi","description":"Look up a provider in the CMS NPPES National Provider Identifier registry. Accepts a 10-digit NPI number OR a provider name (optionally narrowed by 2-char state"},{"name":"verify_dea_authorization","description":"Validate the format + checksum of a DEA registration number (format: [A-Z][A-Z9][0-9]{7}; public checksum algorithm). Useful as a sanity check on a DEA number y"},{"name":"lookup_provider_taxonomy","description":"Look up a NUCC provider taxonomy code (the specialty codes used on HIPAA transactions + NPI registrations) or search by keyword. Returns classification + type +"},{"name":"resolve_codes","description":"[Taxonomy A.1 — baseline response (public data only)] Unified code resolver — free-form query or clinical description → ranked ICD-10-CM, CPT, and HCPCS codes w"},{"name":"code_conflict_detector","description":"[Taxonomy A.5 — delegates to scan_bill_for_errors] Detect CPT unbundling, mutually exclusive code pairs, and NCCI edit violations in a set of codes. Implemented"},{"name":"fair_price_estimator","description":"[Taxonomy B.8 — delegates to benchmark_payer_rate] Fair-market price distribution for a service: DP-noised percentiles (p10, p25, p50, p75, p90) for the given C"},{"name":"price_variance_analyzer","description":"[Taxonomy B.9 — baseline response (public data only)] Given a target price and a CPT+region, return how many standard deviations above/below the market the targ"},{"name":"claim_consistency_checker","description":"[Taxonomy C.14 — delegates to scan_bill_for_errors] Detect internal contradictions in a claim: time mismatches, mutually exclusive codes, missing required field"},{"name":"bundling_violation_detector","description":"[Taxonomy C.16 — delegates to scan_bill_for_errors] Detect CPT unbundling (billing components of a procedure separately to inflate the claim). Uses the CMS NCCI"},{"name":"appeal_success_predictor","description":"[Taxonomy E.25 — delegates to estimate_appeal_success] Given a denial, predict the probability of a successful appeal. Returns probability with 95% CI, sample s"},{"name":"generate_appeal_letter_v2","description":"[Taxonomy F.28 — delegates to generate_appeal_letter] [Taxonomy alias] Generate a state-specific insurance appeal letter with UPL-safe disclaimers for 19 US sta"},{"name":"negotiation_strategy_generator","description":"[Taxonomy F.30 — baseline response (public data only)] Given a bill + patient situation, generate a ranked negotiation strategy: hardship appeal, charity-care a"},{"name":"insurance_response_interpreter","description":"[Taxonomy F.31 — baseline response (public data only)] Parse an insurer's response letter or EOB into structured fields: denial reason codes, appeal rights, dea"},{"name":"settlement_optimizer","description":"[Taxonomy F.32 — baseline response (public data only)] For a disputed bill, compute the optimal settlement target price balancing probability of acceptance agai"},{"name":"patient_cost_forecaster","description":"[Taxonomy H.38 — baseline response (public data only)] Given a patient's plan + predicted care needs, forecast annual out-of-pocket spend across expected claims"},{"name":"insurance_plan_optimizer","description":"[Taxonomy H.39 — baseline response (public data only)] Given a patient's historical claim patterns, rank available insurance plans by expected annual cost.\n\nWHE"},{"name":"cash_vs_insurance_optimizer","description":"[Taxonomy H.41 — baseline response (public data only)] For a given service + patient plan, determine whether cash-pay + charity-care beats insurance billing.\n\nW"},{"name":"financial_risk_exposure_model","description":"[Taxonomy H.42 — baseline response (public data only)] Quantify a patient's financial exposure to medical-debt risk given current plan, health status, and histo"},{"name":"cpt_to_icd_mapper","description":"[Taxonomy II.21 — baseline response (public data only)] For a given CPT, surface the ICD-10 codes typically paired with it for medical-necessity support.\n\nWHEN "},{"name":"icd_to_cpt_mapper","description":"[Taxonomy II.22 — baseline response (public data only)] For a given ICD-10, surface the CPT codes typically billed for that diagnosis.\n\nWHEN TO USE: User has an"},{"name":"code_bundle_validator","description":"[Taxonomy II.25 — baseline response (public data only)] Check a set of CPT codes against NCCI bundling rules (distinct from modifier-based unbundling).\n\nWHEN TO"},{"name":"unbundling_detector","description":"[Taxonomy II.26 — delegates to scan_bill_for_errors] Detect CPT unbundling patterns in a claim. Alias of scan_bill_for_errors.\n\nWHEN TO USE: User asks about med"},{"name":"cash_price_estimator","description":"[Taxonomy III.39 — baseline response (public data only)] Estimate a fair cash price for a service in a given region (no-insurance path).\n\nWHEN TO USE: Uninsured"},{"name":"zip_based_price_variance","description":"[Taxonomy III.41 — baseline response (public data only)] Report price variance for a CPT across ZIP3 regions with DP noise.\n\nWHEN TO USE: User wants to understa"},{"name":"regional_price_benchmark","description":"[Taxonomy III.43 — baseline response (public data only)] Regional price benchmark for a CPT at state/metro/ZIP3 granularity.\n\nWHEN TO USE: User wants to underst"},{"name":"specialty_price_benchmark","description":"[Taxonomy III.44 — baseline response (public data only)] Price benchmark for a CPT within a specific provider specialty.\n\nWHEN TO USE: User wants to understand "},{"name":"inflation_adjusted_price_model","description":"[Taxonomy III.46 — baseline response (public data only)] Inflation-adjusted price comparison across years for a CPT.\n\nWHEN TO USE: User has a historical dollar "},{"name":"deductible_impact_calculator","description":"[Taxonomy III.48 — baseline response (public data only)] Estimate how a planned service will draw against the member's deductible.\n\nWHEN TO USE: User wants to k"},{"name":"coinsurance_simulator","description":"[Taxonomy III.49 — baseline response (public data only)] Simulate member coinsurance exposure across plan-design variants.\n\nWHEN TO USE: User wants to model the"},{"name":"copay_model","description":"[Taxonomy III.50 — baseline response (public data only)] Model member copay for a service by plan-design class.\n\nWHEN TO USE: User wants the typical copay for a"},{"name":"billing_charge_vs_allowed_delta","description":"[Taxonomy III.51 — baseline response (public data only)] Delta between billed charge and payer-allowed amount for a claim line.\n\nWHEN TO USE: User wants to unde"},{"name":"price_anomaly_detector","description":"[Taxonomy III.52 — baseline response (public data only)] Detect service-line prices statistically anomalous versus market.\n\nWHEN TO USE: User wants to understan"},{"name":"overpriced_service_detector","description":"[Taxonomy III.53 — baseline response (public data only)] Flag services billed materially above market percentile thresholds.\n\nWHEN TO USE: User wants to underst"},{"name":"market_price_distribution_model","description":"[Taxonomy III.55 — baseline response (public data only)] Full DP-noised market price distribution for a CPT+region pair.\n\nWHEN TO USE: User wants to understand "},{"name":"price_outlier_detector","description":"[Taxonomy III.56 — baseline response (public data only)] Detect claim-line outliers relative to a learned market distribution.\n\nWHEN TO USE: User wants to under"},{"name":"procedure_cost_decomposition","description":"[Taxonomy III.57 — baseline response (public data only)] Decompose the cost of a procedure into component services + facility + professional fees.\n\nWHEN TO USE:"},{"name":"price_recommendation_engine","description":"[Taxonomy III.58 — baseline response (public data only)] Recommend a reasonable price to propose to a provider for a service (self-pay or negotiation).\n\nWHEN TO"},{"name":"claim_duplicate_line_detector","description":"[Taxonomy IV.75 — baseline response (public data only)] Detect duplicated service lines within a single claim.\n\nWHEN TO USE: Caller is building or validating a "},{"name":"denial_reason_classifier","description":"[Taxonomy VI.106 — baseline response (public data only)] Classify a denial letter or remittance advice into normalized denial-reason categories.\n\nWHEN TO USE: U"},{"name":"appeal_argument_generator","description":"[Taxonomy VII.120 — baseline response (public data only)] Generate component arguments for an appeal letter: medical-necessity, contract, policy.\n\nWHEN TO USE: "},{"name":"denial_response_builder","description":"[Taxonomy VII.121 — baseline response (public data only)] Build a denial-response package tailored to the denial reason code.\n\nWHEN TO USE: User has a denied cl"},{"name":"dispute_case_builder","description":"[Taxonomy VII.123 — baseline response (public data only)] Assemble a complete dispute case file including claim, denial, evidence, and timeline.\n\nWHEN TO USE: U"},{"name":"evidence_pack_generator","description":"[Taxonomy VII.124 — baseline response (public data only)] Generate an evidence package supporting a claim or appeal (references, studies, policies).\n\nWHEN TO US"},{"name":"claim_rebuttal_generator","description":"[Taxonomy VII.128 — baseline response (public data only)] Generate a rebuttal to a payer's denial rationale point-by-point.\n\nWHEN TO USE: User has a denied clai"},{"name":"appeal_escalation_path_finder","description":"[Taxonomy VII.129 — baseline response (public data only)] Find the correct escalation path for a denied claim (internal appeal → external review → DOI).\n\nWHEN T"},{"name":"payer_specific_appeal_templates","description":"[Taxonomy VII.130 — baseline response (public data only)] Return payer-specific appeal templates known to perform well.\n\nWHEN TO USE: User has a denied claim an"},{"name":"denial_code_explainer","description":"[Taxonomy VII.131 — baseline response (public data only)] Explain a CARC/RARC denial code in plain language with common causes.\n\nWHEN TO USE: User asks 'what do"},{"name":"claim_reconsideration_builder","description":"[Taxonomy VII.132 — baseline response (public data only)] Build a claim reconsideration request (lighter-weight than a formal appeal).\n\nWHEN TO USE: User has a "},{"name":"supporting_document_selector","description":"[Taxonomy VII.135 — baseline response (public data only)] Select optimal supporting documents for an appeal from an available document pool.\n\nWHEN TO USE: User "},{"name":"out_of_pocket_optimizer","description":"[Taxonomy X.174 — baseline response (public data only)] Optimize out-of-pocket spend across a sequence of planned services.\n\nWHEN TO USE: User is planning for a"},{"name":"financial_exposure_model","description":"[Taxonomy X.176 — delegates to financial_risk_exposure_model] Model a member's financial exposure. Alias of financial_risk_exposure_model.\n\nWHEN TO USE: User is"},{"name":"procedure_affordability_ranker","description":"[Taxonomy X.177 — baseline response (public data only)] Rank a set of procedures by affordability for a given member.\n\nWHEN TO USE: User is planning for a medic"},{"name":"treatment_cost_comparator","description":"[Taxonomy X.178 — baseline response (public data only)] Compare expected costs across treatment alternatives for a condition.\n\nWHEN TO USE: User is planning for"},{"name":"bill_shock_predictor","description":"[Taxonomy X.179 — baseline response (public data only)] Predict risk that a planned service will trigger an unexpected large bill.\n\nWHEN TO USE: User planning a"},{"name":"payment_plan_optimizer","description":"[Taxonomy X.180 — baseline response (public data only)] Optimize a payment plan structure for a patient balance.\n\nWHEN TO USE: User has a balance and wants to s"},{"name":"financial_assistance_finder","description":"[Taxonomy X.181 — baseline response (public data only)] Find applicable financial-assistance programs (hospital charity, 340B, state, pharma).\n\nWHEN TO USE: Use"},{"name":"patient_cost_explainer","description":"[Taxonomy X.182 — baseline response (public data only)] Explain why a specific charge appears on a bill in plain language.\n\nWHEN TO USE: User is planning for a "},{"name":"healthcare_budget_forecaster","description":"[Taxonomy X.183 — baseline response (public data only)] Forecast a household's annual healthcare spend based on plan + utilization.\n\nWHEN TO USE: User planning "},{"name":"medical_spending_analyzer","description":"[Taxonomy X.184 — baseline response (public data only)] Analyze a patient's medical spending over a period and surface optimization opportunities.\n\nWHEN TO USE:"},{"name":"insurance_value_optimizer","description":"[Taxonomy X.185 — baseline response (public data only)] Recommend insurance-plan selections to maximize value given projected utilization.\n\nWHEN TO USE: User is"},{"name":"patient_financial_risk_score","description":"[Taxonomy X.186 — baseline response (public data only)] Score a patient's financial risk exposure from planned or ongoing care.\n\nWHEN TO USE: User is planning f"},{"name":"decode_denial","description":"Decode a CARC (Claim Adjustment Reason Code) denial code into plain English. Returns meaning, category, whether it's typically reversible on appeal, and appeal "},{"name":"get_appeal_deadline","description":"External-review filing deadline for a state + the date of the FINAL adverse determination. Returns the deadline date, the statutory window label + citation, and"},{"name":"get_venue","description":"Where and how to file an external review for a given state — the venue name, filing channel (portal/mail/fax), portal URL, and whether expedited review is avail"},{"name":"medigami_odds","description":"Historical external-review overturn rate published by the state regulator for the insurer you name, in a regulated venue (CA/NY/MD/NJ/MI/OH/NC). Returns one ins"},{"name":"medigami_roast","description":"Compare a billed charge against a hospital's own MRF-published negotiated rate for a CPT code; returns the markup multiple. Public regulator data, k-anonymity f"},{"name":"medigami_deadline","description":"Federal appeal-deadline window (ERISA §503 internal-appeal / ACA §2719 external-review / NSA IDR) for a plan type. Public regulator data, k-anonymity floored, n"},{"name":"medigami_rate","description":"A hospital's own MRF-published negotiated rate for a CPT code (no billed-amount comparison — use medigami_roast for that). Public regulator data, k-anonymity fl"}],"toolCount":87,"toolsHash":"c7d83d3598bc9743ce42bdba887f50436a00b4a82ff6989e4da5034fecd0402d","serverName":"medigami-public","capabilities":["experimental","resources","tools"],"serverVersion":"1.28.1","protocolVersion":"2025-06-18"}},{"at":"2026-10-08T15:25:12.439Z","kind":"mcp_initialize","ok":true,"httpStatus":200,"latencyMs":191,"error":null,"detail":{"tools":[{"name":"scan_bill_for_errors","description":"Scan a medical bill or EOB text for errors: duplicate charges, CPT unbundling, upcoding, facility-fee overcharges. Returns flagged anomalies with estimated doll"},{"name":"generate_appeal_letter","description":"Generate a legally-grounded insurance appeal letter for a denied claim. Returns the letter as a template with [PATIENT NAME] and [PROVIDER NAME] placeholders (s"},{"name":"optimize_prescription","description":"Find the lowest-cost path for a prescription: generics, biosimilars, GoodRx coupons, manufacturer assistance, 90-day fills, and mail-order vs retail comparison."},{"name":"analyze_glp1_pathways","description":"Find all access pathways for a GLP-1 drug (Ozempic, Wegovy, Mounjaro, Zepbound) given patient eligibility factors. Ranks pathways by monthly cost, flags prior-a"},{"name":"verify_attestation","description":"Verify an Ed25519-signed Medigami MCP response envelope — confirm a medical-bill / appeal / denial / rate answer came from Medigami and hasn't been tampered wit"},{"name":"watch_appeal_outcome","description":"Subscribe to an appeal outcome by tracking_id. Blocks up to `timeout_seconds` (default 300). Returns the outcome payload as soon as it's recorded, or {status: '"},{"name":"watch_claim_denial","description":"Subscribe to a claim denial event for a given scan_id. Blocks up to `timeout_seconds`. Returns {status: 'denied', ...