chatgpt
Medigami patient tools: rates, markups, denial codes, deadlines, overturn rates, procedure codes
使うべきか
品質と安全性
検出事項（1）
- LOWTool 'lookup_procedure_code' description lacks action verblookup_procedure_code 内
ツール定義とプロトコルへの準拠に関する自動分析に基づいています。
コンテキストコスト
これは、サーバーのツールがモデルのコンテキストに読み込まれるたびに消費されるおおよそのトークン数です。数が多いほど、ほかのタスクに使える注意が減ります。
インストール
ワンクリックインストール
これを `claude_desktop_config.json` ファイルに追加してください:
{
"mcpServers": {
"chatgpt": {
"url": "https://mcp.medigami.com/chatgpt/mcp"
}
}
}リモートエンドポイント
https://mcp.medigami.com/chatgpt/mcpstreamable-httpできること
ツール一覧
ツール（6）
🟢get_hospital_rate(hospital, cpt)
Returns the negotiated rate a named hospital publishes in its federally required machine-readable file for a CPT/HCPCS code, with the file's as-of date. Public hospital-transparency data; educational, not billing advice.
入力スキーマ
{
"type": "object",
"properties": {
"hospital": {
"type": "string",
"maxLength": 200,
"description": "Hospital / facility name."
},
"cpt": {
"type": "string",
"maxLength": 10,
"description": "CPT/HCPCS procedure code."
}
},
"required": [
"hospital",
"cpt"
]
}🟢check_bill_markup(hospital, cpt, billed_amount)
Compares one billed line to the hospital's own published negotiated rate for that code and returns the multiple. You type the code and amount; no bill upload. Educational, not billing advice.
入力スキーマ
{
"type": "object",
"properties": {
"hospital": {
"type": "string",
"maxLength": 200,
"description": "Hospital / facility name."
},
"cpt": {
"type": "string",
"maxLength": 10,
"description": "CPT/HCPCS procedure code."
},
"billed_amount": {
"type": "number",
"minimum": 0,
"description": "Amount billed, USD."
}
},
"required": [
"hospital",
"cpt",
"billed_amount"
]
}🟢explain_denial_code(carc_code)
Explains a CARC claim-adjustment reason code from the public X12 code list: what it means, whether it is typically appealable, and the general appeal path. Not legal advice.
入力スキーマ
{
"type": "object",
"properties": {
"carc_code": {
"type": "string",
"maxLength": 20,
"description": "CARC/RARC code, e.g. 'CO-16', '16', 'CO-50'."
}
},
"required": [
"carc_code"
]
}🟢get_appeal_deadline(state, plan_type)
Returns the appeal window that applies to a plan type (employer ERISA plan, marketplace/individual, Medicare Advantage, Medicaid) with the federal citation and how the clock is counted. Cites the rule; does not tell you whether to file.
入力スキーマ
{
"type": "object",
"properties": {
"state": {
"type": "string",
"maxLength": 32,
"description": "2-letter US state (echoed on the row; the window itself is federal)."
},
"plan_type": {
"type": "string",
"maxLength": 40,
"description": "e.g. 'self_funded', 'aca_marketplace', 'medicare', 'medicaid'."
}
},
"required": [
"state",
"plan_type"
]
}🟢get_insurer_overturn_rate(insurer, state)
Returns, for one insurer in one state, the share of external-review appeals the state regulator reports as overturned, with the sample size, the regulator's report as the source, and the as-of date. Available for CA, NY, MD, NJ, MI, OH, NC. This is one insurer's own historical rate — not a ranking or comparison against other insurers, and not a prediction for your case.
入力スキーマ
{
"type": "object",
"properties": {
"insurer": {
"type": "string",
"maxLength": 100,
"description": "Insurer / payer name."
},
"state": {
"type": "string",
"maxLength": 32,
"description": "Venue state: CA, NY, MD, NJ, MI, OH, or NC."
}
},
"required": [
"insurer",
"state"
]
}🟢lookup_procedure_code(cpt_code)
Plain-English description of a CPT/HCPCS procedure code and its category, from public code references.
入力スキーマ
{
"type": "object",
"properties": {
"cpt_code": {
"type": "string",
"maxLength": 200,
"description": "CPT / HCPCS-J code ('99213', 'J1885') or keyword ('knee MRI', 'colonoscopy')."
}
},
"required": [
"cpt_code"
]
}コミュニティ
エビデンス