lookup_appeal_statistics_by_category
View aggregated appeal statistics for NHI claim disputes by category and review stage to understand general win rates, without individual case details.
Instructions
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).
Input Schema
| Name | Required | Description | Default |
|---|---|---|---|
| dispute_category | Yes | Category of dispute. medication = drug/payment rules; procedure = treatment/handling codes; fee_calculation = fee scheduling/calculation; qualification = contract qualification (停約/終止特約 etc.); special_material = implants/IOL/stents; admission = inpatient billing; other = miscellaneous. | |
| stage_tier | No | Optional resolution-stage filter. stage_1_initial_review = first-tier administrative review; stage_2_first_court = first-instance administrative court; stage_3_appeals_court = highest administrative court. Omit to aggregate across all stages. |