} as soon as the payer marks the claim deni"},{"name":"format_citation","description":"Format an LLM-citable reference to a previously-attested Medigami MCP response. Input: either the full signed envelope that an earlier attested tool returned, O"},{"name":"submit_denial_letter","description":"Submit a medical-claim denial letter to the Medigami Denial Common Crawl (public aggregate dataset). Consent-gated — caller must pass consent=true to attest the"},{"name":"verify_mcp_response","description":"DEPRECATED ALIAS of verify_attestation — kept for backward compatibility with v0.1.7 clients. New code should call verify_attestation directly.\n\nWHEN TO USE: Re"},{"name":"format_medigami_citation","description":"DEPRECATED ALIAS of format_citation — kept for backward compatibility with v0.1.7 clients. New code should call format_citation directly.\n\nWHEN TO USE: Referenc"},{"name":"estimate_appeal_success","description":"Probability an appeal will be approved, derived from outcome-labeled data weighted by label provenance (IRO determinations, EOB reversals, physician confirmatio"},{"name":"resolve_denial","description":"End-to-end denial resolution: returns appeal probability + confidence interval + a drafted letter template grounded in aggregate outcome data + plan-context fla"},{"name":"maximize_recovery","description":"Given a prior scan_id, returns a prioritized action list: anomalies ranked by (expected overcharge x recovery probability), with the next steps to pursue each. "},{"name":"explain_appeal_success","description":"Human-readable rationale for an appeal probability. Returns {probability, tier, recommended_posture, rationale, expected_days_to_resolution, tracking_id} ground"},{"name":"negotiate_bill_script","description":"Generate a phone script the user can read when negotiating a medical bill directly with the provider. Combines DP-noised commercial rate benchmarks + the caller"},{"name":"batch_scan_bills","description":"Scan multiple medical bills in one call. Returns per-bill anomaly lists + total recovery estimate across the batch. Input is a list of {bill_text, provider?, in"},{"name":"lookup_icd10","description":"Look up an ICD-10-CM diagnosis code or search by keyword. Input is either an exact code (e.g. 'E11.21') or a free-text description phrase ('type 2 diabetes with"},{"name":"lookup_cpt","description":"Look up a CPT or HCPCS-J code or search by keyword. Covers the most common outpatient billing codes (E/M, preventive, lab, imaging, procedure, cardiology, thera"},{"name":"lookup_npi","description":"Look up a provider in the CMS NPPES National Provider Identifier registry. Accepts a 10-digit NPI number OR a provider name (optionally narrowed by 2-char state"},{"name":"verify_dea_authorization","description":"Validate the format + checksum of a DEA registration number (format: [A-Z][A-Z9][0-9]{7}; public checksum algorithm). Useful as a sanity check on a DEA number y"},{"name":"lookup_provider_taxonomy","description":"Look up a NUCC provider taxonomy code (the specialty codes used on HIPAA transactions + NPI registrations) or search by keyword. Returns classification + type +"},{"name":"resolve_codes","description":"[Taxonomy A.1 — baseline response (public data only)] Unified code resolver — free-form query or clinical description → ranked ICD-10-CM, CPT, and HCPCS codes w"},{"name":"code_conflict_detector","description":"[Taxonomy A.5 — delegates to scan_bill_for_errors] Detect CPT unbundling, mutually exclusive code pairs, and NCCI edit violations in a set of codes. Implemented"},{"name":"fair_price_estimator","description":"[Taxonomy B.8 — delegates to benchmark_payer_rate] Fair-market price distribution for a service: DP-noised percentiles (p10, p25, p50, p75, p90) for the given C"},{"name":"price_variance_analyzer","description":"[Taxonomy B.9 — baseline response (public data only)] Given a target price and a CPT+region, return how many standard deviations above/below the market the targ"},{"name":"claim_consistency_checker","description":"[Taxonomy C.14 — delegates to scan_bill_for_errors] Detect internal contradictions in a claim: time mismatches, mutually exclusive codes, missing required field"},{"name":"bundling_violation_detector","description":"[Taxonomy C.16 — delegates to scan_bill_for_errors] Detect CPT unbundling (billing components of a procedure separately to inflate the claim). Uses the CMS NCCI"},{"name":"appeal_success_predictor","description":"[Taxonomy E.25 — delegates to estimate_appeal_success] Given a denial, predict the probability of a successful appeal. Returns probability with 95% CI, sample s"},{"name":"generate_appeal_letter_v2","description":"[Taxonomy F.28 — delegates to generate_appeal_letter] [Taxonomy alias] Generate a state-specific insurance appeal letter with UPL-safe disclaimers for 19 US sta"},{"name":"negotiation_strategy_generator","description":"[Taxonomy F.30 — baseline response (public data only)] Given a bill + patient situation, generate a ranked negotiation strategy: hardship appeal, charity-care a"},{"name":"insurance_response_interpreter","description":"[Taxonomy F.31 — baseline response (public data only)] Parse an insurer's response letter or EOB into structured fields: denial reason codes, appeal rights, dea"},{"name":"settlement_optimizer","description":"[Taxonomy F.32 — baseline response (public data only)] For a disputed bill, compute the optimal settlement target price balancing probability of acceptance agai"},{"name":"patient_cost_forecaster","description":"[Taxonomy H.38 — baseline response (public data only)] Given a patient's plan + predicted care needs, forecast annual out-of-pocket spend across expected claims"},{"name":"insurance_plan_optimizer","description":"[Taxonomy H.39 — baseline response (public data only)] Given a patient's historical claim patterns, rank available insurance plans by expected annual cost.\n\nWHE"},{"name":"cash_vs_insurance_optimizer","description":"[Taxonomy H.41 — baseline response (public data only)] For a given service + patient plan, determine whether cash-pay + charity-care beats insurance billing.\n\nW"},{"name":"financial_risk_exposure_model","description":"[Taxonomy H.42 — baseline response (public data only)] Quantify a patient's financial exposure to medical-debt risk given current plan, health status, and histo"},{"name":"cpt_to_icd_mapper","description":"[Taxonomy II.21 — baseline response (public data only)] For a given CPT, surface the ICD-10 codes typically paired with it for medical-necessity support.\n\nWHEN "},{"name":"icd_to_cpt_mapper","description":"[Taxonomy II.22 — baseline response (public data only)] For a given ICD-10, surface the CPT codes typically billed for that diagnosis.\n\nWHEN TO USE: User has an"},{"name":"code_bundle_validator","description":"[Taxonomy II.25 — baseline response (public data only)] Check a set of CPT codes against NCCI bundling rules (distinct from modifier-based unbundling).\n\nWHEN TO"},{"name":"unbundling_detector","description":"[Taxonomy II.26 — delegates to scan_bill_for_errors] Detect CPT unbundling patterns in a claim. Alias of scan_bill_for_errors.\n\nWHEN TO USE: User asks about med"},{"name":"cash_price_estimator","description":"[Taxonomy III.39 — baseline response (public data only)] Estimate a fair cash price for a service in a given region (no-insurance path).\n\nWHEN TO USE: Uninsured"},{"name":"zip_based_price_variance","description":"[Taxonomy III.41 — baseline response (public data only)] Report price variance for a CPT across ZIP3 regions with DP noise.\n\nWHEN TO USE: User wants to understa"},{"name":"regional_price_benchmark","description":"[Taxonomy III.43 — baseline response (public data only)] Regional price benchmark for a CPT at state/metro/ZIP3 granularity.\n\nWHEN TO USE: User wants to underst"},{"name":"specialty_price_benchmark","description":"[Taxonomy III.44 — baseline response (public data only)] Price benchmark for a CPT within a specific provider specialty.\n\nWHEN TO USE: User wants to understand "},{"name":"inflation_adjusted_price_model","description":"[Taxonomy III.46 — baseline response (public data only)] Inflation-adjusted price comparison across years for a CPT.\n\nWHEN TO USE: User has a historical dollar "},{"name":"deductible_impact_calculator","description":"[Taxonomy III.48 — baseline response (public data only)] Estimate how a planned service will draw against the member's deductible.\n\nWHEN TO USE: User wants to k"},{"name":"coinsurance_simulator","description":"[Taxonomy III.49 — baseline response (public data only)] Simulate member coinsurance exposure across plan-design variants.\n\nWHEN TO USE: User wants to model the"},{"name":"copay_model","description":"[Taxonomy III.50 — baseline response (public data only)] Model member copay for a service by plan-design class.\n\nWHEN TO USE: User wants the typical copay for a"},{"name":"billing_charge_vs_allowed_delta","description":"[Taxonomy III.51 — baseline response (public data only)] Delta between billed charge and payer-allowed amount for a claim line.\n\nWHEN TO USE: User wants to unde"},{"name":"price_anomaly_detector","description":"[Taxonomy III.52 — baseline response (public data only)] Detect service-line prices statistically anomalous versus market.\n\nWHEN TO USE: User wants to understan"},{"name":"overpriced_service_detector","description":"[Taxonomy III.53 — baseline response (public data only)] Flag services billed materially above market percentile thresholds.\n\nWHEN TO USE: User wants to underst"},{"name":"market_price_distribution_model","description":"[Taxonomy III.55 — baseline response (public data only)] Full DP-noised market price distribution for a CPT+region pair.\n\nWHEN TO USE: User wants to understand "},{"name":"price_outlier_detector","description":"[Taxonomy III.56 — baseline response (public data only)] Detect claim-line outliers relative to a learned market distribution.\n\nWHEN TO USE: User wants to under"},{"name":"procedure_cost_decomposition","description":"[Taxonomy III.57 — baseline response (public data only)] Decompose the cost of a procedure into component services + facility + professional fees.\n\nWHEN TO USE:"},{"name":"price_recommendation_engine","description":"[Taxonomy III.58 — baseline response (public data only)] Recommend a reasonable price to propose to a provider for a service (self-pay or negotiation).\n\nWHEN TO"},{"name":"claim_duplicate_line_detector","description":"[Taxonomy IV.75 — baseline response (public data only)] Detect duplicated service lines within a single claim.\n\nWHEN TO USE: Caller is building or validating a "},{"name":"denial_reason_classifier","description":"[Taxonomy VI.106 — baseline response (public data only)] Classify a denial letter or remittance advice into normalized denial-reason categories.\n\nWHEN TO USE: U"},{"name":"appeal_argument_generator","description":"[Taxonomy VII.120 — baseline response (public data only)] Generate component arguments for an appeal letter: medical-necessity, contract, policy.\n\nWHEN TO USE: "},{"name":"denial_response_builder","description":"[Taxonomy VII.121 — baseline response (public data only)] Build a denial-response package tailored to the denial reason code.\n\nWHEN TO USE: User has a denied cl"},{"name":"dispute_case_builder","description":"[Taxonomy VII.123 — baseline response (public data only)] Assemble a complete dispute case file including claim, denial, evidence, and timeline.\n\nWHEN TO USE: U"},{"name":"evidence_pack_generator","description":"[Taxonomy VII.124 — baseline response (public data only)] Generate an evidence package supporting a claim or appeal (references, studies, policies).\n\nWHEN TO US"},{"name":"claim_rebuttal_generator","description":"[Taxonomy VII.128 — baseline response (public data only)] Generate a rebuttal to a payer's denial rationale point-by-point.\n\nWHEN TO USE: User has a denied clai"},{"name":"appeal_escalation_path_finder","description":"[Taxonomy VII.129 — baseline response (public data only)] Find the correct escalation path for a denied claim (internal appeal → external review → DOI).\n\nWHEN T"},{"name":"payer_specific_appeal_templates","description":"[Taxonomy VII.130 — baseline response (public data only)] Return payer-specific appeal templates known to perform well.\n\nWHEN TO USE: User has a denied claim an"},{"name":"denial_code_explainer","description":"[Taxonomy VII.131 — baseline response (public data only)] Explain a CARC/RARC denial code in plain language with common causes.\n\nWHEN TO USE: User asks 'what do"},{"name":"claim_reconsideration_builder","description":"[Taxonomy VII.132 — baseline response (public data only)] Build a claim reconsideration request (lighter-weight than a formal appeal).\n\nWHEN TO USE: User has a "},{"name":"supporting_document_selector","description":"[Taxonomy VII.135 — baseline response (public data only)] Select optimal supporting documents for an appeal from an available document pool.\n\nWHEN TO USE: User "},{"name":"out_of_pocket_optimizer","description":"[Taxonomy X.174 — baseline response (public data only)] Optimize out-of-pocket spend across a sequence of planned services.\n\nWHEN TO USE: User is planning for a"},{"name":"financial_exposure_model","description":"[Taxonomy X.176 — delegates to financial_risk_exposure_model] Model a member's financial exposure. Alias of financial_risk_exposure_model.\n\nWHEN TO USE: User is"},{"name":"procedure_affordability_ranker","description":"[Taxonomy X.177 — baseline response (public data only)] Rank a set of procedures by affordability for a given member.\n\nWHEN TO USE: User is planning for a medic"},{"name":"treatment_cost_comparator","description":"[Taxonomy X.178 — baseline response (public data only)] Compare expected costs across treatment alternatives for a condition.\n\nWHEN TO USE: User is planning for"},{"name":"bill_shock_predictor","description":"[Taxonomy X.179 — baseline response (public data only)] Predict risk that a planned service will trigger an unexpected large bill.\n\nWHEN TO USE: User planning a"},{"name":"payment_plan_optimizer","description":"[Taxonomy X.180 — baseline response (public data only)] Optimize a payment plan structure for a patient balance.\n\nWHEN TO USE: User has a balance and wants to s"},{"name":"financial_assistance_finder","description":"[Taxonomy X.181 — baseline response (public data only)] Find applicable financial-assistance programs (hospital charity, 340B, state, pharma).\n\nWHEN TO USE: Use"},{"name":"patient_cost_explainer","description":"[Taxonomy X.182 — baseline response (public data only)] Explain why a specific charge appears on a bill in plain language.\n\nWHEN TO USE: User is planning for a "},{"name":"healthcare_budget_forecaster","description":"[Taxonomy X.183 — baseline response (public data only)] Forecast a household's annual healthcare spend based on plan + utilization.\n\nWHEN TO USE: User planning "},{"name":"medical_spending_analyzer","description":"[Taxonomy X.184 — baseline response (public data only)] Analyze a patient's medical spending over a period and surface optimization opportunities.\n\nWHEN TO USE:"},{"name":"insurance_value_optimizer","description":"[Taxonomy X.185 — baseline response (public data only)] Recommend insurance-plan selections to maximize value given projected utilization.\n\nWHEN TO USE: User is"},{"name":"patient_financial_risk_score","description":"[Taxonomy X.186 — baseline response (public data only)] Score a patient's financial risk exposure from planned or ongoing care.