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com.medigami/mcp

com.medigami/mcp · v1.0.0

Measured by MCP Station

Description written by the publisher, not verified

Medigami: medical bill error scan, denial decoding, appeal deadlines, hospital price lookup

Connect

claude mcp add --transport http mcp https://mcp.medigami.com/public/mcp

{
  "mcpServers": {
    "mcp": {
      "url": "https://mcp.medigami.com/public/mcp"
    }
  }
}

Tools as reported by the server

• scan_bill_for_errors
  Scan a medical bill or EOB text for errors: duplicate charges, CPT unbundling, upcoding, facility-fee overcharges. Returns flagged anomalies with estimated dollar impact and a total recovery estimate. PHI WARNING: bill text typically contains PHI (patient name, DOB, MRN, insurer ID). Medigami runs a
• generate_appeal_letter
  Generate a legally-grounded insurance appeal letter for a denied claim. Returns the letter as a template with [PATIENT NAME] and [PROVIDER NAME] placeholders (structured-only PHI posture). Includes legal citations, recommended attachments, and appeal-deadline calendar. WHEN TO USE: User has a specif
• optimize_prescription
  Find the lowest-cost path for a prescription: generics, biosimilars, GoodRx coupons, manufacturer assistance, 90-day fills, and mail-order vs retail comparison. Returns ranked options with annual savings vs current copay. WHEN TO USE: User asks about prescription cost — lowest-price generic, biosimi
• analyze_glp1_pathways
  Find all access pathways for a GLP-1 drug (Ozempic, Wegovy, Mounjaro, Zepbound) given patient eligibility factors. Ranks pathways by monthly cost, flags prior-authorization rules and step-therapy, and returns the recommended appeal strategy if denial is likely. WHEN TO USE: User specifically asks ab
• verify_attestation
  Verify an Ed25519-signed Medigami MCP response envelope — confirm a medical-bill / appeal / denial / rate answer came from Medigami and hasn't been tampered with. Input: the signed envelope + a public key (PEM) or expected-fingerprint you pinned out-of-band. Returns {valid, reason, tracking_id, time
• watch_appeal_outcome
  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: 'timeout'} if nothing resolved within the window — caller re-invokes to keep watching. Tracking ids are returned by estimate_appeal_success a
• watch_claim_denial
  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 denied in claim_status_history, or {status: 'timeout'} if no denial observed within the window. WHEN TO USE: Caller wants to stream denial event
• format_citation
  Format an LLM-citable reference to a previously-attested Medigami MCP response. Input: either the full signed envelope that an earlier attested tool returned, OR just a tracking_id. Returns a short citation string, a public verification URL a third party can open to inspect and cryptographically ver
• submit_denial_letter
  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 submission is voluntary. Server-side PHI scrubber runs before any storage; the public aggregate contains only coded fields (insurer_canonic
• verify_mcp_response
  DEPRECATED ALIAS of verify_attestation — kept for backward compatibility with v0.1.7 clients. New code should call verify_attestation directly. WHEN TO USE: Reference lookups: individual code details, verifying a provider registry entry, checking a prior Medigami response's signature, or tracking an
• format_medigami_citation
  DEPRECATED ALIAS of format_citation — kept for backward compatibility with v0.1.7 clients. New code should call format_citation directly. WHEN TO USE: Reference lookups: individual code details, verifying a provider registry entry, checking a prior Medigami response's signature, or tracking an outco
• estimate_appeal_success
  Probability an appeal will be approved, derived from outcome-labeled data weighted by label provenance (IRO determinations, EOB reversals, physician confirmations). Returns probability + 95% CI + sample_size + expected_days_to_resolution + tracking_id. Report the actual outcome later via POST /api/o
• resolve_denial
  End-to-end denial resolution: returns appeal probability + confidence interval + a drafted letter template grounded in aggregate outcome data + plan-context flags (ERISA, restrictive-adjuster state). One call, one tracking_id. No recovery-financing product is offered by this tool. WHEN TO USE: Singl
• maximize_recovery
  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. Use after scan_bill_for_errors. WHEN TO USE: User has already run scan_bill_for_errors and wants the anomalies ranked by expected dollar rec
• explain_appeal_success
  Human-readable rationale for an appeal probability. Returns {probability, tier, recommended_posture, rationale, expected_days_to_resolution, tracking_id} grounded in aggregate outcome rates — not model feature weights. Use this when the caller wants 'why' in plain English alongside the number. WHEN
