Look up a single Taiwan NHI rejection code (5-character format NNNNL — 4 digits + 1 uppercase letter A/B/C/..., e.g. '0317A', '0338A', '0114A'). Returns severity (low / medium / high), category (00 診療品質 · 01 病歷紀錄 · 02 基本診療 · 03 藥品特材 · 04 手術處置 · 05 檢查檢驗 · 06 論病例計酬 · 07 復健精神 · 08 其他 · 09 法令 — first two digits encode the category), and the official Chinese description from 健保署 專業審查不予支付理由代碼. Returns a not-found message (not an error) if the code does not exist. Use when an agent encounters a known rejection code in a notice or claim response and needs the human-readable explanation, or when triaging which category a code belongs to. Typical follow-up: call get_drug_rules({rejection_code}) if the code is in category 03 (藥品特材) to surface the drug rule behind the rejection; call search_audit_guidelines({query: <code>}) for codes in 04 / 05 to read the underlying audit-clause text; call count_appeal_precedents_for_rejection_code({rejection_code}) to gauge whether disputes for this code are commonly successful. Don't use to enumerate codes by category — call get_rejection_code_category({category}) instead. Reference only — the official 健保署 code list is authoritative. Curated by OPDSTAR (https://opdstar.com).

Given a Taiwan ICD-10 code and a medical specialty, return the NHI procedure codes plausibly applicable to that diagnosis within that specialty. Each result includes the procedure code, Chinese name, English name, nhi_points (payment points), and audit_notes (specialty-specific review caveats and risk hints). Results are ordered by curated relevance (most commonly applied codes first), capped at limit (default 10, max 20). Returns an empty list (not an error) when no curated mapping exists for the given (icd10, specialty) pair — this is common because the mapping is intentionally conservative. Use when an agent is drafting SOAP and needs a starting set of procedure codes for the diagnosis within the clinician's specialty context — e.g. dermatologist with L30.9 (chronic eczema) needs candidate procedure codes. Typical follow-up: for each candidate code, call lookup_fee_code({q: <code>}) to confirm current points and effective dates, and lookup_audit_clauses_for_procedure({procedure_code}) to surface any audit-clause caveats. Don't use as a billing source of truth — the original NHI fee schedule has no ICD field, this is a curated, intentionally conservative mapping that prefers false negatives over false positives; for the canonical fee-schedule entry of a known code, call lookup_fee_code. Reference only — final code selection remains the clinician's responsibility. Curated by OPDSTAR (https://opdstar.com).

Look up a single Taiwan NHI prescribing-pattern indicator. These are 1-4 character codes that encode common over-prescribing patterns: 3-digit numeric codes (e.g. '008' antibiotic-on-URI, '014' multi-PPI co-prescribing, '027' duration limit) or 'P'-prefixed codes (e.g. 'P043' chronic-prescription duration cap). Returns the indicator name, the threshold (e.g. '7-day URI episode'), applicable drugs / diagnoses, and the compliance meaning. Returns a not-found message (not an error) if the code does not exist. Use when an agent needs the human-readable explanation for a specific indicator code referenced during a SOAP review or audit response — e.g. an audit notice cites indicator 008 and the agent needs to surface what 008 monitors and why a prescription tripped it. Typical follow-up: call get_drug_rules({rejection_code}) with the indicator's downstream rejection code to read the formal payment rule, or search_audit_guidelines({query}) to read related audit-clause text. Don't use for the official 分析審查不予支付指標 (percentage-cap audit) list — that's a different system — call lookup_audit_indicator instead. Reference only — thresholds and applicable lists reflect published guidance and may change with each NHI release; agents should re-read the indicator each session rather than caching values across sessions. Curated by OPDSTAR (https://opdstar.com).

