coverage-rights

get_treatment_outcomes

Read-onlyIdempotent

External-review outcomes for a treatment: how often insurer denials of this treatment/drug/procedure were overturned by independent reviewers (42,749 published CA IMR decisions, 2001–2026). Accepts a category slug (e.g. 'pharmacy') or specific treatment slug (e.g. 'zepbound', 'speech-therapy').

Input Schema

TableJSON Schema

Name	Required	Description	Default
`slug`	Yes	Treatment slug, e.g. 'zepbound', 'pharmacy', 'speech-therapy'. Use search_outcomes to find slugs.

TDQS

A4.4/5.0

Behavior4/5

Does the description disclose side effects, auth requirements, rate limits, or destructive behavior?

Annotations already declare readOnlyHint and idempotentHint. The description adds that the data is from published CA IMR decisions (2001–2026), which provides useful context about scope and source.

Agents need to know what a tool does to the world before calling it. Descriptions should go beyond structured annotations to explain consequences.

Conciseness5/5

Is the description appropriately sized, front-loaded, and free of redundancy?

Two sentences with no wasted words. The first sentence explains what the tool does, the second explains input requirements. Perfectly front-loaded.

Shorter descriptions cost fewer tokens and are easier for agents to parse. Every sentence should earn its place.

Completeness4/5

Given the tool's complexity, does the description cover enough for an agent to succeed on first attempt?

For a simple single-parameter tool with no output schema, the description covers the data source, scope, and how to use the input. It's nearly complete; missing explicit output structure but not required.

Complex tools with many parameters or behaviors need more documentation. Simple tools need less. This dimension scales expectations accordingly.

Parameters4/5

Does the description clarify parameter syntax, constraints, interactions, or defaults beyond what the schema provides?

Schema description coverage is 100%, as the slug parameter is well-documented with examples. The description adds examples of category vs specific slugs and reinforces finding slugs via search_outcomes, adding meaning beyond the schema.

Input schemas describe structure but not intent. Descriptions should explain non-obvious parameter relationships and valid value ranges.

Purpose5/5

Does the description clearly state what the tool does and how it differs from similar tools?

The description clearly states it retrieves external-review outcomes for a treatment, with specific data about insurer denial overturn rates. It distinguishes from siblings like get_condition_outcomes and get_insurer_metrics by focusing on treatments and drugs.

Agents choose between tools based on descriptions. A clear purpose with a specific verb and resource helps agents select the right tool.

Usage Guidelines4/5

Does the description explain when to use this tool, when not to, or what alternatives exist?

It explicitly states it accepts category or treatment slugs and directs users to search_outcomes to find slugs. Though it doesn't mention when not to use, the guidance is clear and contextual.

Agents often have multiple tools that could apply. Explicit usage guidance like "use X instead of Y when Z" prevents misuse.

All coverage-rights tools Inspect

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TDQS

A4/5.0

Disambiguation3/5

Most tools have distinct purposes (e.g., get_appeal_rights vs. get_state_external_review), but get_condition_outcomes, get_treatment_outcomes, and get_drug_playbook overlap in the domain of external-review outcomes. An agent may confuse which to use for a given query, especially for drugs that appear in both drug_playbook and treatment_outcomes.

Naming Consistency5/5

All tool names follow a consistent verb_noun snake_case pattern: get_* for retrieval, list_* for enumeration, rank_* for rankings, and search_* for discovery. No mixed styles or inconsistent verb usage.

Tool Count5/5

Nine tools is well within the ideal 3-15 range. Each tool covers a distinct aspect of the coverage rights domain, and the count feels neither excessive nor thin.

Completeness4/5

The tool surface covers the core workflow: determining appeal rights, researching outcomes by condition/treatment, accessing insurer metrics, and understanding state processes. Minor gaps exist, such as no direct tool for state comparison or bulk retrieval of all states' external review rules, but these are not critical to the main purpose.

Resources

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