• negotiate_bill_script
  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's household income + federal charity-care rules (IRS §501(r)) into three negotiation angles: financial assistance, self-pay discount, and i
• batch_scan_bills
  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?, insurer?} items (max 10 per call). Much faster than serial scan_bill_for_errors when handling a bulk upload. WHEN TO USE: User has multiple bi
• lookup_icd10
  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 nephropathy'). Returns either the matching code + description or up to 20 candidate matches. Use when a clinical note uses non-standard phr
• lookup_cpt
  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, therapy, behavioral, vaccine, injectable drugs). Note: CPT is a registered trademark of the American Medical Association; full-dataset commercial
• lookup_npi
  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). Returns up to 20 matches with entity type, specialty, taxonomy code, address, and status. Source: CMS NPPES public API (free, no key requ
• verify_dea_authorization
  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 you were given (e.g. on a prescription label or a provider's letterhead). Scope note: this tool confirms the number is well-formed — it does
• lookup_provider_taxonomy
  Look up a NUCC provider taxonomy code (the specialty codes used on HIPAA transactions + NPI registrations) or search by keyword. Returns classification + type + optional specialization. Source: NUCC Health Care Provider Taxonomy Code Set (public; CMS-accepted). WHEN TO USE: Resolving a NUCC provider
• resolve_codes
  [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 with confidence scores. Use when you need to translate symptoms, procedures, or diagnoses into billable codes without running three separate
• code_conflict_detector
  [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 by the bill scanner's anomaly engine. WHEN TO USE: User asks about medical codes: what a CPT/ICD/HCPCS code means, whether a code combinati
• fair_price_estimator
  [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 CPT in a ZIP3 region. WHEN TO USE: User wants to understand what a service typically costs, compare prices across regions/providers, or gauge
• price_variance_analyzer
  [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 target sits, plus confidence. WHEN TO USE: User wants to understand what a service typically costs, compare prices across regions/providers, or
• claim_consistency_checker
  [Taxonomy C.14 — delegates to scan_bill_for_errors] Detect internal contradictions in a claim: time mismatches, mutually exclusive codes, missing required fields, patient-gender/procedure mismatches. WHEN TO USE: Caller is building or validating a claim payload before submission — format, structure,
• bundling_violation_detector
  [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 edits plus payer-specific bundling rules. WHEN TO USE: Caller is building or validating a claim payload before submission — format, structu
• appeal_success_predictor
  [Taxonomy E.25 — delegates to estimate_appeal_success] Given a denial, predict the probability of a successful appeal. Returns probability with 95% CI, sample size, and recommended appeal-strategy tags. WHEN TO USE: User or caller wants a probabilistic estimate (denial likelihood, appeal success, pa
• generate_appeal_letter_v2
  [Taxonomy F.28 — delegates to generate_appeal_letter] [Taxonomy alias] Generate a state-specific insurance appeal letter with UPL-safe disclaimers for 19 US states. Same impl as generate_appeal_letter. WHEN TO USE: User has a denied claim and wants to appeal, or is preparing arguments / evidence / e
• negotiation_strategy_generator
  [Taxonomy F.30 — baseline response (public data only)] Given a bill + patient situation, generate a ranked negotiation strategy: hardship appeal, charity-care application, itemization request, phone scripts. WHEN TO USE: User has a denied claim and wants to appeal, or is preparing arguments / eviden
• insurance_response_interpreter
  [Taxonomy F.31 — baseline response (public data only)] Parse an insurer's response letter or EOB into structured fields: denial reason codes, appeal rights, deadlines, next-step recommendations. WHEN TO USE: User has a denied claim and wants to appeal, or is preparing arguments / evidence / escalati
• settlement_optimizer
  [Taxonomy F.32 — baseline response (public data only)] For a disputed bill, compute the optimal settlement target price balancing probability of acceptance against amount saved. WHEN TO USE: User has a denied claim and wants to appeal, or is preparing arguments / evidence / escalation steps for one.
