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claims_validate

Validate healthcare claims before submission to identify errors, missing fields, and code mismatches, with suggestions for corrections.

Instructions

Pre-submission claims validation. Checks for errors, missing fields, code mismatches, and provides fix suggestions before you submit to the payer.

Input Schema

TableJSON Schema
NameRequiredDescriptionDefault
claimYesClaim data to validate
Behavior2/5

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

With no annotations provided, the description carries full burden for behavioral disclosure. It mentions the tool 'checks for errors' and 'provides fix suggestions', which gives some behavioral context. However, it doesn't disclose important traits like whether this is a read-only operation, what format the suggestions come in, whether it makes any external calls, or any rate limits/authentication requirements.

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?

The description is perfectly concise at two sentences that directly state the tool's purpose and function. Every word earns its place with no redundancy or unnecessary elaboration. It's front-loaded with the core purpose immediately clear.

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

Completeness3/5

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

For a validation tool with no annotations and no output schema, the description provides adequate but incomplete context. It explains what the tool does but doesn't describe the output format, error handling, or what 'fix suggestions' entail. Given the complexity of claims validation and lack of structured output documentation, more behavioral context would be helpful.

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 description coverage is 100%, with the 'claim' parameter well-documented in the schema. The description adds minimal value beyond the schema by mentioning 'missing fields' and 'code mismatches', which aligns with the schema's required fields and code arrays. However, it doesn't provide additional semantic context about parameter usage or constraints beyond what's in the schema.

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

Purpose4/5

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

The description clearly states the tool's purpose: 'Pre-submission claims validation' with specific checks for 'errors, missing fields, code mismatches' and providing 'fix suggestions'. It distinguishes from siblings by focusing on claims validation rather than code lookup or other functions. However, it doesn't explicitly differentiate from 'code_validate' which might validate codes specifically.

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

Usage Guidelines3/5

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

The description implies usage context with 'before you submit to the payer', suggesting this should be used pre-submission. However, it doesn't provide explicit guidance on when to use this vs. alternatives like 'code_validate' or 'compliance_audit', nor does it mention any exclusions or prerequisites for use.

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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