chatgpt
Medigami patient tools: rates, markups, denial codes, deadlines, overturn rates, procedure codes
사용해야 할까요
품질 및 안전성
발견 사항 (1)
- LOWTool 'lookup_procedure_code' description lacks action verblookup_procedure_code에서
도구 정의와 프로토콜 준수에 대한 자동 분석을 기반으로 합니다.
컨텍스트 비용
이는 서버의 도구가 모델의 컨텍스트에 로드될 때마다 소비되는 대략적인 토큰 수입니다. 수치가 높을수록 다른 작업에 사용할 수 있는 주의가 줄어듭니다.
설치
원클릭 설치
`claude_desktop_config.json` 파일에 다음을 추가하세요:
{
"mcpServers": {
"chatgpt": {
"url": "https://mcp.medigami.com/chatgpt/mcp"
}
}
}원격 엔드포인트
https://mcp.medigami.com/chatgpt/mcpstreamable-http할 수 있는 일
도구 목록
도구 (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.
입력 스키마
{
"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.
입력 스키마
{
"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.
입력 스키마
{
"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.
입력 스키마
{
"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.
입력 스키마
{
"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.
입력 스키마
{
"type": "object",
"properties": {
"cpt_code": {
"type": "string",
"maxLength": 200,
"description": "CPT / HCPCS-J code ('99213', 'J1885') or keyword ('knee MRI', 'colonoscopy')."
}
},
"required": [
"cpt_code"
]
}커뮤니티
증거