Analyze quotes for other services
Run this in your AI assistant
If you already use Claude Desktop, Cursor, or another MCP-compatible assistant, install the Woogoro Medical Bill MCP. Your assistant becomes a bill auditor: paste the bill into chat, get the same flywheel-calibrated price check this page produces — plus a dispute letter and a phone-negotiation script, all in one conversation.
- 5 tools: parse bill, check errors, look up fair price, draft dispute letter, generate phone script
- Compares to 146 Medicare codes (state-adjusted) + flags No Surprises Act violations
- Cites 42 USC 300gg-111, NCCI bundling rules, ACA preventive-care framework
- Free. No API key. No account. Hosted at $0/mo.
Or paste this into Claude Desktop config
Add to %APPDATA%\Claude\claude_desktop_config.json on Windows or ~/Library/Application Support/Claude/claude_desktop_config.json on Mac, then restart Claude Desktop.
{
"mcpServers": {
"woogoro-medical": {
"url": "https://mcp.woogoro.com/mcp"
}
}
}Then in Claude: "Use the woogoro-medical MCP to audit this bill: [paste]"
What to look for on a medical bill
Medical bills are designed to be opaque. Billing codes, "charges" vs "allowed amounts" vs "patient responsibility," and balance billing make it nearly impossible to tell if a bill is fair. A proper analysis breaks down the chargemaster price, insurance-negotiated rate, and your actual obligation — because the three are very different numbers.
5-digit codes (e.g., 99213, 45378) that identify each service. Each code has a standard fee schedule. Unbundled codes for services that should be bundled is a common error.
Inpatient admissions paid by DRG (diagnosis-related group), not itemized charges. Verify DRG matches discharge paperwork.
The "chargemaster" price, usually 2–10x what insurance pays. Rarely what anyone actually owes if insured.
The contractually negotiated rate between insurance and provider. This is the actual price of the service.
What insurance contributed. Depends on deductible, copay, coinsurance, and plan benefits.
What you actually owe — should equal allowed amount minus insurance paid (after deductible/coinsurance math). Commonly wrong.
Sent by insurance, not provider. The authoritative version of what insurance covered — always cross-reference against the bill.
Why you were seen. Wrong diagnosis can cause denied claims. E-codes for accidents may trigger subrogation.
Codes that adjust base CPT pricing. Modifier 22 (unusual procedure), 26 (professional component), 59 (distinct service), and others. Fraudulent modifier use inflates bills.
National Provider Identifier. Cross-reference with insurance network status — out-of-network triggers balance billing.
Where service was performed (11 = office, 21 = inpatient, 22 = outpatient hospital, 23 = ER). Higher codes allow higher billing.
Red flags in a medical bill
The No Surprises Act (2022+) protects against balance billing from ancillary providers at in-network hospitals. If balance-billed, dispute with insurance.
Same CPT code billed twice (same date, same provider) without separate documentation. Common in ER and surgical billing.
Billing separate codes for services that should be bundled under one CPT. E.g., billing separately for "surgical incision" + "procedure" + "wound closure" instead of one procedure code.
Billing a higher-complexity code than the service justified. E.g., 99214 (moderate complexity office visit) when service was 99213 (low complexity). 15–30% higher payment.
Items on bill for services not rendered. Common: supplies, lab tests, or equipment patient didn't receive.
Some procedures legitimately bill both facility (hospital) + professional (doctor) fees. But check that they're not double-billing for the same component.
Was a specialist who saw you at an in-network hospital actually in-network? If not, the hospital should have disclosed in writing. No Surprises Act provides protections.
You have the right to an itemized bill under HIPAA. If only summary is provided, request itemized in writing.
Common hidden costs and change orders
These items are often missing from the initial medical bill and show up later as change orders or surprise fees. Ask about each before signing.
- Facility fees in hospital-owned clinics ($100–$500)
- Radiology read fees (separate from X-ray itself)
- Anesthesia billed separately from surgery
- Pathology fees for biopsy or surgical specimen
- Out-of-network ambulance transport
- Observation status vs inpatient admission (huge cost difference)
- Drugs dispensed during visit (pharmacy vs clinic billing)
- Consultations added by specialists during hospitalization