• patient_cost_forecaster
  [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. WHEN TO USE: User is planning for a medical expense, comparing plan options, looking for financial assistance, or trying to structure a pa
• insurance_plan_optimizer
  [Taxonomy H.39 — baseline response (public data only)] Given a patient's historical claim patterns, rank available insurance plans by expected annual cost. WHEN TO USE: User is planning for a medical expense, comparing plan options, looking for financial assistance, or trying to structure a payment
• cash_vs_insurance_optimizer
  [Taxonomy H.41 — baseline response (public data only)] For a given service + patient plan, determine whether cash-pay + charity-care beats insurance billing. WHEN TO USE: User is planning for a medical expense, comparing plan options, looking for financial assistance, or trying to structure a paymen
• financial_risk_exposure_model
  [Taxonomy H.42 — baseline response (public data only)] Quantify a patient's financial exposure to medical-debt risk given current plan, health status, and historical claim volatility. WHEN TO USE: User is planning for a medical expense, comparing plan options, looking for financial assistance, or tr
• cpt_to_icd_mapper
  [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. WHEN TO USE: User has a CPT code and wants to know what ICD-10 diagnoses commonly pair with it for medical-necessity support. WHEN NOT: For specif
• icd_to_cpt_mapper
  [Taxonomy II.22 — baseline response (public data only)] For a given ICD-10, surface the CPT codes typically billed for that diagnosis. WHEN TO USE: User has an ICD-10 diagnosis and wants to know what CPTs are commonly billed for it. WHEN NOT: For planning specific services (use benchmark_payer_rate
• code_bundle_validator
  [Taxonomy II.25 — baseline response (public data only)] Check a set of CPT codes against NCCI bundling rules (distinct from modifier-based unbundling). WHEN TO USE: User asks about medical codes: what a CPT/ICD/HCPCS code means, whether a code combination is valid, or how to map between them. WHEN N
• unbundling_detector
  [Taxonomy II.26 — delegates to scan_bill_for_errors] Detect CPT unbundling patterns in a claim. Alias of scan_bill_for_errors. WHEN TO USE: User asks about medical codes: what a CPT/ICD/HCPCS code means, whether a code combination is valid, or how to map between them. WHEN NOT: For full bill scans (
• cash_price_estimator
  [Taxonomy III.39 — baseline response (public data only)] Estimate a fair cash price for a service in a given region (no-insurance path). WHEN TO USE: Uninsured/self-pay user wants a fair-market cash price for a service. Returns Medicare national as a floor + commercial-multiple band. WHEN NOT: For i
• zip_based_price_variance
  [Taxonomy III.41 — baseline response (public data only)] Report price variance for a CPT across ZIP3 regions with DP noise. WHEN TO USE: User wants to understand what a service typically costs, compare prices across regions/providers, or gauge whether a billed amount is reasonable. WHEN NOT: For a s
• regional_price_benchmark
  [Taxonomy III.43 — baseline response (public data only)] Regional price benchmark for a CPT at state/metro/ZIP3 granularity. WHEN TO USE: User wants to understand what a service typically costs, compare prices across regions/providers, or gauge whether a billed amount is reasonable. WHEN NOT: For a
• specialty_price_benchmark
  [Taxonomy III.44 — baseline response (public data only)] Price benchmark for a CPT within a specific provider specialty. WHEN TO USE: User wants to understand what a service typically costs, compare prices across regions/providers, or gauge whether a billed amount is reasonable. WHEN NOT: For a spec
• inflation_adjusted_price_model
  [Taxonomy III.46 — baseline response (public data only)] Inflation-adjusted price comparison across years for a CPT. WHEN TO USE: User has a historical dollar amount and wants it adjusted for medical-care inflation to a given year. WHEN NOT: For current market prices (benchmark_payer_rate). EXAMPLES
• deductible_impact_calculator
  [Taxonomy III.48 — baseline response (public data only)] Estimate how a planned service will draw against the member's deductible. WHEN TO USE: User wants to know how a specific charge affects their deductible (how much draws down, remaining after, post-deductible exposure). WHEN NOT: For total annu
• coinsurance_simulator