\n\nWHEN TO USE: User is planning f"},{"name":"decode_denial","description":"Decode a CARC (Claim Adjustment Reason Code) denial code into plain English. Returns meaning, category, whether it's typically reversible on appeal, and appeal "},{"name":"get_appeal_deadline","description":"External-review filing deadline for a state + the date of the FINAL adverse determination. Returns the deadline date, the statutory window label + citation, and"},{"name":"get_venue","description":"Where and how to file an external review for a given state — the venue name, filing channel (portal/mail/fax), portal URL, and whether expedited review is avail"},{"name":"medigami_odds","description":"Historical external-review overturn rate published by the state regulator for the insurer you name, in a regulated venue (CA/NY/MD/NJ/MI/OH/NC). Returns one ins"},{"name":"medigami_roast","description":"Compare a billed charge against a hospital's own MRF-published negotiated rate for a CPT code; returns the markup multiple. Public regulator data, k-anonymity f"},{"name":"medigami_deadline","description":"Federal appeal-deadline window (ERISA §503 internal-appeal / ACA §2719 external-review / NSA IDR) for a plan type. Public regulator data, k-anonymity floored, n"},{"name":"medigami_rate","description":"A hospital's own MRF-published negotiated rate for a CPT code (no billed-amount comparison — use medigami_roast for that). Public regulator data, k-anonymity fl"}],"toolCount":87,"toolsHash":"c7d83d3598bc9743ce42bdba887f50436a00b4a82ff6989e4da5034fecd0402d","serverName":"medigami-public","capabilities":["experimental","resources","tools"],"serverVersion":"1.28.1","protocolVersion":"2025-06-18"}},{"at":"2026-10-08T09:24:26.660Z","kind":"mcp_initialize","ok":true,"httpStatus":200,"latencyMs":194,"error":null,"detail":{"tools":[{"name":"scan_bill_for_errors","description":"Scan a medical bill or EOB text for errors: duplicate charges, CPT unbundling, upcoding, facility-fee overcharges. Returns flagged anomalies with estimated doll"},{"name":"generate_appeal_letter","description":"Generate a legally-grounded insurance appeal letter for a denied claim. Returns the letter as a template with [PATIENT NAME] and [PROVIDER NAME] placeholders (s"},{"name":"optimize_prescription","description":"Find the lowest-cost path for a prescription: generics, biosimilars, GoodRx coupons, manufacturer assistance, 90-day fills, and mail-order vs retail comparison."},{"name":"analyze_glp1_pathways","description":"Find all access pathways for a GLP-1 drug (Ozempic, Wegovy, Mounjaro, Zepbound) given patient eligibility factors. Ranks pathways by monthly cost, flags prior-a"},{"name":"verify_attestation","description":"Verify an Ed25519-signed Medigami MCP response envelope — confirm a medical-bill / appeal / denial / rate answer came from Medigami and hasn't been tampered wit"},{"name":"watch_appeal_outcome","description":"Subscribe to an appeal outcome by tracking_id. Blocks up to `timeout_seconds` (default 300). Returns the outcome payload as soon as it's recorded, or {status: '"},{"name":"watch_claim_denial","description":"Subscribe to a claim denial event for a given scan_id. Blocks up to `timeout_seconds`. Returns {status: 'denied', ...} as soon as the payer marks the claim deni"},{"name":"format_citation","description":"Format an LLM-citable reference to a previously-attested Medigami MCP response. Input: either the full signed envelope that an earlier attested tool returned, O"},{"name":"submit_denial_letter","description":"Submit a medical-claim denial letter to the Medigami Denial Common Crawl (public aggregate dataset). Consent-gated — caller must pass consent=true to attest the"},{"name":"verify_mcp_response","description":"DEPRECATED ALIAS of verify_attestation — kept for backward compatibility with v0.1.7 clients. New code should call verify_attestation directly.\n\nWHEN TO USE: Re"},{"name":"format_medigami_citation","description":"DEPRECATED ALIAS of format_citation — kept for backward compatibility with v0.1.7 clients. New code should call format_citation directly.\n\nWHEN TO USE: Referenc"},{"name":"estimate_appeal_success","description":"Probability an appeal will be approved, derived from outcome-labeled data weighted by label provenance (IRO determinations, EOB reversals, physician confirmatio"},{"name":"resolve_denial","description":"End-to-end denial resolution: returns appeal probability + confidence interval + a drafted letter template grounded in aggregate outcome data + plan-context fla"},{"name":"maximize_recovery","description":"Given a prior scan_id, returns a prioritized action list: anomalies ranked by (expected overcharge x recovery probability), with the next steps to pursue each. "},{"name":"explain_appeal_success","description":"Human-readable rationale for an appeal probability. Returns {probability, tier, recommended_posture, rationale, expected_days_to_resolution, tracking_id} ground"},{"name":"negotiate_bill_script","description":"Generate a phone script the user can read when negotiating a medical bill directly with the provider. Combines DP-noised commercial rate benchmarks + the caller"},{"name":"batch_scan_bills","description":"Scan multiple medical bills in one call. Returns per-bill anomaly lists + total recovery estimate across the batch. Input is a list of {bill_text, provider?, in"},{"name":"lookup_icd10","description":"Look up an ICD-10-CM diagnosis code or search by keyword. Input is either an exact code (e.g. 'E11.21') or a free-text description phrase ('type 2 diabetes with"},{"name":"lookup_cpt","description":"Look up a CPT or HCPCS-J code or search by keyword. Covers the most common outpatient billing codes (E/M, preventive, lab, imaging, procedure, cardiology, thera"},{"name":"lookup_npi","description":"Look up a provider in the CMS NPPES National Provider Identifier registry. Accepts a 10-digit NPI number OR a provider name (optionally narrowed by 2-char state"},{"name":"verify_dea_authorization","description":"Validate the format + checksum of a DEA registration number (format: [A-Z][A-Z9][0-9]{7}; public checksum algorithm). Useful as a sanity check on a DEA number y"},{"name":"lookup_provider_taxonomy","description":"Look up a NUCC provider taxonomy code (the specialty codes used on HIPAA transactions + NPI registrations) or search by keyword. Returns classification + type +"},{"name":"resolve_codes","description":"[Taxonomy A.1 — baseline response (public data only)] Unified code resolver — free-form query or clinical description → ranked ICD-10-CM, CPT, and HCPCS codes w"},{"name":"code_conflict_detector","description":"[Taxonomy A.5 — delegates to scan_bill_for_errors] Detect CPT unbundling, mutually exclusive code pairs, and NCCI edit violations in a set of codes. Implemented"},{"name":"fair_price_estimator","description":"[Taxonomy B.8 — delegates to benchmark_payer_rate] Fair-market price distribution for a service: DP-noised percentiles (p10, p25, p50, p75, p90) for the given C"},{"name":"price_variance_analyzer","description":"[Taxonomy B.9 — baseline response (public data only)] Given a target price and a CPT+region, return how many standard deviations above/below the market the targ"},{"name":"claim_consistency_checker","description":"[Taxonomy C.14 — delegates to scan_bill_for_errors] Detect internal contradictions in a claim: time mismatches, mutually exclusive codes, missing required field"},{"name":"bundling_violation_detector","description":"[Taxonomy C.16 — delegates to scan_bill_for_errors] Detect CPT unbundling (billing components of a procedure separately to inflate the claim). Uses the CMS NCCI"},{"name":"appeal_success_predictor","description":"[Taxonomy E.25 — delegates to estimate_appeal_success] Given a denial, predict the probability of a successful appeal. Returns probability with 95% CI, sample s"},{"name":"generate_appeal_letter_v2","description":"[Taxonomy F.28 — delegates to generate_appeal_letter] [Taxonomy alias] Generate a state-specific insurance appeal letter with UPL-safe disclaimers for 19 US sta"},{"name":"negotiation_strategy_generator","description":"[Taxonomy F.30 — baseline response (public data only)] Given a bill + patient situation, generate a ranked negotiation strategy: hardship appeal, charity-care a"},{"name":"insurance_response_interpreter","description":"[Taxonomy F.31 — baseline response (public data only)] Parse an insurer's response letter or EOB into structured fields: denial reason codes, appeal rights, dea"},{"name":"settlement_optimizer","description":"[Taxonomy F.32 — baseline response (public data only)] For a disputed bill, compute the optimal settlement target price balancing probability of acceptance agai"},{"name":"patient_cost_forecaster","description":"[Taxonomy H.38 — baseline response (public data only)] Given a patient's plan + predicted care needs, forecast annual out-of-pocket spend across expected claims"},{"name":"insurance_plan_optimizer","description":"[Taxonomy H.39 — baseline response (public data only)] Given a patient's historical claim patterns, rank available insurance plans by expected annual cost.\n\nWHE"},{"name":"cash_vs_insurance_optimizer","description":"[Taxonomy H.41 — baseline response (public data only)] For a given service + patient plan, determine whether cash-pay + charity-care beats insurance billing.\n\nW"},{"name":"financial_risk_exposure_model","description":"[Taxonomy H.42 — baseline response (public data only)] Quantify a patient's financial exposure to medical-debt risk given current plan, health status, and histo"},{"name":"cpt_to_icd_mapper","description":"[Taxonomy II.21 — baseline response (public data only)] For a given CPT, surface the ICD-10 codes typically paired with it for medical-necessity support.\n\nWHEN "},{"name":"icd_to_cpt_mapper","description":"[Taxonomy II.22 — baseline response (public data only)] For a given ICD-10, surface the CPT codes typically billed for that diagnosis.\n\nWHEN TO USE: User has an"},{"name":"code_bundle_validator","description":"[Taxonomy II.25 — baseline response (public data only)] Check a set of CPT codes against NCCI bundling rules (distinct from modifier-based unbundling).\n\nWHEN TO"},{"name":"unbundling_detector","description":"[Taxonomy II.26 — delegates to scan_bill_for_errors] Detect CPT unbundling patterns in a claim. Alias of scan_bill_for_errors.\n\nWHEN TO USE: User asks about med"},{"name":"cash_price_estimator","description":"[Taxonomy III.39 — baseline response (public data only)] Estimate a fair cash price for a service in a given region (no-insurance path).\n\nWHEN TO USE: Uninsured"},{"name":"zip_based_price_variance","description":"[Taxonomy III.41 — baseline response (public data only)] Report price variance for a CPT across ZIP3 regions with DP noise.\n\nWHEN TO USE: User wants to understa"},{"name":"regional_price_benchmark","description":"[Taxonomy III.43 — baseline response (public data only)] Regional price benchmark for a CPT at state/metro/ZIP3 granularity.\n\nWHEN TO USE: User wants to underst"},{"name":"specialty_price_benchmark","description":"[Taxonomy III.44 — baseline response (public data only)] Price benchmark for a CPT within a specific provider specialty.\n\nWHEN TO USE: User wants to understand "},{"name":"inflation_adjusted_price_model","description":"[Taxonomy III.46 — baseline response (public data only)] Inflation-adjusted price comparison across years for a CPT.\n\nWHEN TO USE: User has a historical dollar "},{"name":"deductible_impact_calculator","description":"[Taxonomy III.48 — baseline response (public data only)] Estimate how a planned service will draw against the member's deductible.\n\nWHEN TO USE: User wants to k"},{"name":"coinsurance_simulator","description":"[Taxonomy III.49 — baseline response (public data only)] Simulate member coinsurance exposure across plan-design variants.\n\nWHEN TO USE: User wants to model the"},{"name":"copay_model","description":"[Taxonomy III.50 — baseline response (public data only)] Model member copay for a service by plan-design class.\n\nWHEN TO USE: User wants the typical copay for a"},{"name":"billing_charge_vs_allowed_delta","description":"[Taxonomy III.51 — baseline response (public data only)] Delta between billed charge and payer-allowed amount for a claim line.\n\nWHEN TO USE: User wants to unde"},{"name":"price_anomaly_detector","description":"[Taxonomy III.52 — baseline response (public data only)] Detect service-line prices statistically anomalous versus market.\n\nWHEN TO USE: User wants to understan"},{"name":"overpriced_service_detector","description":"[Taxonomy III.53 — baseline response (public data only)] Flag services billed materially above market percentile thresholds.\n\nWHEN TO USE: User wants to underst"},{"name":"market_price_distribution_model","description":"[Taxonomy III.55 — baseline response (public data only)] Full DP-noised market price distribution for a CPT+region pair.\n\nWHEN TO USE: User wants to understand "},{"name":"price_outlier_detector","description":"[Taxonomy III.56 — baseline response (public data only)] Detect claim-line outliers relative to a learned market distribution.\n\nWHEN TO USE: User wants to under"},{"name":"procedure_cost_decomposition","description":"[Taxonomy III.57 — baseline response (public data only)] Decompose the cost of a procedure into component services + facility + professional fees.\n\nWHEN TO USE:"},{"name":"price_recommendation_engine","description":"[Taxonomy III.58 — baseline response (public data only)] Recommend a reasonable price to propose to a provider for a service (self-pay or negotiation).\n\nWHEN TO"},{"name":"claim_duplicate_line_detector","description":"[Taxonomy IV.75 — baseline response (public data only)] Detect duplicated service lines within a single claim.\n\nWHEN TO USE: Caller is building or validating a "},{"name":"denial_reason_classifier","description":"[Taxonomy VI.106 — baseline response (public data only)] Classify a denial letter or remittance advice into normalized denial-reason categories.\n\nWHEN TO USE: U"},{"name":"appeal_argument_generator","description":"[Taxonomy VII.120 — baseline response (public data only)] Generate component arguments for an appeal letter: medical-necessity, contract, policy.\n\nWHEN TO USE: "},{"name":"denial_response_builder","description":"[Taxonomy VII.121 — baseline response (public data only)] Build a denial-response package tailored to the denial reason code.\n\nWHEN TO USE: User has a denied cl"},{"name":"dispute_case_builder","description":"[Taxonomy VII.123 — baseline response (public data only)] Assemble a complete dispute case file including claim, denial, evidence, and timeline.\n\nWHEN TO USE: U"},{"name":"evidence_pack_generator","description":"[Taxonomy VII.124 — baseline response (public data only)] Generate an evidence package supporting a claim or appeal (references, studies, policies).\n\nWHEN TO US"},{"name":"claim_rebuttal_generator","description":"[Taxonomy VII.128 — baseline response (public data only)] Generate a rebuttal to a payer's denial rationale point-by-point.\n\nWHEN TO USE: User has a denied clai"},{"name":"appeal_escalation_path_finder","description":"[Taxonomy VII.129 — baseline response (public data only)] Find the correct escalation path for a denied claim (internal appeal → external review → DOI).\n\nWHEN T"},{"name":"payer_specific_appeal_templates","description":"[Taxonomy VII.130 — baseline response (public data only)] Return payer-specific appeal templates known to perform well.\n\nWHEN TO USE: User has a denied claim an"},{"name":"denial_code_explainer","description":"[Taxonomy VII.131 — baseline response (public data only)] Explain a CARC/RARC denial code in plain language with common causes.