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No Surprises Act IDR: a filer's or payer's scorecard

idr_scorecard
Read-only

The Q4 2025 IDR scorecard of one filing organization (provider email domain, e.g. fam-llc.com, qmacsmso.com, usap.com, halomd.com) or payer (uhc.com, bcbstx.com, aetna.com): disputes, win rate against the 85% provider norm, arbitrator fees paid on losses, overreach and under-ask shares, money left on the table at the norm, worst cells against the cell norm, arbitrator mix with loss rate per entity; for payers, the concede cells where providers win 90%+. With no domain: the arbitrator propensity table and the lists of filers and payers with 500+ disputes. Free. The full calibration file is sold by invoice.

Tool call template

This tool declares no required parameters. Add optional parameters from the input schema as needed.

{
  "id": 1,
  "jsonrpc": "2.0",
  "method": "tools/call",
  "params": {
    "arguments": {},
    "name": "idr_scorecard"
  }
}

Input Schema

NameRequiredDescriptionDefault
domainNoEmail domain of the filer or payer as the CMS file records it

Schema Changelog

Changes observed during successful MCP inspections.

  1. Added

TDQS

A4/5.0
Behavior4/5

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

Annotations already cover safety (readOnlyHint true, destructiveHint false, openWorldHint false), so the description's added value is the cost model and result composition: the call is free, the full calibration file is sold by invoice, and the no-argument call returns broader tables. That upsell and the two-mode behavior are genuinely beyond the structured fields. It says nothing about pagination or result size, which keeps it from a 5.

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

Conciseness3/5

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

Everything is crammed into one long semicolon-chained sentence with a dense metric list; the key fact (entity scorecard, or arbitrator table when no domain) is front-loaded, but the list of metrics is hard to parse and would scan far better as bullets. Little is wasted, but the structure works against comprehension.

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?

There is no output schema, so the description has to carry the return contents, and it does: it names both result modes and the metric families in each. What remains unstated is the return container/format and how a caller should treat unmatched domains, but for a single optional-parameter read tool this is close to sufficient.

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

Parameters3/5

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

Schema coverage is 100% and the single parameter is already documented as 'Email domain of the filer or payer as the CMS file records it'. The description mostly restates that and supplies illustrative examples, without adding format rules (bare domain vs email, case handling, unknown-domain behavior). Baseline 3 is appropriate.

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?

States a specific verb+resource: a Q4 2025 IDR scorecard for one filing organization or payer, enumerated with the exact metrics returned (disputes, win rate vs the 85% provider norm, arbitrator fees, overreach shares, worst cells, arbitrator mix). It also carves out the no-domain mode, which produces a different result set, so an agent can tell what this tool does and what shape the answer takes.

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?

Gives clear routing on the one branch that matters: supply a domain to get an entity scorecard, supply nothing to get the arbitrator propensity table plus the 500+ dispute lists. Real example domains (fam-llc.com, uhc.com) show the expected input. It does not name a sibling or state when a different entity-level tool (e.g. idr_entity_pick) should be preferred, so it stops short of full alternative routing.

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

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