  [Taxonomy III.49 — baseline response (public data only)] Simulate member coinsurance exposure across plan-design variants. WHEN TO USE: User wants to model their coinsurance share of a post-deductible charge. Pass charge_usd and optionally coinsurance_rate. WHEN NOT: For flat-copay services (copay_m
• copay_model
  [Taxonomy III.50 — baseline response (public data only)] Model member copay for a service by plan-design class. WHEN TO USE: User wants the typical copay for a service type (primary / specialist / er). Uses KFF EHBS 2024 averages. WHEN NOT: For patient-specific plan details — copay varies by plan de
• billing_charge_vs_allowed_delta
  [Taxonomy III.51 — baseline response (public data only)] Delta between billed charge and payer-allowed amount for a claim line. WHEN TO USE: User wants to understand what a service typically costs, compare prices across regions/providers, or gauge whether a billed amount is reasonable. WHEN NOT: For
• price_anomaly_detector
  [Taxonomy III.52 — baseline response (public data only)] Detect service-line prices statistically anomalous versus market. WHEN TO USE: User wants to understand what a service typically costs, compare prices across regions/providers, or gauge whether a billed amount is reasonable. WHEN NOT: For a sp
• overpriced_service_detector
  [Taxonomy III.53 — baseline response (public data only)] Flag services billed materially above market percentile thresholds. WHEN TO USE: User wants to understand what a service typically costs, compare prices across regions/providers, or gauge whether a billed amount is reasonable. WHEN NOT: For a
• market_price_distribution_model
  [Taxonomy III.55 — baseline response (public data only)] Full DP-noised market price distribution for a CPT+region pair. WHEN TO USE: User wants to understand what a service typically costs, compare prices across regions/providers, or gauge whether a billed amount is reasonable. WHEN NOT: For a spec
• price_outlier_detector
  [Taxonomy III.56 — baseline response (public data only)] Detect claim-line outliers relative to a learned market distribution. WHEN TO USE: User wants to understand what a service typically costs, compare prices across regions/providers, or gauge whether a billed amount is reasonable. WHEN NOT: For
• procedure_cost_decomposition
  [Taxonomy III.57 — baseline response (public data only)] Decompose the cost of a procedure into component services + facility + professional fees. WHEN TO USE: User wants to understand what a service typically costs, compare prices across regions/providers, or gauge whether a billed amount is reason
• price_recommendation_engine
  [Taxonomy III.58 — baseline response (public data only)] Recommend a reasonable price to propose to a provider for a service (self-pay or negotiation). WHEN TO USE: User wants to understand what a service typically costs, compare prices across regions/providers, or gauge whether a billed amount is r
• claim_duplicate_line_detector
  [Taxonomy IV.75 — baseline response (public data only)] Detect duplicated service lines within a single claim. WHEN TO USE: Caller is building or validating a claim payload before submission — format, structure, completeness, alignment. WHEN NOT: For an already-submitted and denied claim, use genera
• denial_reason_classifier
  [Taxonomy VI.106 — baseline response (public data only)] Classify a denial letter or remittance advice into normalized denial-reason categories. WHEN TO USE: User or caller wants a probabilistic estimate (denial likelihood, appeal success, payment delay, etc.) to decide whether to pursue a path. WHE
• appeal_argument_generator
  [Taxonomy VII.120 — baseline response (public data only)] Generate component arguments for an appeal letter: medical-necessity, contract, policy. WHEN TO USE: User has a denied claim and wants to appeal, or is preparing arguments / evidence / escalation steps for one. WHEN NOT: For explaining what a
• denial_response_builder
  [Taxonomy VII.121 — baseline response (public data only)] Build a denial-response package tailored to the denial reason code. WHEN TO USE: User has a denied claim and wants to appeal, or is preparing arguments / evidence / escalation steps for one. WHEN NOT: For explaining what a denial code means w
• dispute_case_builder
  [Taxonomy VII.123 — baseline response (public data only)] Assemble a complete dispute case file including claim, denial, evidence, and timeline. WHEN TO USE: User has a denied claim and wants to appeal, or is preparing arguments / evidence / escalation steps for one. WHEN NOT: For explaining what a