\n\nWHEN TO USE: User asks 'what do"},{"name":"claim_reconsideration_builder","description":"[Taxonomy VII.132 — baseline response (public data only)] Build a claim reconsideration request (lighter-weight than a formal appeal).\n\nWHEN TO USE: User has a "},{"name":"supporting_document_selector","description":"[Taxonomy VII.135 — baseline response (public data only)] Select optimal supporting documents for an appeal from an available document pool.\n\nWHEN TO USE: User "},{"name":"out_of_pocket_optimizer","description":"[Taxonomy X.174 — baseline response (public data only)] Optimize out-of-pocket spend across a sequence of planned services.\n\nWHEN TO USE: User is planning for a"},{"name":"financial_exposure_model","description":"[Taxonomy X.176 — delegates to financial_risk_exposure_model] Model a member's financial exposure. Alias of financial_risk_exposure_model.\n\nWHEN TO USE: User is"},{"name":"procedure_affordability_ranker","description":"[Taxonomy X.177 — baseline response (public data only)] Rank a set of procedures by affordability for a given member.\n\nWHEN TO USE: User is planning for a medic"},{"name":"treatment_cost_comparator","description":"[Taxonomy X.178 — baseline response (public data only)] Compare expected costs across treatment alternatives for a condition.\n\nWHEN TO USE: User is planning for"},{"name":"bill_shock_predictor","description":"[Taxonomy X.179 — baseline response (public data only)] Predict risk that a planned service will trigger an unexpected large bill.\n\nWHEN TO USE: User planning a"},{"name":"payment_plan_optimizer","description":"[Taxonomy X.180 — baseline response (public data only)] Optimize a payment plan structure for a patient balance.\n\nWHEN TO USE: User has a balance and wants to s"},{"name":"financial_assistance_finder","description":"[Taxonomy X.181 — baseline response (public data only)] Find applicable financial-assistance programs (hospital charity, 340B, state, pharma).\n\nWHEN TO USE: Use"},{"name":"patient_cost_explainer","description":"[Taxonomy X.182 — baseline response (public data only)] Explain why a specific charge appears on a bill in plain language.\n\nWHEN TO USE: User is planning for a "},{"name":"healthcare_budget_forecaster","description":"[Taxonomy X.183 — baseline response (public data only)] Forecast a household's annual healthcare spend based on plan + utilization.\n\nWHEN TO USE: User planning "},{"name":"medical_spending_analyzer","description":"[Taxonomy X.184 — baseline response (public data only)] Analyze a patient's medical spending over a period and surface optimization opportunities.\n\nWHEN TO USE:"},{"name":"insurance_value_optimizer","description":"[Taxonomy X.185 — baseline response (public data only)] Recommend insurance-plan selections to maximize value given projected utilization.\n\nWHEN TO USE: User is"},{"name":"patient_financial_risk_score","description":"[Taxonomy X.186 — baseline response (public data only)] Score a patient's financial risk exposure from planned or ongoing care.\n\nWHEN TO USE: User is planning f"},{"name":"decode_denial","description":"Decode a CARC (Claim Adjustment Reason Code) denial code into plain English. Returns meaning, category, whether it's typically reversible on appeal, and appeal "},{"name":"get_appeal_deadline","description":"External-review filing deadline for a state + the date of the FINAL adverse determination. Returns the deadline date, the statutory window label + citation, and"},{"name":"get_venue","description":"Where and how to file an external review for a given state — the venue name, filing channel (portal/mail/fax), portal URL, and whether expedited review is avail"},{"name":"medigami_odds","description":"Historical external-review overturn rate published by the state regulator for the insurer you name, in a regulated venue (CA/NY/MD/NJ/MI/OH/NC). Returns one ins"},{"name":"medigami_roast","description":"Compare a billed charge against a hospital's own MRF-published negotiated rate for a CPT code; returns the markup multiple. Public regulator data, k-anonymity f"},{"name":"medigami_deadline","description":"Federal appeal-deadline window (ERISA §503 internal-appeal / ACA §2719 external-review / NSA IDR) for a plan type. Public regulator data, k-anonymity floored, n"},{"name":"medigami_rate","description":"A hospital's own MRF-published negotiated rate for a CPT code (no billed-amount comparison — use medigami_roast for that). Public regulator data, k-anonymity fl"}],"toolCount":87,"toolsHash":"c7d83d3598bc9743ce42bdba887f50436a00b4a82ff6989e4da5034fecd0402d","serverName":"medigami-public","capabilities":["experimental","resources","tools"],"serverVersion":"1.28.1","protocolVersion":"2025-06-18"}},{"at":"2026-10-08T03:24:47.668Z","kind":"mcp_initialize","ok":true,"httpStatus":200,"latencyMs":212,"error":null,"detail":{"tools":[{"name":"scan_bill_for_errors","description":"Scan a medical bill or EOB text for errors: duplicate charges, CPT unbundling, upcoding, facility-fee overcharges. Returns flagged anomalies with estimated doll"},{"name":"generate_appeal_letter","description":"Generate a legally-grounded insurance appeal letter for a denied claim. Returns the letter as a template with [PATIENT NAME] and [PROVIDER NAME] placeholders (s"},{"name":"optimize_prescription","description":"Find the lowest-cost path for a prescription: generics, biosimilars, GoodRx coupons, manufacturer assistance, 90-day fills, and mail-order vs retail comparison."},{"name":"analyze_glp1_pathways","description":"Find all access pathways for a GLP-1 drug (Ozempic, Wegovy, Mounjaro, Zepbound) given patient eligibility factors. Ranks pathways by monthly cost, flags prior-a"},{"name":"verify_attestation","description":"Verify an Ed25519-signed Medigami MCP response envelope — confirm a medical-bill / appeal / denial / rate answer came from Medigami and hasn't been tampered wit"},{"name":"watch_appeal_outcome","description":"Subscribe to an appeal outcome by tracking_id. Blocks up to `timeout_seconds` (default 300). Returns the outcome payload as soon as it's recorded, or {status: '"},{"name":"watch_claim_denial","description":"Subscribe to a claim denial event for a given scan_id. Blocks up to `timeout_seconds`. Returns {status: 'denied', ...} as soon as the payer marks the claim deni"},{"name":"format_citation","description":"Format an LLM-citable reference to a previously-attested Medigami MCP response. Input: either the full signed envelope that an earlier attested tool returned, O"},{"name":"submit_denial_letter","description":"Submit a medical-claim denial letter to the Medigami Denial Common Crawl (public aggregate dataset). Consent-gated — caller must pass consent=true to attest the"},{"name":"verify_mcp_response","description":"DEPRECATED ALIAS of verify_attestation — kept for backward compatibility with v0.1.7 clients. New code should call verify_attestation directly.\n\nWHEN TO USE: Re"},{"name":"format_medigami_citation","description":"DEPRECATED ALIAS of format_citation — kept for backward compatibility with v0.1.7 clients. New code should call format_citation directly.\n\nWHEN TO USE: Referenc"},{"name":"estimate_appeal_success","description":"Probability an appeal will be approved, derived from outcome-labeled data weighted by label provenance (IRO determinations, EOB reversals, physician confirmatio"},{"name":"resolve_denial","description":"End-to-end denial resolution: returns appeal probability + confidence interval + a drafted letter template grounded in aggregate outcome data + plan-context fla"},{"name":"maximize_recovery","description":"Given a prior scan_id, returns a prioritized action list: anomalies ranked by (expected overcharge x recovery probability), with the next steps to pursue each. "},{"name":"explain_appeal_success","description":"Human-readable rationale for an appeal probability. Returns {probability, tier, recommended_posture, rationale, expected_days_to_resolution, tracking_id} ground"},{"name":"negotiate_bill_script","description":"Generate a phone script the user can read when negotiating a medical bill directly with the provider. Combines DP-noised commercial rate benchmarks + the caller"},{"name":"batch_scan_bills","description":"Scan multiple medical bills in one call. Returns per-bill anomaly lists + total recovery estimate across the batch. Input is a list of {bill_text, provider?, in"},{"name":"lookup_icd10","description":"Look up an ICD-10-CM diagnosis code or search by keyword. Input is either an exact code (e.g. 'E11.21') or a free-text description phrase ('type 2 diabetes with"},{"name":"lookup_cpt","description":"Look up a CPT or HCPCS-J code or search by keyword. Covers the most common outpatient billing codes (E/M, preventive, lab, imaging, procedure, cardiology, thera"},{"name":"lookup_npi","description":"Look up a provider in the CMS NPPES National Provider Identifier registry. Accepts a 10-digit NPI number OR a provider name (optionally narrowed by 2-char state"},{"name":"verify_dea_authorization","description":"Validate the format + checksum of a DEA registration number (format: [A-Z][A-Z9][0-9]{7}; public checksum algorithm). Useful as a sanity check on a DEA number y"},{"name":"lookup_provider_taxonomy","description":"Look up a NUCC provider taxonomy code (the specialty codes used on HIPAA transactions + NPI registrations) or search by keyword. Returns classification + type +"},{"name":"resolve_codes","description":"[Taxonomy A.1 — baseline response (public data only)] Unified code resolver — free-form query or clinical description → ranked ICD-10-CM, CPT, and HCPCS codes w"},{"name":"code_conflict_detector","description":"[Taxonomy A.5 — delegates to scan_bill_for_errors] Detect CPT unbundling, mutually exclusive code pairs, and NCCI edit violations in a set of codes. Implemented"},{"name":"fair_price_estimator","description":"[Taxonomy B.8 — delegates to benchmark_payer_rate] Fair-market price distribution for a service: DP-noised percentiles (p10, p25, p50, p75, p90) for the given C"},{"name":"price_variance_analyzer","description":"[Taxonomy B.9 — baseline response (public data only)] Given a target price and a CPT+region, return how many standard deviations above/below the market the targ"},{"name":"claim_consistency_checker","description":"[Taxonomy C.14 — delegates to scan_bill_for_errors] Detect internal contradictions in a claim: time mismatches, mutually exclusive codes, missing required field"},{"name":"bundling_violation_detector","description":"[Taxonomy C.16 — delegates to scan_bill_for_errors] Detect CPT unbundling (billing components of a procedure separately to inflate the claim). Uses the CMS NCCI"},{"name":"appeal_success_predictor","description":"[Taxonomy E.25 — delegates to estimate_appeal_success] Given a denial, predict the probability of a successful appeal. Returns probability with 95% CI, sample s"},{"name":"generate_appeal_letter_v2","description":"[Taxonomy F.28 — delegates to generate_appeal_letter] [Taxonomy alias] Generate a state-specific insurance appeal letter with UPL-safe disclaimers for 19 US sta"},{"name":"negotiation_strategy_generator","description":"[Taxonomy F.30 — baseline response (public data only)] Given a bill + patient situation, generate a ranked negotiation strategy: hardship appeal, charity-care a"},{"name":"insurance_response_interpreter","description":"[Taxonomy F.31 — baseline response (public data only)] Parse an insurer's response letter or EOB into structured fields: denial reason codes, appeal rights, dea"},{"name":"settlement_optimizer","description":"[Taxonomy F.32 — baseline response (public data only)] For a disputed bill, compute the optimal settlement target price balancing probability of acceptance agai"},{"name":"patient_cost_forecaster","description":"[Taxonomy H.38 — baseline response (public data only)] Given a patient's plan + predicted care needs, forecast annual out-of-pocket spend across expected claims"},{"name":"insurance_plan_optimizer","description":"[Taxonomy H.39 — baseline response (public data only)] Given a patient's historical claim patterns, rank available insurance plans by expected annual cost.\n\nWHE"},{"name":"cash_vs_insurance_optimizer","description":"[Taxonomy H.41 — baseline response (public data only)] For a given service + patient plan, determine whether cash-pay + charity-care beats insurance billing.\n\nW"},{"name":"financial_risk_exposure_model","description":"[Taxonomy H.42 — baseline response (public data only)] Quantify a patient's financial exposure to medical-debt risk given current plan, health status, and histo"},{"name":"cpt_to_icd_mapper","description":"[Taxonomy II.21 — baseline response (public data only)] For a given CPT, surface the ICD-10 codes typically paired with it for medical-necessity support.\n\nWHEN "},{"name":"icd_to_cpt_mapper","description":"[Taxonomy II.22 — baseline response (public data only)] For a given ICD-10, surface the CPT codes typically billed for that diagnosis.\n\nWHEN TO USE: User has an"},{"name":"code_bundle_validator","description":"[Taxonomy II.25 — baseline response (public data only)] Check a set of CPT codes against NCCI bundling rules (distinct from modifier-based unbundling).\n\nWHEN TO"},{"name":"unbundling_detector","description":"[Taxonomy II.26 — delegates to scan_bill_for_errors] Detect CPT unbundling patterns in a claim. Alias of scan_bill_for_errors.\n\nWHEN TO USE: User asks about med"},{"name":"cash_price_estimator","description":"[Taxonomy III.39 — baseline response (public data only)] Estimate a fair cash price for a service in a given region (no-insurance path).\n\nWHEN TO USE: Uninsured"},{"name":"zip_based_price_variance","description":"[Taxonomy III.41 — baseline response (public data only)] Report price variance for a CPT across ZIP3 regions with DP noise.\n\nWHEN TO USE: User wants to understa"},{"name":"regional_price_benchmark","description":"[Taxonomy III.43 — baseline response (public data only)] Regional price benchmark for a CPT at state/metro/ZIP3 granularity.\n\nWHEN TO USE: User wants to underst"},{"name":"specialty_price_benchmark","description":"[Taxonomy III.44 — baseline response (public data only)] Price benchmark for a CPT within a specific provider specialty.\n\nWHEN TO USE: User wants to understand "},{"name":"inflation_adjusted_price_model","description":"[Taxonomy III.46 — baseline response (public data only)] Inflation-adjusted price comparison across years for a CPT.\n\nWHEN TO USE: User has a historical dollar "},{"name":"deductible_impact_calculator","description":"[Taxonomy III.48 — baseline response (public data only)] Estimate how a planned service will draw against the member's deductible.\n\nWHEN TO USE: User wants to k"},{"name":"coinsurance_simulator","description":"[Taxonomy III.49 — baseline response (public data only)] Simulate member coinsurance exposure across plan-design variants.\n\nWHEN TO USE: User wants to model the"},{"name":"copay_model","description":"[Taxonomy III.50 — baseline response (public data only)] Model member copay for a service by plan-design class.\n\nWHEN TO USE: User wants the typical copay for a"},{"name":"billing_charge_vs_allowed_delta","description":"[Taxonomy III.51 — baseline response (public data only)] Delta between billed charge and payer-allowed amount for a claim line.\n\nWHEN TO USE: User wants to unde"},{"name":"price_anomaly_detector","description":"[Taxonomy III.52 — baseline response (public data only)] Detect service-line prices statistically anomalous versus market.\n\nWHEN TO USE: User wants to understan"},{"name":"overpriced_service_detector","description":"[Taxonomy III.53 — baseline response (public data only)] Flag services billed materially above market percentile thresholds.\n\nWHEN TO USE: User wants to underst"},{"name":"market_price_distribution_model","description":"[Taxonomy III.55 — baseline response (public data only)] Full DP-noised market price distribution for a CPT+region pair.