Search across Taiwan's official NHI knowledge base (健保署全球資訊網) for natural-language background questions. Covers 9 categories: audit (審查 — review rules / rejection grounds), drugs (藥品特材 — formulary, payment limits), fees (費用 — copay, premiums, contribution), plans (醫療計畫 — disease-management programs), services (醫療服務 — covered benefits), insurance (投保 — enrollment), forms (表單 — applications), records (紀錄 — documentation rules), admin (行政 — contracting, accreditation). Returns up to 10 ranked excerpts (most relevant first); each result includes title, content snippet, source URL, and category tag. Returns an empty list (not an error) when the query has no matches. Use when an agent needs broad NHI policy background not tied to a specific code — e.g. '慢性病連續處方箋天數上限' / 'how does balance billing work for orthodontics' / 'what are the rules for telemedicine reimbursement'. Typical follow-up: when an excerpt mentions a specific code (e.g. '0317A', '00101B'), call the appropriate code-specific tool (lookup_rejection_code, lookup_fee_code) for the canonical entry. Don't use when you already know a specific rejection code, procedure code, drug name, or audit-clause topic — those have dedicated tools that return structured fields rather than excerpts. Reference only — official 健保署 publications are authoritative; ranked excerpts may lag the latest revision and the snippet is not the full document. Curated by OPDSTAR (https://opdstar.com).

Look up Taiwan NHI drug payment rules (藥品給付規定) — when a drug class is / isn't reimbursable, with severity and source citation. Filter by specialty, rejection_code, or drug_category_query (at least one required). Use when an agent is checking whether a drug choice will trigger a rejection before submission, or wants to read the rule behind a known rejection code. Don't use to identify a specific drug (brand / generic / strength) — call lookup_drug instead; for the underlying audit clauses, use lookup_audit_clauses_for_procedure or lookup_audit_clauses_for_specialty. Reference only — official 健保藥品給付規定 is authoritative; curated subset, not exhaustive. Curated by OPDSTAR (https://opdstar.com).

Preview which documentation scenarios have OPDSTAR-curated NHI-safe phrasing patterns for a given specialty (e.g. dermatology + 抗生素) — returns scenario name, high-risk wording to avoid, the key difference, and the first sentence of the safe-phrasing example. Up to 5 scenarios per call. Use when an agent is helping draft SOAP wording and needs to flag risky phrasing before submission. Don't use to retrieve full ready-to-copy templates (full library is part of the paid OPDSTAR product — link the user to opdstar.com); for the underlying audit rule that motivates a safe phrase, call search_audit_guidelines. Reference only — phrasing patterns reflect curated review experience, not formal NHI directives. Curated by OPDSTAR (https://opdstar.com).

Free-text search over Taiwan NHI 審查注意事項 rules — returns reason + suggestion summaries (first sentence only) for up to 10 rules matching a keyword (Traditional Chinese or English). Use when an agent is exploring whether any audit rule covers a topic (e.g. '抗生素', '檢查頻率', '慢性病處方') without knowing a specific code. Don't use for clauses tied to a known procedure code — call lookup_audit_clauses_for_procedure instead. Full SOAP example templates and detailed reasoning are part of the paid OPDSTAR product. Reference only — official 健保署 審查注意事項 is authoritative; results are previews. Curated by OPDSTAR (https://opdstar.com).

Browse Taiwan NHI rejection codes by category (00-09) for discovery — returns code, severity, and short description, up to 50 per call. Categories: 00 診療品質 · 01 病歷紀錄 · 02 基本診療 · 03 藥品特材 · 04 手術處置 · 05 檢查檢驗 · 06 論病例計酬 · 07 復健精神 · 08 其他 · 09 法令. Use when an agent needs to enumerate all rejection codes within a workflow domain (e.g. all surgery-handling codes). Don't use to look up a known specific code — call lookup_rejection_code instead. Reference only — official 健保署 不予支付理由代碼 is authoritative. Curated by OPDSTAR (https://opdstar.com).

Look up the active Taiwan NHI drug catalog by generic name, brand name, NHI drug code, or alias — returns up to 10 matches with strength, dosage form, route, ATC code, therapeutic class, and brand list. Use when an agent needs to identify or disambiguate a drug before recommending dosage / formulation in a SOAP draft. Don't use to look up payment / reimbursement rules for the drug — call get_drug_rules instead; for an audit clause referencing the drug, call search_audit_guidelines. Reference only — official 健保署 藥品給付項目及支付標準 is authoritative; the catalog is a working snapshot. Curated by OPDSTAR (https://opdstar.com).

