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Servidor MCP

chatgpt

com.medigami/chatgpt
Salud Legal y cumplimiento Público y accesible MCP 2025-11-25

Qué hace este MCP

Explains medical procedure and denial codes, hospital rates, insurance appeal deadlines, insurer overturn rates, and billed-price markups.

Capacidades

Herramientas

6 herramientas
check_bill_markup
Bill markup check
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.
Solo lectura
Esquema de entrada 
{'type': 'object', 'required': ['hospital', 'cpt', 'billed_amount'], 'properties': {'cpt': {'type': 'string', 'maxLength': 10, 'description': 'CPT/HCPCS procedure code.'}, 'hospital': {'type': 'string', 'maxLength': 200, 'description': 'Hospital / facility name.'}, 'billed_amount': {'type': 'number', 'minimum': 0, 'description': 'Amount billed, USD.'}}}
explain_denial_code
Denial code explainer
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.
Solo lectura
Esquema de entrada 
{'type': 'object', 'required': ['carc_code'], 'properties': {'carc_code': {'type': 'string', 'maxLength': 20, 'description': "CARC/RARC code, e.g. 'CO-16', '16', 'CO-50'."}}}
get_appeal_deadline
Appeal deadline rule
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.
Solo lectura
Esquema de entrada 
{'type': 'object', 'required': ['state', 'plan_type'], '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'."}}}
get_hospital_rate
Hospital published rate
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.
Solo lectura
Esquema de entrada 
{'type': 'object', 'required': ['hospital', 'cpt'], 'properties': {'cpt': {'type': 'string', 'maxLength': 10, 'description': 'CPT/HCPCS procedure code.'}, 'hospital': {'type': 'string', 'maxLength': 200, 'description': 'Hospital / facility name.'}}}
get_insurer_overturn_rate
Insurer overturn rate
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.
Solo lectura
Esquema de entrada 
{'type': 'object', 'required': ['insurer', 'state'], 'properties': {'state': {'type': 'string', 'maxLength': 32, 'description': 'Venue state: CA, NY, MD, NJ, MI, OH, or NC.'}, 'insurer': {'type': 'string', 'maxLength': 100, 'description': 'Insurer / payer name.'}}}
lookup_procedure_code
Procedure code lookup
Plain-English description of a CPT/HCPCS procedure code and its category, from public code references.
Solo lectura
Esquema de entrada 
{'type': 'object', 'required': ['cpt_code'], 'properties': {'cpt_code': {'type': 'string', 'maxLength': 200, 'description': "CPT / HCPCS-J code ('99213', 'J1885') or keyword ('knee MRI', 'colonoscopy')."}}}
Historial

Cambios recientes en herramientas

Añadido
lookup_procedure_code
17 de September de 2026 a las 12:36
Añadido
get_insurer_overturn_rate
17 de September de 2026 a las 12:36
Añadido
get_appeal_deadline
17 de September de 2026 a las 12:36
Añadido
explain_denial_code
17 de September de 2026 a las 12:36
Añadido
check_bill_markup
17 de September de 2026 a las 12:36
Añadido
get_hospital_rate
17 de September de 2026 a las 12:36
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