\n\nWHEN TO USE: User wants to understand "},{"name":"price_outlier_detector","description":"[Taxonomy III.56 — baseline response (public data only)] Detect claim-line outliers relative to a learned market distribution.\n\nWHEN TO USE: User wants to under"},{"name":"procedure_cost_decomposition","description":"[Taxonomy III.57 — baseline response (public data only)] Decompose the cost of a procedure into component services + facility + professional fees.\n\nWHEN TO USE:"},{"name":"price_recommendation_engine","description":"[Taxonomy III.58 — baseline response (public data only)] Recommend a reasonable price to propose to a provider for a service (self-pay or negotiation).\n\nWHEN TO"},{"name":"claim_duplicate_line_detector","description":"[Taxonomy IV.75 — baseline response (public data only)] Detect duplicated service lines within a single claim.\n\nWHEN TO USE: Caller is building or validating a "},{"name":"denial_reason_classifier","description":"[Taxonomy VI.106 — baseline response (public data only)] Classify a denial letter or remittance advice into normalized denial-reason categories.\n\nWHEN TO USE: U"},{"name":"appeal_argument_generator","description":"[Taxonomy VII.120 — baseline response (public data only)] Generate component arguments for an appeal letter: medical-necessity, contract, policy.\n\nWHEN TO USE: "},{"name":"denial_response_builder","description":"[Taxonomy VII.121 — baseline response (public data only)] Build a denial-response package tailored to the denial reason code.\n\nWHEN TO USE: User has a denied cl"},{"name":"dispute_case_builder","description":"[Taxonomy VII.123 — baseline response (public data only)] Assemble a complete dispute case file including claim, denial, evidence, and timeline.\n\nWHEN TO USE: U"},{"name":"evidence_pack_generator","description":"[Taxonomy VII.124 — baseline response (public data only)] Generate an evidence package supporting a claim or appeal (references, studies, policies).\n\nWHEN TO US"},{"name":"claim_rebuttal_generator","description":"[Taxonomy VII.128 — baseline response (public data only)] Generate a rebuttal to a payer's denial rationale point-by-point.\n\nWHEN TO USE: User has a denied clai"},{"name":"appeal_escalation_path_finder","description":"[Taxonomy VII.129 — baseline response (public data only)] Find the correct escalation path for a denied claim (internal appeal → external review → DOI).\n\nWHEN T"},{"name":"payer_specific_appeal_templates","description":"[Taxonomy VII.130 — baseline response (public data only)] Return payer-specific appeal templates known to perform well.\n\nWHEN TO USE: User has a denied claim an"},{"name":"denial_code_explainer","description":"[Taxonomy VII.131 — baseline response (public data only)] Explain a CARC/RARC denial code in plain language with common causes.\n\nWHEN TO USE: User asks 'what do"},{"name":"claim_reconsideration_builder","description":"[Taxonomy VII.132 — baseline response (public data only)] Build a claim reconsideration request (lighter-weight than a formal appeal).\n\nWHEN TO USE: User has a "},{"name":"supporting_document_selector","description":"[Taxonomy VII.135 — baseline response (public data only)] Select optimal supporting documents for an appeal from an available document pool.\n\nWHEN TO USE: User "},{"name":"out_of_pocket_optimizer","description":"[Taxonomy X.174 — baseline response (public data only)] Optimize out-of-pocket spend across a sequence of planned services.\n\nWHEN TO USE: User is planning for a"},{"name":"financial_exposure_model","description":"[Taxonomy X.176 — delegates to financial_risk_exposure_model] Model a member's financial exposure. Alias of financial_risk_exposure_model.\n\nWHEN TO USE: User is"},{"name":"procedure_affordability_ranker","description":"[Taxonomy X.177 — baseline response (public data only)] Rank a set of procedures by affordability for a given member.\n\nWHEN TO USE: User is planning for a medic"},{"name":"treatment_cost_comparator","description":"[Taxonomy X.178 — baseline response (public data only)] Compare expected costs across treatment alternatives for a condition.\n\nWHEN TO USE: User is planning for"},{"name":"bill_shock_predictor","description":"[Taxonomy X.179 — baseline response (public data only)] Predict risk that a planned service will trigger an unexpected large bill.\n\nWHEN TO USE: User planning a"},{"name":"payment_plan_optimizer","description":"[Taxonomy X.180 — baseline response (public data only)] Optimize a payment plan structure for a patient balance.\n\nWHEN TO USE: User has a balance and wants to s"},{"name":"financial_assistance_finder","description":"[Taxonomy X.181 — baseline response (public data only)] Find applicable financial-assistance programs (hospital charity, 340B, state, pharma).\n\nWHEN TO USE: Use"},{"name":"patient_cost_explainer","description":"[Taxonomy X.182 — baseline response (public data only)] Explain why a specific charge appears on a bill in plain language.\n\nWHEN TO USE: User is planning for a "},{"name":"healthcare_budget_forecaster","description":"[Taxonomy X.183 — baseline response (public data only)] Forecast a household's annual healthcare spend based on plan + utilization.\n\nWHEN TO USE: User planning "},{"name":"medical_spending_analyzer","description":"[Taxonomy X.184 — baseline response (public data only)] Analyze a patient's medical spending over a period and surface optimization opportunities.\n\nWHEN TO USE:"},{"name":"insurance_value_optimizer","description":"[Taxonomy X.185 — baseline response (public data only)] Recommend insurance-plan selections to maximize value given projected utilization.\n\nWHEN TO USE: User is"},{"name":"patient_financial_risk_score","description":"[Taxonomy X.186 — baseline response (public data only)] Score a patient's financial risk exposure from planned or ongoing care.\n\nWHEN TO USE: User is planning f"},{"name":"decode_denial","description":"Decode a CARC (Claim Adjustment Reason Code) denial code into plain English. Returns meaning, category, whether it's typically reversible on appeal, and appeal "},{"name":"get_appeal_deadline","description":"External-review filing deadline for a state + the date of the FINAL adverse determination. Returns the deadline date, the statutory window label + citation, and"},{"name":"get_venue","description":"Where and how to file an external review for a given state — the venue name, filing channel (portal/mail/fax), portal URL, and whether expedited review is avail"},{"name":"medigami_odds","description":"Historical external-review overturn rate published by the state regulator for the insurer you name, in a regulated venue (CA/NY/MD/NJ/MI/OH/NC). Returns one ins"},{"name":"medigami_roast","description":"Compare a billed charge against a hospital's own MRF-published negotiated rate for a CPT code; returns the markup multiple. Public regulator data, k-anonymity f"},{"name":"medigami_deadline","description":"Federal appeal-deadline window (ERISA §503 internal-appeal / ACA §2719 external-review / NSA IDR) for a plan type. Public regulator data, k-anonymity floored, n"},{"name":"medigami_rate","description":"A hospital's own MRF-published negotiated rate for a CPT code (no billed-amount comparison — use medigami_roast for that). Public regulator data, k-anonymity fl"}],"toolCount":87,"toolsHash":"c7d83d3598bc9743ce42bdba887f50436a00b4a82ff6989e4da5034fecd0402d","serverName":"medigami-public","capabilities":["experimental","resources","tools"],"serverVersion":"1.28.1","protocolVersion":"2025-06-18"}},{"at":"2026-10-07T21:27:33.923Z","kind":"mcp_initialize","ok":true,"httpStatus":200,"latencyMs":176,"error":null,"detail":{"tools":[{"name":"scan_bill_for_errors","description":"Scan a medical bill or EOB text for errors: duplicate charges, CPT unbundling, upcoding, facility-fee overcharges. Returns flagged anomalies with estimated doll"},{"name":"generate_appeal_letter","description":"Generate a legally-grounded insurance appeal letter for a denied claim. Returns the letter as a template with [PATIENT NAME] and [PROVIDER NAME] placeholders (s"},{"name":"optimize_prescription","description":"Find the lowest-cost path for a prescription: generics, biosimilars, GoodRx coupons, manufacturer assistance, 90-day fills, and mail-order vs retail comparison."},{"name":"analyze_glp1_pathways","description":"Find all access pathways for a GLP-1 drug (Ozempic, Wegovy, Mounjaro, Zepbound) given patient eligibility factors. Ranks pathways by monthly cost, flags prior-a"},{"name":"verify_attestation","description":"Verify an Ed25519-signed Medigami MCP response envelope — confirm a medical-bill / appeal / denial / rate answer came from Medigami and hasn't been tampered wit"},{"name":"watch_appeal_outcome","description":"Subscribe to an appeal outcome by tracking_id. Blocks up to `timeout_seconds` (default 300). Returns the outcome payload as soon as it's recorded, or {status: '"},{"name":"watch_claim_denial","description":"Subscribe to a claim denial event for a given scan_id. Blocks up to `timeout_seconds`. Returns {status: 'denied', ...} as soon as the payer marks the claim deni"},{"name":"format_citation","description":"Format an LLM-citable reference to a previously-attested Medigami MCP response. Input: either the full signed envelope that an earlier attested tool returned, O"},{"name":"submit_denial_letter","description":"Submit a medical-claim denial letter to the Medigami Denial Common Crawl (public aggregate dataset). Consent-gated — caller must pass consent=true to attest the"},{"name":"verify_mcp_response","description":"DEPRECATED ALIAS of verify_attestation — kept for backward compatibility with v0.1.7 clients. New code should call verify_attestation directly.\n\nWHEN TO USE: Re"},{"name":"format_medigami_citation","description":"DEPRECATED ALIAS of format_citation — kept for backward compatibility with v0.1.7 clients. New code should call format_citation directly.\n\nWHEN TO USE: Referenc"},{"name":"estimate_appeal_success","description":"Probability an appeal will be approved, derived from outcome-labeled data weighted by label provenance (IRO determinations, EOB reversals, physician confirmatio"},{"name":"resolve_denial","description":"End-to-end denial resolution: returns appeal probability + confidence interval + a drafted letter template grounded in aggregate outcome data + plan-context fla"},{"name":"maximize_recovery","description":"Given a prior scan_id, returns a prioritized action list: anomalies ranked by (expected overcharge x recovery probability), with the next steps to pursue each. "},{"name":"explain_appeal_success","description":"Human-readable rationale for an appeal probability. Returns {probability, tier, recommended_posture, rationale, expected_days_to_resolution, tracking_id} ground"},{"name":"negotiate_bill_script","description":"Generate a phone script the user can read when negotiating a medical bill directly with the provider. Combines DP-noised commercial rate benchmarks + the caller"},{"name":"batch_scan_bills","description":"Scan multiple medical bills in one call. Returns per-bill anomaly lists + total recovery estimate across the batch. Input is a list of {bill_text, provider?, in"},{"name":"lookup_icd10","description":"Look up an ICD-10-CM diagnosis code or search by keyword. Input is either an exact code (e.g. 'E11.21') or a free-text description phrase ('type 2 diabetes with"},{"name":"lookup_cpt","description":"Look up a CPT or HCPCS-J code or search by keyword. Covers the most common outpatient billing codes (E/M, preventive, lab, imaging, procedure, cardiology, thera"},{"name":"lookup_npi","description":"Look up a provider in the CMS NPPES National Provider Identifier registry. Accepts a 10-digit NPI number OR a provider name (optionally narrowed by 2-char state"},{"name":"verify_dea_authorization","description":"Validate the format + checksum of a DEA registration number (format: [A-Z][A-Z9][0-9]{7}; public checksum algorithm). Useful as a sanity check on a DEA number y"},{"name":"lookup_provider_taxonomy","description":"Look up a NUCC provider taxonomy code (the specialty codes used on HIPAA transactions + NPI registrations) or search by keyword. Returns classification + type +"},{"name":"resolve_codes","description":"[Taxonomy A.1 — baseline response (public data only)] Unified code resolver — free-form query or clinical description → ranked ICD-10-CM, CPT, and HCPCS codes w"},{"name":"code_conflict_detector","description":"[Taxonomy A.5 — delegates to scan_bill_for_errors] Detect CPT unbundling, mutually exclusive code pairs, and NCCI edit violations in a set of codes. Implemented"},{"name":"fair_price_estimator","description":"[Taxonomy B.8 — delegates to benchmark_payer_rate] Fair-market price distribution for a service: DP-noised percentiles (p10, p25, p50, p75, p90) for the given C"},{"name":"price_variance_analyzer","description":"[Taxonomy B.9 — baseline response (public data only)] Given a target price and a CPT+region, return how many standard deviations above/below the market the targ"},{"name":"claim_consistency_checker","description":"[Taxonomy C.14 — delegates to scan_bill_for_errors] Detect internal contradictions in a claim: time mismatches, mutually exclusive codes, missing required field"},{"name":"bundling_violation_detector","description":"[Taxonomy C.16 — delegates to scan_bill_for_errors] Detect CPT unbundling (billing components of a procedure separately to inflate the claim). Uses the CMS NCCI"},{"name":"appeal_success_predictor","description":"[Taxonomy E.25 — delegates to estimate_appeal_success] Given a denial, predict the probability of a successful appeal. Returns probability with 95% CI, sample s"},{"name":"generate_appeal_letter_v2","description":"[Taxonomy F.28 — delegates to generate_appeal_letter] [Taxonomy alias] Generate a state-specific insurance appeal letter with UPL-safe disclaimers for 19 US sta"},{"name":"negotiation_strategy_generator","description":"[Taxonomy F.30 — baseline response (public data only)] Given a bill + patient situation, generate a ranked negotiation strategy: hardship appeal, charity-care a"},{"name":"insurance_response_interpreter","description":"[Taxonomy F.31 — baseline response (public data only)] Parse an insurer's response letter or EOB into structured fields: denial reason codes, appeal rights, dea"},{"name":"settlement_optimizer","description":"[Taxonomy F.32 — baseline response (public data only)] For a disputed bill, compute the optimal settlement target price balancing probability of acceptance agai"},{"name":"patient_cost_forecaster","description":"[Taxonomy H.38 — baseline response (public data only)] Given a patient's plan + predicted care needs, forecast annual out-of-pocket spend across expected claims"},{"name":"insurance_plan_optimizer","description":"[Taxonomy H.39 — baseline response (public data only)] Given a patient's historical claim patterns, rank available insurance plans by expected annual cost.\n\nWHE"},{"name":"cash_vs_insurance_optimizer","description":"[Taxonomy H.41 — baseline response (public data only)] For a given service + patient plan, determine whether cash-pay + charity-care beats insurance billing.\n\nW"},{"name":"financial_risk_exposure_model","description":"[Taxonomy H.42 — baseline response (public data only)] Quantify a patient's financial exposure to medical-debt risk given current plan, health status, and histo"},{"name":"cpt_to_icd_mapper","description":"[Taxonomy II.21 — baseline response (public data only)] For a given CPT, surface the ICD-10 codes typically paired with it for medical-necessity support.\n\nWHEN "},{"name":"icd_to_cpt_mapper","description":"[Taxonomy II.22 — baseline response (public data only)] For a given ICD-10, surface the CPT codes typically billed for that diagnosis.