Look up the Taiwan NHI fee schedule (全民健康保險醫療服務給付項目及支付標準, current effective edition). Search by exact code (e.g. '00101B', 'P15001') or by Chinese / English name (e.g. '門診診察', 'ICU') — returns code, points, effective dates, and audit notes (truncated to 600 chars). Use category prefix to scope ('00' 基本診療, '06' 手術, 'P1' 病例計酬, 'N2' 護理). Use when an agent needs the canonical fee entry for a known procedure code, or wants to discover codes by name. Don't use for drugs (call lookup_drug) or for ICD-10 → procedure suggestions (call get_procedures_for_icd). The optional icd filter applies an OPDSTAR-curated mapping that is intentionally sparse (the original NHI data has no ICD field) — most codes will return no result with icd active. Reference only — official 健保署 支付標準 is authoritative. Curated by OPDSTAR (https://opdstar.com).

Find Taiwan NHI 審查注意事項 clauses that reference a specific procedure code (e.g. '00101B', '51017C') — each result indicates whether the clause carries an amount limit, frequency rule, or indication restriction (critical signals for rejection-risk assessment). Returns clause summary, specialty, and risk flags. Use when an agent has a candidate procedure code and needs to surface the audit context attached to it. Don't use for the procedure's fee-schedule entry (points / effective dates) — call lookup_fee_code; for browsing all clauses within a specialty, call lookup_audit_clauses_for_specialty. Reference only — clause summaries are first-sentence previews; official 健保署 審查注意事項 is the source of truth. Curated by OPDSTAR (https://opdstar.com).

Browse Taiwan NHI 審查注意事項 clauses for a specific medical specialty (dermatology, ophthalmology, ENT, TCM, dentistry, family medicine, etc.) — returns clause headlines with risk flags (amount_limit / frequency_rule / indication) and a short preview of the procedures each clause governs. Use when an agent needs section-wide audit context before assisting with claim coding for a specialty. Don't use for clauses tied to a known specific procedure code — call lookup_audit_clauses_for_procedure instead. Reference only — official 健保署 審查注意事項 (current edition) is authoritative; clause summaries are previews. Curated by OPDSTAR (https://opdstar.com).

Browse Taiwan NHI 重大傷病 (major illness) categories — official categories that grant copayment exemption and a more lenient claim-review process. Returns category name, ICD-10 code coverage, application requirement, and validity period. Use when an agent needs to enumerate or filter major-illness categories (e.g. 'all cancer categories', 'categories that don't require an application'). Don't use if you already have an ICD-10 code and want to know which categories it qualifies for — call check_icd_for_major_illness_eligibility instead. Reference only — final eligibility requires a formal application with supporting documentation per the official 重大傷病範圍及項目. Curated by OPDSTAR (https://opdstar.com).

Reverse-lookup: given a single ICD-10 code, return the Taiwan NHI 重大傷病 (major illness) categories the diagnosis may qualify for, including category name, the ICD pattern that matched, and copayment-exemption flag. Use when an agent has a diagnosis and needs to flag major-illness applicability before claim submission. Don't use to browse all categories — call lookup_major_illness instead (also use it for the category → applicable ICDs direction). Reference only — confirmed eligibility still requires a formal application with supporting documentation per the official 重大傷病範圍及項目. Curated by OPDSTAR (https://opdstar.com).

Look up Taiwan NHI 分析審查不予支付指標 (official threshold-based audit rules where claims exceeding a percentage are denied) — returns indicator code, category, threshold, applicable specialty, monitored procedure codes, and official action description. Use when an agent needs to know whether a procedure code is under a percentage-cap audit (e.g. '23401C' is monitored by indicator 001 眼科局部處置申報率, 30% threshold). Omit indicator_code to browse by category / specialty / procedure. Don't use for prescribing-pattern indicators (008 / 014 / 027 / P043 etc.) — those live in get_indicator. Reference only — thresholds change with each official release. Curated by OPDSTAR (https://opdstar.com).

