io.github.costkits/costkits-mcp

Tools

• calculate_liability

  Stateless insurance math: given an allowed amount and a plan snapshot (deductible, coinsurance, OOP max), returns exact patient responsibility, plan payment, and the breakdown, plus p25/p75 scenarios. Use when you already have a dollar amount (e.g. from an EOB or a prior estimate).

  shallow
• check_financial_assistance

  Screen a household for hospital financial assistance (charity care): returns income as a percent of the federal poverty guidelines, the typical range hospital policies cover, what federal rules (IRS 501(r)) do and do not guarantee, and next steps. Use when a user asks whether they might qualify for help paying a hospital bill. It is a screening estimate, not an eligibility decision: each hospital sets its own limits. Needs household size and annual household income; do not ask for names, account numbers or bill details.

  shallow
• compare_bill_amount

  Compares one dollar amount from a medical bill or explanation of benefits with the typical allowed-amount range (low, median, high) for the same procedure in the same US state, and says whether it is below, within or above that range, with questions worth asking the billing office. Pass amount_type 'billed' for the charge on the bill or 'allowed' for the insurer's allowed amount. Billed charges are usually higher than allowed amounts, so a high billed charge alone is not an error. Needs only the procedure, state and amount; do not send names, dates, account or member numbers.

  shallow
• demo_estimate

  Static sample cost estimate (colonoscopy in Connecticut) from the CostKits API. Works with NO API key — use it to verify connectivity and see the response shape.

  shallow
• estimate_procedure_cost

  Returns the typical allowed-amount range (low, median, high) for one medical procedure in one US state, the usual billing components (facility, physician, anesthesia, pathology), and the data vintage. If the user chooses to give their own deductible, coinsurance and out-of-pocket figures, it also returns an estimated patient share. These are estimates of typical prices from hospital price transparency and Medicare data, not quotes. Only the procedure and state are required; ZIP code and plan figures are optional and are used only for this one calculation.

  shallow
• find_providers

  Lists up to 5 facilities in one US state that perform a procedure, with name, address and a pricing_status field: 'observed' means a negotiated rate is published in that facility's price transparency data, 'estimated' means only a state-level benchmark applies, 'none' means no price data. Dollar amounts are not returned. The list is partial and is not a ranking or a recommendation.

  shallow
• full_estimate

  One call chaining procedure ontology + cost + providers + patient liability. Cheapest way (one metered request) to get the complete picture. Use `fields` to request a subset; liability requires the plan_* inputs.

  shallow
• get_coverage

  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).

  shallow
• get_procedure_details

  Structured knowledge about one procedure. aspect='facts' returns LLM-ready billing rules and cost drivers (best for grounding an answer); 'bundle' explains which separate bills to expect (facility, physician, anesthesia...); 'full' returns the complete ontology.

  shallow
• get_provider

  Public profile for a single provider by 10-digit NPI number: name, specialty, address, entity type.

  shallow
• list_carriers

  All insurance carrier keys supported by the coverage tools (aetna, cigna, bcbs, medicare, ...). Works on the Free plan — also a good API-key sanity check.

  shallow
• list_procedures

  The full CostKits catalog: 30 procedures with slugs, display names, categories, and CPT codes (paginated).

  shallow
• resolve_procedure

  Maps a free-text procedure name ('knee mri', 'gallbladder removal') to a CostKits catalog slug with a confidence score. Returns best_match and alternatives; best_match is null when the procedure is not in the catalog.

  shallow

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