\n\nWHEN TO USE: User has an"},{"name":"code_bundle_validator","description":"[Taxonomy II.25 — baseline response (public data only)] Check a set of CPT codes against NCCI bundling rules (distinct from modifier-based unbundling).\n\nWHEN TO"},{"name":"unbundling_detector","description":"[Taxonomy II.26 — delegates to scan_bill_for_errors] Detect CPT unbundling patterns in a claim. Alias of scan_bill_for_errors.\n\nWHEN TO USE: User asks about med"},{"name":"cash_price_estimator","description":"[Taxonomy III.39 — baseline response (public data only)] Estimate a fair cash price for a service in a given region (no-insurance path).\n\nWHEN TO USE: Uninsured"},{"name":"zip_based_price_variance","description":"[Taxonomy III.41 — baseline response (public data only)] Report price variance for a CPT across ZIP3 regions with DP noise.\n\nWHEN TO USE: User wants to understa"},{"name":"regional_price_benchmark","description":"[Taxonomy III.43 — baseline response (public data only)] Regional price benchmark for a CPT at state/metro/ZIP3 granularity.\n\nWHEN TO USE: User wants to underst"},{"name":"specialty_price_benchmark","description":"[Taxonomy III.44 — baseline response (public data only)] Price benchmark for a CPT within a specific provider specialty.\n\nWHEN TO USE: User wants to understand "},{"name":"inflation_adjusted_price_model","description":"[Taxonomy III.46 — baseline response (public data only)] Inflation-adjusted price comparison across years for a CPT.\n\nWHEN TO USE: User has a historical dollar "},{"name":"deductible_impact_calculator","description":"[Taxonomy III.48 — baseline response (public data only)] Estimate how a planned service will draw against the member's deductible.\n\nWHEN TO USE: User wants to k"},{"name":"coinsurance_simulator","description":"[Taxonomy III.49 — baseline response (public data only)] Simulate member coinsurance exposure across plan-design variants.\n\nWHEN TO USE: User wants to model the"},{"name":"copay_model","description":"[Taxonomy III.50 — baseline response (public data only)] Model member copay for a service by plan-design class.\n\nWHEN TO USE: User wants the typical copay for a"},{"name":"billing_charge_vs_allowed_delta","description":"[Taxonomy III.51 — baseline response (public data only)] Delta between billed charge and payer-allowed amount for a claim line.\n\nWHEN TO USE: User wants to unde"},{"name":"price_anomaly_detector","description":"[Taxonomy III.52 — baseline response (public data only)] Detect service-line prices statistically anomalous versus market.\n\nWHEN TO USE: User wants to understan"},{"name":"overpriced_service_detector","description":"[Taxonomy III.53 — baseline response (public data only)] Flag services billed materially above market percentile thresholds.\n\nWHEN TO USE: User wants to underst"},{"name":"market_price_distribution_model","description":"[Taxonomy III.55 — baseline response (public data only)] Full DP-noised market price distribution for a CPT+region pair.\n\nWHEN TO USE: User wants to understand "},{"name":"price_outlier_detector","description":"[Taxonomy III.56 — baseline response (public data only)] Detect claim-line outliers relative to a learned market distribution.\n\nWHEN TO USE: User wants to under"},{"name":"procedure_cost_decomposition","description":"[Taxonomy III.57 — baseline response (public data only)] Decompose the cost of a procedure into component services + facility + professional fees.\n\nWHEN TO USE:"},{"name":"price_recommendation_engine","description":"[Taxonomy III.58 — baseline response (public data only)] Recommend a reasonable price to propose to a provider for a service (self-pay or negotiation).\n\nWHEN TO"},{"name":"claim_duplicate_line_detector","description":"[Taxonomy IV.75 — baseline response (public data only)] Detect duplicated service lines within a single claim.\n\nWHEN TO USE: Caller is building or validating a "},{"name":"denial_reason_classifier","description":"[Taxonomy VI.106 — baseline response (public data only)] Classify a denial letter or remittance advice into normalized denial-reason categories.\n\nWHEN TO USE: U"},{"name":"appeal_argument_generator","description":"[Taxonomy VII.120 — baseline response (public data only)] Generate component arguments for an appeal letter: medical-necessity, contract, policy.\n\nWHEN TO USE: "},{"name":"denial_response_builder","description":"[Taxonomy VII.121 — baseline response (public data only)] Build a denial-response package tailored to the denial reason code.\n\nWHEN TO USE: User has a denied cl"},{"name":"dispute_case_builder","description":"[Taxonomy VII.123 — baseline response (public data only)] Assemble a complete dispute case file including claim, denial, evidence, and timeline.\n\nWHEN TO USE: U"},{"name":"evidence_pack_generator","description":"[Taxonomy VII.124 — baseline response (public data only)] Generate an evidence package supporting a claim or appeal (references, studies, policies).\n\nWHEN TO US"},{"name":"claim_rebuttal_generator","description":"[Taxonomy VII.128 — baseline response (public data only)] Generate a rebuttal to a payer's denial rationale point-by-point.\n\nWHEN TO USE: User has a denied clai"},{"name":"appeal_escalation_path_finder","description":"[Taxonomy VII.129 — baseline response (public data only)] Find the correct escalation path for a denied claim (internal appeal → external review → DOI).\n\nWHEN T"},{"name":"payer_specific_appeal_templates","description":"[Taxonomy VII.130 — baseline response (public data only)] Return payer-specific appeal templates known to perform well.\n\nWHEN TO USE: User has a denied claim an"},{"name":"denial_code_explainer","description":"[Taxonomy VII.131 — baseline response (public data only)] Explain a CARC/RARC denial code in plain language with common causes.\n\nWHEN TO USE: User asks 'what do"},{"name":"claim_reconsideration_builder","description":"[Taxonomy VII.132 — baseline response (public data only)] Build a claim reconsideration request (lighter-weight than a formal appeal).\n\nWHEN TO USE: User has a "},{"name":"supporting_document_selector","description":"[Taxonomy VII.135 — baseline response (public data only)] Select optimal supporting documents for an appeal from an available document pool.\n\nWHEN TO USE: User "},{"name":"out_of_pocket_optimizer","description":"[Taxonomy X.174 — baseline response (public data only)] Optimize out-of-pocket spend across a sequence of planned services.\n\nWHEN TO USE: User is planning for a"},{"name":"financial_exposure_model","description":"[Taxonomy X.176 — delegates to financial_risk_exposure_model] Model a member's financial exposure. Alias of financial_risk_exposure_model.\n\nWHEN TO USE: User is"},{"name":"procedure_affordability_ranker","description":"[Taxonomy X.177 — baseline response (public data only)] Rank a set of procedures by affordability for a given member.\n\nWHEN TO USE: User is planning for a medic"},{"name":"treatment_cost_comparator","description":"[Taxonomy X.178 — baseline response (public data only)] Compare expected costs across treatment alternatives for a condition.\n\nWHEN TO USE: User is planning for"},{"name":"bill_shock_predictor","description":"[Taxonomy X.179 — baseline response (public data only)] Predict risk that a planned service will trigger an unexpected large bill.\n\nWHEN TO USE: User planning a"},{"name":"payment_plan_optimizer","description":"[Taxonomy X.180 — baseline response (public data only)] Optimize a payment plan structure for a patient balance.\n\nWHEN TO USE: User has a balance and wants to s"},{"name":"financial_assistance_finder","description":"[Taxonomy X.181 — baseline response (public data only)] Find applicable financial-assistance programs (hospital charity, 340B, state, pharma).\n\nWHEN TO USE: Use"},{"name":"patient_cost_explainer","description":"[Taxonomy X.182 — baseline response (public data only)] Explain why a specific charge appears on a bill in plain language.\n\nWHEN TO USE: User is planning for a "},{"name":"healthcare_budget_forecaster","description":"[Taxonomy X.183 — baseline response (public data only)] Forecast a household's annual healthcare spend based on plan + utilization.\n\nWHEN TO USE: User planning "},{"name":"medical_spending_analyzer","description":"[Taxonomy X.184 — baseline response (public data only)] Analyze a patient's medical spending over a period and surface optimization opportunities.\n\nWHEN TO USE:"},{"name":"insurance_value_optimizer","description":"[Taxonomy X.185 — baseline response (public data only)] Recommend insurance-plan selections to maximize value given projected utilization.\n\nWHEN TO USE: User is"},{"name":"patient_financial_risk_score","description":"[Taxonomy X.186 — baseline response (public data only)] Score a patient's financial risk exposure from planned or ongoing care.\n\nWHEN TO USE: User is planning f"},{"name":"decode_denial","description":"Decode a CARC (Claim Adjustment Reason Code) denial code into plain English. Returns meaning, category, whether it's typically reversible on appeal, and appeal "},{"name":"get_appeal_deadline","description":"External-review filing deadline for a state + the date of the FINAL adverse determination. Returns the deadline date, the statutory window label + citation, and"},{"name":"get_venue","description":"Where and how to file an external review for a given state — the venue name, filing channel (portal/mail/fax), portal URL, and whether expedited review is avail"},{"name":"medigami_odds","description":"Historical external-review overturn rate published by the state regulator for the insurer you name, in a regulated venue (CA/NY/MD/NJ/MI/OH/NC). Returns one ins"},{"name":"medigami_roast","description":"Compare a billed charge against a hospital's own MRF-published negotiated rate for a CPT code; returns the markup multiple. Public regulator data, k-anonymity f"},{"name":"medigami_deadline","description":"Federal appeal-deadline window (ERISA §503 internal-appeal / ACA §2719 external-review / NSA IDR) for a plan type. Public regulator data, k-anonymity floored, n"},{"name":"medigami_rate","description":"A hospital's own MRF-published negotiated rate for a CPT code (no billed-amount comparison — use medigami_roast for that). Public regulator data, k-anonymity fl"}],"toolCount":87,"toolsHash":"c7d83d3598bc9743ce42bdba887f50436a00b4a82ff6989e4da5034fecd0402d","serverName":"medigami-public","capabilities":["experimental","resources","tools"],"serverVersion":"1.28.1","protocolVersion":"2025-06-18"}},{"at":"2026-10-07T14:31:27.548Z","kind":"mcp_initialize","ok":true,"httpStatus":200,"latencyMs":170,"error":null,"detail":{"tools":[{"name":"scan_bill_for_errors","description":"Scan a medical bill or EOB text for errors: duplicate charges, CPT unbundling, upcoding, facility-fee overcharges. Returns flagged anomalies with estimated doll"},{"name":"generate_appeal_letter","description":"Generate a legally-grounded insurance appeal letter for a denied claim. Returns the letter as a template with [PATIENT NAME] and [PROVIDER NAME] placeholders (s"},{"name":"optimize_prescription","description":"Find the lowest-cost path for a prescription: generics, biosimilars, GoodRx coupons, manufacturer assistance, 90-day fills, and mail-order vs retail comparison."},{"name":"analyze_glp1_pathways","description":"Find all access pathways for a GLP-1 drug (Ozempic, Wegovy, Mounjaro, Zepbound) given patient eligibility factors. Ranks pathways by monthly cost, flags prior-a"},{"name":"verify_attestation","description":"Verify an Ed25519-signed Medigami MCP response envelope — confirm a medical-bill / appeal / denial / rate answer came from Medigami and hasn't been tampered wit"},{"name":"watch_appeal_outcome","description":"Subscribe to an appeal outcome by tracking_id. Blocks up to `timeout_seconds` (default 300). Returns the outcome payload as soon as it's recorded, or {status: '"},{"name":"watch_claim_denial","description":"Subscribe to a claim denial event for a given scan_id. Blocks up to `timeout_seconds`. Returns {status: 'denied', ...} as soon as the payer marks the claim deni"},{"name":"format_citation","description":"Format an LLM-citable reference to a previously-attested Medigami MCP response. Input: either the full signed envelope that an earlier attested tool returned, O"},{"name":"submit_denial_letter","description":"Submit a medical-claim denial letter to the Medigami Denial Common Crawl (public aggregate dataset). Consent-gated — caller must pass consent=true to attest the"},{"name":"verify_mcp_response","description":"DEPRECATED ALIAS of verify_attestation — kept for backward compatibility with v0.1.7 clients. New code should call verify_attestation directly.\n\nWHEN TO USE: Re"},{"name":"format_medigami_citation","description":"DEPRECATED ALIAS of format_citation — kept for backward compatibility with v0.1.7 clients. New code should call format_citation directly.\n\nWHEN TO USE: Referenc"},{"name":"estimate_appeal_success","description":"Probability an appeal will be approved, derived from outcome-labeled data weighted by label provenance (IRO determinations, EOB reversals, physician confirmatio"},{"name":"resolve_denial","description":"End-to-end denial resolution: returns appeal probability + confidence interval + a drafted letter template grounded in aggregate outcome data + plan-context fla"},{"name":"maximize_recovery","description":"Given a prior scan_id, returns a prioritized action list: anomalies ranked by (expected overcharge x recovery probability), with the next steps to pursue each. "},{"name":"explain_appeal_success","description":"Human-readable rationale for an appeal probability. Returns {probability, tier, recommended_posture, rationale, expected_days_to_resolution, tracking_id} ground"},{"name":"negotiate_bill_script","description":"Generate a phone script the user can read when negotiating a medical bill directly with the provider. Combines DP-noised commercial rate benchmarks + the caller"},{"name":"batch_scan_bills","description":"Scan multiple medical bills in one call. Returns per-bill anomaly lists + total recovery estimate across the batch. Input is a list of {bill_text, provider?, in"},{"name":"lookup_icd10","description":"Look up an ICD-10-CM diagnosis code or search by keyword. Input is either an exact code (e.g. 