lookup_audit_clauses_for_specialty
Retrieve audit clauses for any medical specialty, filtered by keyword or risk flag, to review coverage rules and claim coding restrictions.
Instructions
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).
Input Schema
| Name | Required | Description | Default |
|---|---|---|---|
| specialty | Yes | Required specialty id. Common values: 'dermatology', 'internal_medicine', 'family_medicine', 'pediatrics', 'ophthalmology', 'ent', 'orthopedics', 'surgery', 'obstetrics_gynecology', 'urology', 'psychiatry', 'neurology', 'neurosurgery', 'pulmonology', 'rehabilitation', 'anesthesiology', 'radiology', 'pathology', 'tcm', 'dentistry', 'general_principles_clinic', 'appendix_clinic'. | |
| keyword | No | Optional keyword (Chinese or English) to narrow within the specialty. Matches against clause text. | |
| risk_flag | No | Optional filter to return only clauses tagged with a specific risk flag. 'any' returns clauses that have at least one of the three flags set. |