Aggregate dispute-resolution statistics for Taiwan NHI claim disputes, broken down by category and (optionally) review stage — returns category counts and rough win-rate signals only, never individual case details, case numbers, or arguments. Use when an agent is helping a clinician understand the general dispute landscape (e.g. 'how often do fee-calculation disputes resolve in the claimant's favor at the first court tier?'). Don't use for code-specific signals — call count_appeal_precedents_for_rejection_code instead. Reference only — historical signal does not predict future outcomes; final decisions rest with the responsible review body. Curated by OPDSTAR (https://opdstar.com).

Aggregate signal-only summary of how disputes involving a given Taiwan NHI rejection code (e.g. '0312A', '0114A') or procedure code (e.g. '86008C') historically resolve — returns rough volume bucket (none / few / several / many), claimant win-rate signal (rare / occasional / moderate / common), and which review stages have on-record outcomes. Use when an agent is helping triage whether contesting a specific code is worth pursuing. Don't use to fetch individual case details (none are exposed) — for the broader landscape across categories, call lookup_appeal_statistics_by_category instead. Reference only — historical signal does not predict future outcomes; final review decisions rest with the responsible authority. Curated by OPDSTAR (https://opdstar.com).

List recent amendments to Taiwan NHI rules and audit guidelines (健保署「醫療費用審查注意事項」近一年修正公告). Returns the publication / effective dates, the amendment title and type ('primary' = main regulation update, 'comparison' = side-by-side diff document), and direct links to the official DOCX / ODT / PDF announcement files plus the 健保署 listing page. Use when an agent needs to answer 'what NHI rule changes are coming?', 'when does the new 審查注意事項 take effect?', or wants to check whether a specific rule has been recently amended before quoting it. Typical follow-up: call search_audit_guidelines({query}) to pull the post-amendment clause text, or lookup_rejection_code({code}) to see how it ties into existing rejection codes. Reference only — official 健保署 announcements are authoritative. Curated by OPDSTAR (https://opdstar.com).

Search Taiwan drugs across NHI and TFDA registries with unified cross-reference. Returns generic name (EN + 中文學名), all brand names + aliases, NHI 9碼 billing code, ATC code, dosage form, strength, route, therapeutic class, applicable specialties, compound-flag, and effective date. The query auto-detects four input shapes: (1) NHI drug code 9碼 (e.g. 'AC4537911', 'A04403412' — 1-2 letter prefix + 6-9 digits) → direct match; (2) ATC code prefix (e.g. 'J01CR02' or 'J01' for the antibacterials class) → class match; (3) Generic name EN or 中文 → ILIKE; (4) Brand name / alias → secondary fallback. Use when an agent has any drug identifier and needs the canonical record for billing / SOAP / appeal context. Typical follow-up: call get_drug_rules({drug_category_query}) for NHI payment rules / prior-authorization on this drug, lookup_icd10_cm for the diagnosis side, or count_appeal_precedents_for_rejection_code if a rejection code is involved. Out of scope: drug-drug interactions, severity scoring, indication-specific dosing. Reference only — TFDA license / 健保 給付規定 are authoritative. Curated by OPDSTAR (https://opdstar.com).

Look up ICD-10-CM diagnosis codes with English / Traditional Chinese descriptions, category, and the OPDSTAR specialties each code is keyed against. Use when the agent encounters an ICD-10 code in a note, claim, or rejection notice and needs the canonical name, or wants to free-text search by EN / 中文 keyword to find candidate codes. Typical follow-up: chain into get_procedures_for_icd({icd10, specialty}) to find the procedures commonly paired with the code, or check_icd_for_major_illness_eligibility({icd10}) to check 重大傷病 coverage. Scope note: Currently backed by OPDSTAR's specialty-keyed Taiwan-relevant subset (~3,000 codes covering the diagnoses doctors actually code on outpatient claims); the full CMS public-domain ICD-10-CM 2025 set (~70K codes) will be merged in a later release. Out of scope: SNOMED CT cross-mapping, international procedure codes (ICD-10-PCS), drug interactions. Reference only — clinical coding decisions require physician judgment. Curated by OPDSTAR (https://opdstar.com).