'E11.21') or a free-text description phrase ('type 2 diabetes with"},{"name":"lookup_cpt","description":"Look up a CPT or HCPCS-J code or search by keyword. Covers the most common outpatient billing codes (E/M, preventive, lab, imaging, procedure, cardiology, thera"},{"name":"lookup_npi","description":"Look up a provider in the CMS NPPES National Provider Identifier registry. Accepts a 10-digit NPI number OR a provider name (optionally narrowed by 2-char state"},{"name":"verify_dea_authorization","description":"Validate the format + checksum of a DEA registration number (format: [A-Z][A-Z9][0-9]{7}; public checksum algorithm). Useful as a sanity check on a DEA number y"},{"name":"lookup_provider_taxonomy","description":"Look up a NUCC provider taxonomy code (the specialty codes used on HIPAA transactions + NPI registrations) or search by keyword. Returns classification + type +"},{"name":"resolve_codes","description":"[Taxonomy A.1 — baseline response (public data only)] Unified code resolver — free-form query or clinical description → ranked ICD-10-CM, CPT, and HCPCS codes w"},{"name":"code_conflict_detector","description":"[Taxonomy A.5 — delegates to scan_bill_for_errors] Detect CPT unbundling, mutually exclusive code pairs, and NCCI edit violations in a set of codes. Implemented"},{"name":"fair_price_estimator","description":"[Taxonomy B.8 — delegates to benchmark_payer_rate] Fair-market price distribution for a service: DP-noised percentiles (p10, p25, p50, p75, p90) for the given C"},{"name":"price_variance_analyzer","description":"[Taxonomy B.9 — baseline response (public data only)] Given a target price and a CPT+region, return how many standard deviations above/below the market the targ"},{"name":"claim_consistency_checker","description":"[Taxonomy C.14 — delegates to scan_bill_for_errors] Detect internal contradictions in a claim: time mismatches, mutually exclusive codes, missing required field"},{"name":"bundling_violation_detector","description":"[Taxonomy C.16 — delegates to scan_bill_for_errors] Detect CPT unbundling (billing components of a procedure separately to inflate the claim). Uses the CMS NCCI"},{"name":"appeal_success_predictor","description":"[Taxonomy E.25 — delegates to estimate_appeal_success] Given a denial, predict the probability of a successful appeal. Returns probability with 95% CI, sample s"},{"name":"generate_appeal_letter_v2","description":"[Taxonomy F.28 — delegates to generate_appeal_letter] [Taxonomy alias] Generate a state-specific insurance appeal letter with UPL-safe disclaimers for 19 US sta"},{"name":"negotiation_strategy_generator","description":"[Taxonomy F.30 — baseline response (public data only)] Given a bill + patient situation, generate a ranked negotiation strategy: hardship appeal, charity-care a"},{"name":"insurance_response_interpreter","description":"[Taxonomy F.31 — baseline response (public data only)] Parse an insurer's response letter or EOB into structured fields: denial reason codes, appeal rights, dea"},{"name":"settlement_optimizer","description":"[Taxonomy F.32 — baseline response (public data only)] For a disputed bill, compute the optimal settlement target price balancing probability of acceptance agai"},{"name":"patient_cost_forecaster","description":"[Taxonomy H.38 — baseline response (public data only)] Given a patient's plan + predicted care needs, forecast annual out-of-pocket spend across expected claims"},{"name":"insurance_plan_optimizer","description":"[Taxonomy H.39 — baseline response (public data only)] Given a patient's historical claim patterns, rank available insurance plans by expected annual cost.\n\nWHE"},{"name":"cash_vs_insurance_optimizer","description":"[Taxonomy H.41 — baseline response (public data only)] For a given service + patient plan, determine whether cash-pay + charity-care beats insurance billing.\n\nW"},{"name":"financial_risk_exposure_model","description":"[Taxonomy H.42 — baseline response (public data only)] Quantify a patient's financial exposure to medical-debt risk given current plan, health status, and histo"},{"name":"cpt_to_icd_mapper","description":"[Taxonomy II.21 — baseline response (public data only)] For a given CPT, surface the ICD-10 codes typically paired with it for medical-necessity support.\n\nWHEN "},{"name":"icd_to_cpt_mapper","description":"[Taxonomy II.22 — baseline response (public data only)] For a given ICD-10, surface the CPT codes typically billed for that diagnosis.\n\nWHEN TO USE: User has an"},{"name":"code_bundle_validator","description":"[Taxonomy II.25 — baseline response (public data only)] Check a set of CPT codes against NCCI bundling rules (distinct from modifier-based unbundling).\n\nWHEN TO"},{"name":"unbundling_detector","description":"[Taxonomy II.26 — delegates to scan_bill_for_errors] Detect CPT unbundling patterns in a claim. Alias of scan_bill_for_errors.\n\nWHEN TO USE: User asks about med"},{"name":"cash_price_estimator","description":"[Taxonomy III.39 — baseline response (public data only)] Estimate a fair cash price for a service in a given region (no-insurance path).\n\nWHEN TO USE: Uninsured"},{"name":"zip_based_price_variance","description":"[Taxonomy III.41 — baseline response (public data only)] Report price variance for a CPT across ZIP3 regions with DP noise.\n\nWHEN TO USE: User wants to understa"},{"name":"regional_price_benchmark","description":"[Taxonomy III.43 — baseline response (public data only)] Regional price benchmark for a CPT at state/metro/ZIP3 granularity.\n\nWHEN TO USE: User wants to underst"},{"name":"specialty_price_benchmark","description":"[Taxonomy III.44 — baseline response (public data only)] Price benchmark for a CPT within a specific provider specialty.\n\nWHEN TO USE: User wants to understand "},{"name":"inflation_adjusted_price_model","description":"[Taxonomy III.46 — baseline response (public data only)] Inflation-adjusted price comparison across years for a CPT.\n\nWHEN TO USE: User has a historical dollar "},{"name":"deductible_impact_calculator","description":"[Taxonomy III.48 — baseline response (public data only)] Estimate how a planned service will draw against the member's deductible.\n\nWHEN TO USE: User wants to k"},{"name":"coinsurance_simulator","description":"[Taxonomy III.49 — baseline response (public data only)] Simulate member coinsurance exposure across plan-design variants.\n\nWHEN TO USE: User wants to model the"},{"name":"copay_model","description":"[Taxonomy III.50 — baseline response (public data only)] Model member copay for a service by plan-design class.\n\nWHEN TO USE: User wants the typical copay for a"},{"name":"billing_charge_vs_allowed_delta","description":"[Taxonomy III.51 — baseline response (public data only)] Delta between billed charge and payer-allowed amount for a claim line.\n\nWHEN TO USE: User wants to unde"},{"name":"price_anomaly_detector","description":"[Taxonomy III.52 — baseline response (public data only)] Detect service-line prices statistically anomalous versus market.\n\nWHEN TO USE: User wants to understan"},{"name":"overpriced_service_detector","description":"[Taxonomy III.53 — baseline response (public data only)] Flag services billed materially above market percentile thresholds.\n\nWHEN TO USE: User wants to underst"},{"name":"market_price_distribution_model","description":"[Taxonomy III.55 — baseline response (public data only)] Full DP-noised market price distribution for a CPT+region pair.\n\nWHEN TO USE: User wants to understand "},{"name":"price_outlier_detector","description":"[Taxonomy III.56 — baseline response (public data only)] Detect claim-line outliers relative to a learned market distribution.\n\nWHEN TO USE: User wants to under"},{"name":"procedure_cost_decomposition","description":"[Taxonomy III.57 — baseline response (public data only)] Decompose the cost of a procedure into component services + facility + professional fees.\n\nWHEN TO USE:"},{"name":"price_recommendation_engine","description":"[Taxonomy III.58 — baseline response (public data only)] Recommend a reasonable price to propose to a provider for a service (self-pay or negotiation).\n\nWHEN TO"},{"name":"claim_duplicate_line_detector","description":"[Taxonomy IV.75 — baseline response (public data only)] Detect duplicated service lines within a single claim.\n\nWHEN TO USE: Caller is building or validating a "},{"name":"denial_reason_classifier","description":"[Taxonomy VI.106 — baseline response (public data only)] Classify a denial letter or remittance advice into normalized denial-reason categories.\n\nWHEN TO USE: U"},{"name":"appeal_argument_generator","description":"[Taxonomy VII.120 — baseline response (public data only)] Generate component arguments for an appeal letter: medical-necessity, contract, policy.\n\nWHEN TO USE: "},{"name":"denial_response_builder","description":"[Taxonomy VII.121 — baseline response (public data only)] Build a denial-response package tailored to the denial reason code.\n\nWHEN TO USE: User has a denied cl"},{"name":"dispute_case_builder","description":"[Taxonomy VII.123 — baseline response (public data only)] Assemble a complete dispute case file including claim, denial, evidence, and timeline.\n\nWHEN TO USE: U"},{"name":"evidence_pack_generator","description":"[Taxonomy VII.124 — baseline response (public data only)] Generate an evidence package supporting a claim or appeal (references, studies, policies).\n\nWHEN TO US"},{"name":"claim_rebuttal_generator","description":"[Taxonomy VII.128 — baseline response (public data only)] Generate a rebuttal to a payer's denial rationale point-by-point.\n\nWHEN TO USE: User has a denied clai"},{"name":"appeal_escalation_path_finder","description":"[Taxonomy VII.129 — baseline response (public data only)] Find the correct escalation path for a denied claim (internal appeal → external review → DOI).\n\nWHEN T"},{"name":"payer_specific_appeal_templates","description":"[Taxonomy VII.130 — baseline response (public data only)] Return payer-specific appeal templates known to perform well.\n\nWHEN TO USE: User has a denied claim an"},{"name":"denial_code_explainer","description":"[Taxonomy VII.131 — baseline response (public data only)] Explain a CARC/RARC denial code in plain language with common causes.\n\nWHEN TO USE: User asks 'what do"},{"name":"claim_reconsideration_builder","description":"[Taxonomy VII.132 — baseline response (public data only)] Build a claim reconsideration request (lighter-weight than a formal appeal).\n\nWHEN TO USE: User has a "},{"name":"supporting_document_selector","description":"[Taxonomy VII.135 — baseline response (public data only)] Select optimal supporting documents for an appeal from an available document pool.\n\nWHEN TO USE: User "},{"name":"out_of_pocket_optimizer","description":"[Taxonomy X.174 — baseline response (public data only)] Optimize out-of-pocket spend across a sequence of planned services.\n\nWHEN TO USE: User is planning for a"},{"name":"financial_exposure_model","description":"[Taxonomy X.176 — delegates to financial_risk_exposure_model] Model a member's financial exposure. Alias of financial_risk_exposure_model.\n\nWHEN TO USE: User is"},{"name":"procedure_affordability_ranker","description":"[Taxonomy X.177 — baseline response (public data only)] Rank a set of procedures by affordability for a given member.\n\nWHEN TO USE: User is planning for a medic"},{"name":"treatment_cost_comparator","description":"[Taxonomy X.178 — baseline response (public data only)] Compare expected costs across treatment alternatives for a condition.\n\nWHEN TO USE: User is planning for"},{"name":"bill_shock_predictor","description":"[Taxonomy X.179 — baseline response (public data only)] Predict risk that a planned service will trigger an unexpected large bill.\n\nWHEN TO USE: User planning a"},{"name":"payment_plan_optimizer","description":"[Taxonomy X.180 — baseline response (public data only)] Optimize a payment plan structure for a patient balance.\n\nWHEN TO USE: User has a balance and wants to s"},{"name":"financial_assistance_finder","description":"[Taxonomy X.181 — baseline response (public data only)] Find applicable financial-assistance programs (hospital charity, 340B, state, pharma).\n\nWHEN TO USE: Use"},{"name":"patient_cost_explainer","description":"[Taxonomy X.182 — baseline response (public data only)] Explain why a specific charge appears on a bill in plain language.\n\nWHEN TO USE: User is planning for a "},{"name":"healthcare_budget_forecaster","description":"[Taxonomy X.183 — baseline response (public data only)] Forecast a household's annual healthcare spend based on plan + utilization.\n\nWHEN TO USE: User planning "},{"name":"medical_spending_analyzer","description":"[Taxonomy X.184 — baseline response (public data only)] Analyze a patient's medical spending over a period and surface optimization opportunities.\n\nWHEN TO USE:"},{"name":"insurance_value_optimizer","description":"[Taxonomy X.185 — baseline response (public data only)] Recommend insurance-plan selections to maximize value given projected utilization.\n\nWHEN TO USE: User is"},{"name":"patient_financial_risk_score","description":"[Taxonomy X.186 — baseline response (public data only)] Score a patient's financial risk exposure from planned or ongoing care.\n\nWHEN TO USE: User is planning f"},{"name":"decode_denial","description":"Decode a CARC (Claim Adjustment Reason Code) denial code into plain English. Returns meaning, category, whether it's typically reversible on appeal, and appeal "},{"name":"get_appeal_deadline","description":"External-review filing deadline for a state + the date of the FINAL adverse determination. Returns the deadline date, the statutory window label + citation, and"},{"name":"get_venue","description":"Where and how to file an external review for a given state — the venue name, filing channel (portal/mail/fax), portal URL, and whether expedited review is avail"},{"name":"medigami_odds","description":"Historical external-review overturn rate published by the state regulator for the insurer you name, in a regulated venue (CA/NY/MD/NJ/MI/OH/NC). Returns one ins"},{"name":"medigami_roast","description":"Compare a billed charge against a hospital's own MRF-published negotiated rate for a CPT code; returns the markup multiple. Public regulator data, k-anonymity f"},{"name":"medigami_deadline","description":"Federal appeal-deadline window (ERISA §503 internal-appeal / ACA §2719 external-review / NSA IDR) for a plan type. Public regulator data, k-anonymity floored, n"},{"name":"medigami_rate","description":"A hospital's own MRF-published negotiated rate for a CPT code (no billed-amount comparison — use medigami_roast for that). Public regulator data, k-anonymity fl"}],"toolCount":87,"toolsHash":"c7d83d3598bc9743ce42bdba887f50436a00b4a82ff6989e4da5034fecd0402d","serverName":"medigami-public","capabilities":["experimental","resources","tools"],"serverVersion":"1.28.1","protocolVersion":"2025-06-18"}}],"tools":[{"name":"scan_bill_for_errors","description":"Scan a medical bill or EOB text for errors: duplicate charges, CPT unbundling, upcoding, facility-fee overcharges. Returns flagged anomalies with estimated doll"},{"name":"generate_appeal_letter","description":"Generate a legally-grounded insurance appeal letter for a denied claim. Returns the letter as a template with [PATIENT NAME] and [PROVIDER NAME] placeholders (s"},{"name":"optimize_prescription","description":"Find the lowest-cost path for a prescription: generics, biosimilars, GoodRx coupons, manufacturer assistance, 90-day fills, and mail-order vs retail comparison."},{"name":"analyze_glp1_pathways","description":"Find all access pathways for a GLP-1 drug (Ozempic, Wegovy, Mounjaro, Zepbound) given patient eligibility factors. Ranks pathways by monthly cost, flags prior-a"},{"name":"verify_attestation","description":"Verify an Ed25519-signed Medigami MCP response envelope — confirm a medical-bill / appeal / denial / rate answer came from Medigami and hasn't been tampered wit"},{"name":"watch_appeal_outcome","description":"Subscribe to an appeal outcome by tracking_id. Blocks up to `timeout_seconds` (default 300). Returns the outcome payload as soon as it's recorded, or {status: '"},{"name":"watch_claim_denial","description":"Subscribe to a claim denial event for a given scan_id. Blocks up to `timeout_seconds`. Returns {status: 'denied', ...} as soon as the payer marks the claim deni"},{"name":"format_citation","description":"Format an LLM-citable reference to a previously-attested Medigami MCP response. Input: either the full signed envelope that an earlier attested tool returned, O"},{"name":"submit_denial_letter","description":"Submit a medical-claim denial letter to the Medigami Denial Common Crawl (public aggregate dataset). Consent-gated — caller must pass consent=true to attest the"},{"name":"verify_mcp_response","description":"DEPRECATED ALIAS of verify_attestation — kept for backward compatibility with v0.1.7 clients. New code should call verify_attestation directly.\n\nWHEN TO USE: Re"},{"name":"format_medigami_citation","description":"DEPRECATED ALIAS of format_citation — kept for backward compatibility with v0.1.7 clients. New code should call format_citation directly.