A
licenseA
qualityD
maintenanceEnables AI assistants to look up medical billing codes, denial reasons, and payer rules for faster claim resolution.
6
6
MIT
Health Agent
Server Details
Look up a denial code, your appeal deadline, a billing code or 2027 Medicare drug plans.
If you are the author of this connector, you can claim ownership by verifying the domain or GitHub account it belongs to. Claimed connector authors can inspect health checks, view analytics, and manage their listing.
- Status
- Healthy
- Uptime
- 100.0% over the last 24 hours
- Last Tested
- Transport
- Streamable HTTP · MCP 2025-03-26
- URL
- ChatGPT
- –
- Claude
- –
TDQS
A3.9/5.0
Scored across 4 tools
Disambiguation4/5
Each tool targets a distinct object: an appeal deadline, a CARC/RARC denial code, a HCPCS Level II code, and a county plan list. The only mild overlap is between denial_code_lookup and hcpcs_lookup, but the descriptions explicitly separate the code systems (X12 adjustment/remark vs. CMS HCPCS Level II, and CPT is excluded).
Naming Consistency4/5
All four names are snake_case, lowercase, and compound noun phrases with no mixed conventions. They are noun-phrase rather than verb_noun style (no list_/get_/create_ prefixes), which is consistent within this read-only lookup set, but the year suffix on medicare_drug_plans_2027 is a small outlier.
Tool Count4/5
Four tools is lean but each occupies a distinct, non-trivial job in the denial/appeal workflow, so none feels like filler. It sits at the low end of the comfortable range for a domain this broad, but is not thin enough to be a scoping problem.
Completeness3/5
The surface covers the denial path well (code meaning, code description, appeal deadline) with no obvious dead ends inside that flow. However, gaps remain for a health/Medicare agent: no drug/formulary coverage check to pair with the plan list, no CPT support (acknowledged but still a hole), no provider or eligibility lookup, and no way to go from plan to covered drugs.
Available Tools
4 toolsappeal_deadlineLast day to appeal a denialARead-onlyIdempotentInspect
The last day to file an appeal of a Medicare, Medicare Advantage, Part D or commercial/ACA/employer plan denial, counted the way the rules count it (Medicare presumes receipt 5 days after the notice date), with days remaining, who decides, and the next level. Not legal advice; confirm the exact date with the official source it names.
Inputs: program (required), noticeDate (required), level, received.
denial_code_lookupWhat a claim denial code meansARead-onlyIdempotentInspect
What an insurance or Medicare denial code on an explanation of benefits means: a Claim Adjustment Reason Code (e.g. CO-97, PR-1, 197) or a Remark Code (e.g. M15, N432), from the X12 code lists. With a prefix it says whether the person may owe the amount (CO is the provider's write-off, PR is patient responsibility); for common codes it gives the typical fix and who acts. Not legal or billing advice.
Inputs: code (required).
hcpcs_lookupWhat a HCPCS billing code isARead-onlyIdempotentInspect
What a HCPCS Level II code on a bill, supplier invoice or explanation of benefits describes (a letter and four digits, e.g. E0601, J9271, A4253), with its Medicare coverage status, from CMS's quarterly HCPCS file. CPT codes (five digits) are not covered: their descriptions are copyrighted.
Inputs: code (required).
medicare_drug_plans_20272027 Medicare drug plans for a countyARead-onlyIdempotentInspect
Every 2027 Medicare plan with drug coverage CMS lists for a county: stand-alone drug plans (with Original Medicare) and Medicare Advantage plans, each with company, monthly premium, change from 2026, drug deductible and, for stand-alone plans, the premium with Extra Help. Give a ZIP code, or a state and county. From CMS's 2027 plan file. It does not say which plan covers which drug (the county page it links checks that against CMS's 2027 drug lists) and it is not a recommendation.
Inputs: zip, state, county.
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