• evidence_pack_generator
  [Taxonomy VII.124 — baseline response (public data only)] Generate an evidence package supporting a claim or appeal (references, studies, policies). WHEN TO USE: User has a denied claim and wants to appeal, or is preparing arguments / evidence / escalation steps for one. WHEN NOT: For explaining wha
• claim_rebuttal_generator
  [Taxonomy VII.128 — baseline response (public data only)] Generate a rebuttal to a payer's denial rationale point-by-point. WHEN TO USE: User has a denied claim and wants to appeal, or is preparing arguments / evidence / escalation steps for one. WHEN NOT: For explaining what a denial code means wit
• appeal_escalation_path_finder
  [Taxonomy VII.129 — baseline response (public data only)] Find the correct escalation path for a denied claim (internal appeal → external review → DOI). WHEN TO USE: User needs to know the deadlines and agencies for each step of appealing a denial. Pass state (e.g. 'CA') and insurer for state-specif
• payer_specific_appeal_templates
  [Taxonomy VII.130 — baseline response (public data only)] Return payer-specific appeal templates known to perform well. WHEN TO USE: User has a denied claim and wants to appeal, or is preparing arguments / evidence / escalation steps for one. WHEN NOT: For explaining what a denial code means without
• denial_code_explainer
  [Taxonomy VII.131 — baseline response (public data only)] Explain a CARC/RARC denial code in plain language with common causes. WHEN TO USE: User asks 'what does CO-16 mean' or similar — any CARC/RARC code. Returns full X12 table entry when available with meaning, category, typical root cause, prima
• claim_reconsideration_builder
  [Taxonomy VII.132 — baseline response (public data only)] Build a claim reconsideration request (lighter-weight than a formal appeal). WHEN TO USE: User has a denied claim and wants to appeal, or is preparing arguments / evidence / escalation steps for one. WHEN NOT: For explaining what a denial cod
• supporting_document_selector
  [Taxonomy VII.135 — baseline response (public data only)] Select optimal supporting documents for an appeal from an available document pool. WHEN TO USE: User is preparing an appeal and needs a ranked list of supporting documents for the denial category. Pass denial_code. WHEN NOT: Without denial_co
• out_of_pocket_optimizer
  [Taxonomy X.174 — baseline response (public data only)] Optimize out-of-pocket spend across a sequence of planned services. WHEN TO USE: User is planning for a medical expense, comparing plan options, looking for financial assistance, or trying to structure a payment plan. WHEN NOT: For billing-erro
• financial_exposure_model
  [Taxonomy X.176 — delegates to financial_risk_exposure_model] Model a member's financial exposure. Alias of financial_risk_exposure_model. WHEN TO USE: User is planning for a medical expense, comparing plan options, looking for financial assistance, or trying to structure a payment plan. WHEN NOT: F
• procedure_affordability_ranker
  [Taxonomy X.177 — baseline response (public data only)] Rank a set of procedures by affordability for a given member. WHEN TO USE: User is planning for a medical expense, comparing plan options, looking for financial assistance, or trying to structure a payment plan. WHEN NOT: For billing-error anal
• treatment_cost_comparator
  [Taxonomy X.178 — baseline response (public data only)] Compare expected costs across treatment alternatives for a condition. WHEN TO USE: User is planning for a medical expense, comparing plan options, looking for financial assistance, or trying to structure a payment plan. WHEN NOT: For billing-er
• bill_shock_predictor
  [Taxonomy X.179 — baseline response (public data only)] Predict risk that a planned service will trigger an unexpected large bill. WHEN TO USE: User planning a service and wants to know if it will trigger an unexpected-large-bill situation. Pass expected_charge_usd and optionally cpt_code to get Med
• payment_plan_optimizer
  [Taxonomy X.180 — baseline response (public data only)] Optimize a payment plan structure for a patient balance. WHEN TO USE: User has a balance and wants to structure a payment plan. Pass balance_usd and months. WHEN NOT: If user may qualify for charity care — run financial_assistance_finder first.
