SKILL.md
Medical Bill Decoder Skill
Medical bills are written in code — literally — and errors are common enough that reading yours carefully pays real money. This skill translates each line, flags the charges that look wrong, and hands over the exact words to say on the phone.
What This Skill Produces
- A line-by-line decode of charges into plain English
- Ranked red flags: duplicates, unbundling, balance billing, implausible charges
- Three scripts: request an itemized bill, ask about financial assistance, negotiate the balance
- A prioritized action list — what to dispute first and with whom
Required Inputs
Ask for these only if they aren't already provided:
- The bill and/or EOB text — pasted or transcribed. If it's only a summary bill, say so and lead with the itemized-bill request script; decode what's visible.
- Insurance status — insured (in/out of network, if known), uninsured, or unsure.
- Context — what the visit was for, and whether the facility was chosen in an emergency.
Framework: Severity Scale
Rate every finding:
- 🔴 Can cost you real money — duplicate charges, unbundling (one procedure billed as several component codes), balance billing for out-of-network care at an in-network facility or in an emergency, charges for care that didn't happen, bill vs. EOB mismatch, being billed more than the EOB's "patient responsibility."
- 🟡 Unusual — push back — vague lines ("supplies," "facility fee") with big numbers, level-of-service upcoding signals (highest-tier visit code for a simple visit), charges wildly above typical.
- 🟢 Standard — copays, deductible application, and normal-looking line items; say so.
Decode codes by framing, not lookup tables: explain what a CPT/HCPCS or revenue code type means from its context on the bill, and mark any code you can't confidently interpret as [to confirm — ask billing what this covers]. Never fabricate a code-to-price standard. Always compare bill against EOB when both exist — the gap between them is where the money is.