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MediBill Saver — medical bill audit tools

Look up Medicare rate for a CPT/HCPCS code

lookup_cpt_rate

Returns the Medicare national-average non-facility allowed amount for a CPT or HCPCS procedure code from the CMS Physician Fee Schedule. Useful for benchmarking what a hospital or clinic billed against what Medicare reimburses. Free, no authentication required. For the patient-facing description and disputes information, link the user to the returned pageUrl.

Input Schema

TableJSON Schema
NameRequiredDescriptionDefault
cptYes5-character CPT or HCPCS code, uppercase (e.g. '99285', 'J7030', 'G0008').

TDQS

A4.2/5.0
Behavior4/5

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

With no annotations, the description carries the burden of disclosure. It explicitly states 'Free, no authentication required' and describes the output (allowed amount) and a return field (pageUrl). This adds meaningful behavioral context beyond the schema, though it does not cover error handling or return format.

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?

Four concise sentences, each serving a distinct purpose: defining the output, providing a use case, stating access requirements, and giving result-handling guidance. No redundancy, and the primary function is 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 one-parameter lookup with no output schema and no annotations, the description is adequate. It covers output definition, use case, access, and a key return field. It omits potential error scenarios or return structure details, but these are less critical for this complexity level.

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%, with a clear pattern and description for the cpt parameter. The tool description adds background about the CMS Physician Fee Schedule but does not add parameter-specific syntax beyond what the schema already provides.

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 a specific verb ('Returns') and resource (Medicare national-average non-facility allowed amount for CPT/HCPCS codes). It distinguishes from sibling tools like lookup_hospital and audit_medical_bill by focusing on rate benchmarking.

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?

Provides a clear use case: benchmarking what a hospital or clinic billed against Medicare reimbursement. Also gives guidance for using the pageUrl for patient-facing disputes information. Does not explicitly name alternative tools, but context strongly implies when to use it.

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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TDQS

A4.2/5.0
Disambiguation5/5

Each tool targets a distinct resource/action: audit, dispute scenario lookup (singular and list), CPT rate lookup, hospital lookup. The list/get pair is clearly differentiated as list vs single item, and the lookups differ by target. No overlapping boundaries.

Naming Consistency5/5

All tool names follow a verb_noun snake_case pattern (audit_medical_bill, get_dispute_scenario, list_dispute_scenarios, lookup_cpt_rate, lookup_hospital). The verbs vary appropriately (audit, get, list, lookup) but the structure is consistent.

Tool Count5/5

5 tools is a well-scoped set for a medical bill audit service: one primary audit action, three supporting lookups/reference tools, and one discovery/index tool. No redundancy or bloat.

Completeness3/5

The core audit workflow is present, but there is no way to retrieve a previously generated audit report or the full paid report content; the audit tool only returns a preview and an external payment URL. Missing a tool to fetch the full report or manage audit history, which creates a minor gap.

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