get_coverage
Retrieve insurance coverage rules for a procedure and carrier, including summary, prior authorization, cost-sharing, frequency, and billing triggers.
Instructions
Insurance coverage rules for a procedure/carrier combination. aspect: 'summary' (status + plain English), 'prior-auth', 'cost-sharing' (deductible/coinsurance/ACA preventive), 'frequency' (how often covered, age rules), or 'triggers' (Pro plan: billing events that flip a $0 preventive claim to diagnostic — the highest-signal aspect).
Input Schema
| Name | Required | Description | Default |
|---|---|---|---|
| aspect | No | Default 'summary' | |
| carrier | Yes | Carrier key, e.g. 'aetna', 'cigna', 'bcbs', 'medicare' — see list_carriers | |
| plan_type | No | ||
| procedure | Yes | Procedure slug, e.g. 'colonoscopy' |