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get_hospital_rate — Returns the negotiated rate a named hospital publishes in its federally required machine-readable file for a CPT/HCPCS code, with the file's

check_bill_markup — Compares one billed line to the hospital's own published negotiated rate for that code and returns the multiple. You type the code and amoun

explain_denial_code — Explains a CARC claim-adjustment reason code from the public X12 code list: what it means, whether it is typically appealable, and the gener

get_appeal_deadline — Returns the appeal window that applies to a plan type (employer ERISA plan, marketplace/individual, Medicare Advantage, Medicaid) with the f

get_insurer_overturn_rate — Returns, for one insurer in one state, the share of external-review appeals the state regulator reports as overturned, with the sample size,

lookup_procedure_code — Plain-English description of a CPT/HCPCS procedure code and its category, from public code references.