\n\nWHEN TO USE: Referenc"},{"name":"estimate_appeal_success","description":"Probability an appeal will be approved, derived from outcome-labeled data weighted by label provenance (IRO determinations, EOB reversals, physician confirmatio"},{"name":"resolve_denial","description":"End-to-end denial resolution: returns appeal probability + confidence interval + a drafted letter template grounded in aggregate outcome data + plan-context fla"},{"name":"maximize_recovery","description":"Given a prior scan_id, returns a prioritized action list: anomalies ranked by (expected overcharge x recovery probability), with the next steps to pursue each. "},{"name":"explain_appeal_success","description":"Human-readable rationale for an appeal probability. Returns {probability, tier, recommended_posture, rationale, expected_days_to_resolution, tracking_id} ground"},{"name":"negotiate_bill_script","description":"Generate a phone script the user can read when negotiating a medical bill directly with the provider. Combines DP-noised commercial rate benchmarks + the caller"},{"name":"batch_scan_bills","description":"Scan multiple medical bills in one call. Returns per-bill anomaly lists + total recovery estimate across the batch. Input is a list of {bill_text, provider?, in"},{"name":"lookup_icd10","description":"Look up an ICD-10-CM diagnosis code or search by keyword. Input is either an exact code (e.g. 'E11.21') or a free-text description phrase ('type 2 diabetes with"},{"name":"lookup_cpt","description":"Look up a CPT or HCPCS-J code or search by keyword. Covers the most common outpatient billing codes (E/M, preventive, lab, imaging, procedure, cardiology, thera"},{"name":"lookup_npi","description":"Look up a provider in the CMS NPPES National Provider Identifier registry. Accepts a 10-digit NPI number OR a provider name (optionally narrowed by 2-char state"},{"name":"verify_dea_authorization","description":"Validate the format + checksum of a DEA registration number (format: [A-Z][A-Z9][0-9]{7}; public checksum algorithm). Useful as a sanity check on a DEA number y"},{"name":"lookup_provider_taxonomy","description":"Look up a NUCC provider taxonomy code (the specialty codes used on HIPAA transactions + NPI registrations) or search by keyword. Returns classification + type +"},{"name":"resolve_codes","description":"[Taxonomy A.1 — baseline response (public data only)] Unified code resolver — free-form query or clinical description → ranked ICD-10-CM, CPT, and HCPCS codes w"},{"name":"code_conflict_detector","description":"[Taxonomy A.5 — delegates to scan_bill_for_errors] Detect CPT unbundling, mutually exclusive code pairs, and NCCI edit violations in a set of codes. Implemented"},{"name":"fair_price_estimator","description":"[Taxonomy B.8 — delegates to benchmark_payer_rate] Fair-market price distribution for a service: DP-noised percentiles (p10, p25, p50, p75, p90) for the given C"},{"name":"price_variance_analyzer","description":"[Taxonomy B.9 — baseline response (public data only)] Given a target price and a CPT+region, return how many standard deviations above/below the market the targ"},{"name":"claim_consistency_checker","description":"[Taxonomy C.14 — delegates to scan_bill_for_errors] Detect internal contradictions in a claim: time mismatches, mutually exclusive codes, missing required field"},{"name":"bundling_violation_detector","description":"[Taxonomy C.16 — delegates to scan_bill_for_errors] Detect CPT unbundling (billing components of a procedure separately to inflate the claim). Uses the CMS NCCI"},{"name":"appeal_success_predictor","description":"[Taxonomy E.25 — delegates to estimate_appeal_success] Given a denial, predict the probability of a successful appeal. Returns probability with 95% CI, sample s"},{"name":"generate_appeal_letter_v2","description":"[Taxonomy F.28 — delegates to generate_appeal_letter] [Taxonomy alias] Generate a state-specific insurance appeal letter with UPL-safe disclaimers for 19 US sta"},{"name":"negotiation_strategy_generator","description":"[Taxonomy F.30 — baseline response (public data only)] Given a bill + patient situation, generate a ranked negotiation strategy: hardship appeal, charity-care a"},{"name":"insurance_response_interpreter","description":"[Taxonomy F.31 — baseline response (public data only)] Parse an insurer's response letter or EOB into structured fields: denial reason codes, appeal rights, dea"},{"name":"settlement_optimizer","description":"[Taxonomy F.32 — baseline response (public data only)] For a disputed bill, compute the optimal settlement target price balancing probability of acceptance agai"},{"name":"patient_cost_forecaster","description":"[Taxonomy H.38 — baseline response (public data only)] Given a patient's plan + predicted care needs, forecast annual out-of-pocket spend across expected claims"},{"name":"insurance_plan_optimizer","description":"[Taxonomy H.39 — baseline response (public data only)] Given a patient's historical claim patterns, rank available insurance plans by expected annual cost.\n\nWHE"},{"name":"cash_vs_insurance_optimizer","description":"[Taxonomy H.41 — baseline response (public data only)] For a given service + patient plan, determine whether cash-pay + charity-care beats insurance billing.\n\nW"},{"name":"financial_risk_exposure_model","description":"[Taxonomy H.42 — baseline response (public data only)] Quantify a patient's financial exposure to medical-debt risk given current plan, health status, and histo"},{"name":"cpt_to_icd_mapper","description":"[Taxonomy II.21 — baseline response (public data only)] For a given CPT, surface the ICD-10 codes typically paired with it for medical-necessity support.\n\nWHEN "},{"name":"icd_to_cpt_mapper","description":"[Taxonomy II.22 — baseline response (public data only)] For a given ICD-10, surface the CPT codes typically billed for that diagnosis.\n\nWHEN TO USE: User has an"},{"name":"code_bundle_validator","description":"[Taxonomy II.25 — baseline response (public data only)] Check a set of CPT codes against NCCI bundling rules (distinct from modifier-based unbundling).\n\nWHEN TO"},{"name":"unbundling_detector","description":"[Taxonomy II.26 — delegates to scan_bill_for_errors] Detect CPT unbundling patterns in a claim. Alias of scan_bill_for_errors.\n\nWHEN TO USE: User asks about med"},{"name":"cash_price_estimator","description":"[Taxonomy III.39 — baseline response (public data only)] Estimate a fair cash price for a service in a given region (no-insurance path).\n\nWHEN TO USE: Uninsured"},{"name":"zip_based_price_variance","description":"[Taxonomy III.41 — baseline response (public data only)] Report price variance for a CPT across ZIP3 regions with DP noise.\n\nWHEN TO USE: User wants to understa"},{"name":"regional_price_benchmark","description":"[Taxonomy III.43 — baseline response (public data only)] Regional price benchmark for a CPT at state/metro/ZIP3 granularity.\n\nWHEN TO USE: User wants to underst"},{"name":"specialty_price_benchmark","description":"[Taxonomy III.44 — baseline response (public data only)] Price benchmark for a CPT within a specific provider specialty.\n\nWHEN TO USE: User wants to understand "},{"name":"inflation_adjusted_price_model","description":"[Taxonomy III.46 — baseline response (public data only)] Inflation-adjusted price comparison across years for a CPT.\n\nWHEN TO USE: User has a historical dollar "},{"name":"deductible_impact_calculator","description":"[Taxonomy III.48 — baseline response (public data only)] Estimate how a planned service will draw against the member's deductible.\n\nWHEN TO USE: User wants to k"},{"name":"coinsurance_simulator","description":"[Taxonomy III.49 — baseline response (public data only)] Simulate member coinsurance exposure across plan-design variants.\n\nWHEN TO USE: User wants to model the"},{"name":"copay_model","description":"[Taxonomy III.50 — baseline response (public data only)] Model member copay for a service by plan-design class.\n\nWHEN TO USE: User wants the typical copay for a"},{"name":"billing_charge_vs_allowed_delta","description":"[Taxonomy III.51 — baseline response (public data only)] Delta between billed charge and payer-allowed amount for a claim line.\n\nWHEN TO USE: User wants to unde"},{"name":"price_anomaly_detector","description":"[Taxonomy III.52 — baseline response (public data only)] Detect service-line prices statistically anomalous versus market.\n\nWHEN TO USE: User wants to understan"},{"name":"overpriced_service_detector","description":"[Taxonomy III.53 — baseline response (public data only)] Flag services billed materially above market percentile thresholds.\n\nWHEN TO USE: User wants to underst"},{"name":"market_price_distribution_model","description":"[Taxonomy III.55 — baseline response (public data only)] Full DP-noised market price distribution for a CPT+region pair.\n\nWHEN TO USE: User wants to understand "},{"name":"price_outlier_detector","description":"[Taxonomy III.56 — baseline response (public data only)] Detect claim-line outliers relative to a learned market distribution.\n\nWHEN TO USE: User wants to under"},{"name":"procedure_cost_decomposition","description":"[Taxonomy III.57 — baseline response (public data only)] Decompose the cost of a procedure into component services + facility + professional fees.\n\nWHEN TO USE:"},{"name":"price_recommendation_engine","description":"[Taxonomy III.58 — baseline response (public data only)] Recommend a reasonable price to propose to a provider for a service (self-pay or negotiation).\n\nWHEN TO"},{"name":"claim_duplicate_line_detector","description":"[Taxonomy IV.75 — baseline response (public data only)] Detect duplicated service lines within a single claim.\n\nWHEN TO USE: Caller is building or validating a "},{"name":"denial_reason_classifier","description":"[Taxonomy VI.106 — baseline response (public data only)] Classify a denial letter or remittance advice into normalized denial-reason categories.\n\nWHEN TO USE: U"},{"name":"appeal_argument_generator","description":"[Taxonomy VII.120 — baseline response (public data only)] Generate component arguments for an appeal letter: medical-necessity, contract, policy.\n\nWHEN TO USE: "},{"name":"denial_response_builder","description":"[Taxonomy VII.121 — baseline response (public data only)] Build a denial-response package tailored to the denial reason code.\n\nWHEN TO USE: User has a denied cl"},{"name":"dispute_case_builder","description":"[Taxonomy VII.123 — baseline response (public data only)] Assemble a complete dispute case file including claim, denial, evidence, and timeline.\n\nWHEN TO USE: U"},{"name":"evidence_pack_generator","description":"[Taxonomy VII.124 — baseline response (public data only)] Generate an evidence package supporting a claim or appeal (references, studies, policies).\n\nWHEN TO US"},{"name":"claim_rebuttal_generator","description":"[Taxonomy VII.128 — baseline response (public data only)] Generate a rebuttal to a payer's denial rationale point-by-point.\n\nWHEN TO USE: User has a denied clai"},{"name":"appeal_escalation_path_finder","description":"[Taxonomy VII.129 — baseline response (public data only)] Find the correct escalation path for a denied claim (internal appeal → external review → DOI).\n\nWHEN T"},{"name":"payer_specific_appeal_templates","description":"[Taxonomy VII.130 — baseline response (public data only)] Return payer-specific appeal templates known to perform well.\n\nWHEN TO USE: User has a denied claim an"},{"name":"denial_code_explainer","description":"[Taxonomy VII.131 — baseline response (public data only)] Explain a CARC/RARC denial code in plain language with common causes.\n\nWHEN TO USE: User asks 'what do"},{"name":"claim_reconsideration_builder","description":"[Taxonomy VII.132 — baseline response (public data only)] Build a claim reconsideration request (lighter-weight than a formal appeal).\n\nWHEN TO USE: User has a "},{"name":"supporting_document_selector","description":"[Taxonomy VII.135 — baseline response (public data only)] Select optimal supporting documents for an appeal from an available document pool.\n\nWHEN TO USE: User "},{"name":"out_of_pocket_optimizer","description":"[Taxonomy X.174 — baseline response (public data only)] Optimize out-of-pocket spend across a sequence of planned services.\n\nWHEN TO USE: User is planning for a"},{"name":"financial_exposure_model","description":"[Taxonomy X.176 — delegates to financial_risk_exposure_model] Model a member's financial exposure. Alias of financial_risk_exposure_model.\n\nWHEN TO USE: User is"},{"name":"procedure_affordability_ranker","description":"[Taxonomy X.177 — baseline response (public data only)] Rank a set of procedures by affordability for a given member.\n\nWHEN TO USE: User is planning for a medic"},{"name":"treatment_cost_comparator","description":"[Taxonomy X.178 — baseline response (public data only)] Compare expected costs across treatment alternatives for a condition.\n\nWHEN TO USE: User is planning for"},{"name":"bill_shock_predictor","description":"[Taxonomy X.179 — baseline response (public data only)] Predict risk that a planned service will trigger an unexpected large bill.\n\nWHEN TO USE: User planning a"},{"name":"payment_plan_optimizer","description":"[Taxonomy X.180 — baseline response (public data only)] Optimize a payment plan structure for a patient balance.\n\nWHEN TO USE: User has a balance and wants to s"},{"name":"financial_assistance_finder","description":"[Taxonomy X.181 — baseline response (public data only)] Find applicable financial-assistance programs (hospital charity, 340B, state, pharma).\n\nWHEN TO USE: Use"},{"name":"patient_cost_explainer","description":"[Taxonomy X.182 — baseline response (public data only)] Explain why a specific charge appears on a bill in plain language.\n\nWHEN TO USE: User is planning for a "},{"name":"healthcare_budget_forecaster","description":"[Taxonomy X.183 — baseline response (public data only)] Forecast a household's annual healthcare spend based on plan + utilization.\n\nWHEN TO USE: User planning "},{"name":"medical_spending_analyzer","description":"[Taxonomy X.184 — baseline response (public data only)] Analyze a patient's medical spending over a period and surface optimization opportunities.\n\nWHEN TO USE:"},{"name":"insurance_value_optimizer","description":"[Taxonomy X.185 — baseline response (public data only)] Recommend insurance-plan selections to maximize value given projected utilization.\n\nWHEN TO USE: User is"},{"name":"patient_financial_risk_score","description":"[Taxonomy X.186 — baseline response (public data only)] Score a patient's financial risk exposure from planned or ongoing care.\n\nWHEN TO USE: User is planning f"},{"name":"decode_denial","description":"Decode a CARC (Claim Adjustment Reason Code) denial code into plain English. Returns meaning, category, whether it's typically reversible on appeal, and appeal "},{"name":"get_appeal_deadline","description":"External-review filing deadline for a state + the date of the FINAL adverse determination. Returns the deadline date, the statutory window label + citation, and"},{"name":"get_venue","description":"Where and how to file an external review for a given state — the venue name, filing channel (portal/mail/fax), portal URL, and whether expedited review is avail"},{"name":"medigami_odds","description":"Historical external-review overturn rate published by the state regulator for the insurer you name, in a regulated venue (CA/NY/MD/NJ/MI/OH/NC). Returns one ins"},{"name":"medigami_roast","description":"Compare a billed charge against a hospital's own MRF-published negotiated rate for a CPT code; returns the markup multiple. Public regulator data, k-anonymity f"},{"name":"medigami_deadline","description":"Federal appeal-deadline window (ERISA §503 internal-appeal / ACA §2719 external-review / NSA IDR) for a plan type. Public regulator data, k-anonymity floored, n"},{"name":"medigami_rate","description":"A hospital's own MRF-published negotiated rate for a CPT code (no billed-amount comparison — use medigami_roast for that). 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