• financial_assistance_finder
  [Taxonomy X.181 — baseline response (public data only)] Find applicable financial-assistance programs (hospital charity, 340B, state, pharma). WHEN TO USE: User needs help paying a medical bill. Pass household_income_usd and family_size for FPL-based eligibility flags across 6 programs (501(r) chari
• patient_cost_explainer
  [Taxonomy X.182 — baseline response (public data only)] Explain why a specific charge appears on a bill in plain language. WHEN TO USE: User is planning for a medical expense, comparing plan options, looking for financial assistance, or trying to structure a payment plan. WHEN NOT: For billing-error
• healthcare_budget_forecaster
  [Taxonomy X.183 — baseline response (public data only)] Forecast a household's annual healthcare spend based on plan + utilization. WHEN TO USE: User planning annual healthcare spend, comparing plans, or estimating worst-case exposure. WHEN NOT: For a specific procedure cost (benchmark_payer_rate).
• medical_spending_analyzer
  [Taxonomy X.184 — baseline response (public data only)] Analyze a patient's medical spending over a period and surface optimization opportunities. WHEN TO USE: User is planning for a medical expense, comparing plan options, looking for financial assistance, or trying to structure a payment plan. WHE
• insurance_value_optimizer
  [Taxonomy X.185 — baseline response (public data only)] Recommend insurance-plan selections to maximize value given projected utilization. WHEN TO USE: User is planning for a medical expense, comparing plan options, looking for financial assistance, or trying to structure a payment plan. WHEN NOT: F
• patient_financial_risk_score
  [Taxonomy X.186 — baseline response (public data only)] Score a patient's financial risk exposure from planned or ongoing care. WHEN TO USE: User is planning for a medical expense, comparing plan options, looking for financial assistance, or trying to structure a payment plan. WHEN NOT: For billing-
• decode_denial
  Decode a CARC (Claim Adjustment Reason Code) denial code into plain English. Returns meaning, category, whether it's typically reversible on appeal, and appeal guidance. Source: public X12 External Code List + CMS/ERISA public rules. Free, no auth. WHEN TO USE: Reference lookups: individual code det
• get_appeal_deadline
  External-review filing deadline for a state + the date of the FINAL adverse determination. Returns the deadline date, the statutory window label + citation, and whether the exact state-specific window still needs verification (most states carry a conservative NAIC-model 4-month floor unless statute-
• get_venue
  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 available. Free, no auth. WHEN TO USE: Reference lookups: individual code details, verifying a provider registry entry, checking a prior Medigami
• medigami_odds
  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 insurer's own rate — not a comparison or ranking against other insurers. Public regulator data, k-anonymity floored, not legal advice. WHEN TO
• medigami_roast
  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 floored, not legal advice. WHEN TO USE: Reference lookups: individual code details, verifying a provider registry entry, checking a prior Med
• medigami_deadline
  Federal appeal-deadline window (ERISA §503 internal-appeal / ACA §2719 external-review / NSA IDR) for a plan type. Public regulator data, k-anonymity floored, not legal advice. WHEN TO USE: Reference lookups: individual code details, verifying a provider registry entry, checking a prior Medigami res
• medigami_rate
  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 floored, not legal advice. WHEN TO USE: Reference lookups: individual code details, verifying a provider registry entry, checking a prior Medi

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