{"name":"DenialGPT","description":"Denial Prevention and Gap Analysis Agent for hospital revenue cycle teams. Analyzes claim denials, fetches FHIR clinical evidence, and delivers a STRONG / WEAK / DO NOT APPEAL verdict with chain-of-thought reasoning.","url":"https://denialgpt.onrender.com","version":"1.0.0","defaultInputModes":["text/plain"],"defaultOutputModes":["text/plain"],"capabilities":{"streaming":false,"pushNotifications":false,"stateTransitionHistory":false,"extensions":[{"uri":"https://app.promptopinion.ai/schemas/a2a/v1/fhir-context","description":"FHIR R4 context for querying patient clinical records.","required":false,"params":{"scopes":[{"name":"patient/Condition.rs","required":true},{"name":"patient/Procedure.rs","required":true},{"name":"patient/MedicationRequest.rs","required":true},{"name":"patient/DocumentReference.rs","required":false},{"name":"patient/Observation.rs","required":false},{"name":"patient/ExplanationOfBenefit.rs","required":false}]}}]},"supportedInterfaces":[{"url":"https://denialgpt.onrender.com","protocolBinding":"JSONRPC","protocolVersion":"1.0"}],"skills":[{"id":"analyze_denial","name":"analyze_denial","description":"Classifies a claim denial, extracts CARC codes, identifies required evidence, calculates appeal deadline, and diagnoses root cause.","tags":["denial","billing","revenue-cycle"]},{"id":"fetch_clinical_evidence","name":"fetch_clinical_evidence","description":"Queries the FHIR sandbox for patient clinical records relevant to the denial type using SHARP context headers.","tags":["fhir","clinical","evidence"]},{"id":"gap_analysis","name":"gap_analysis","description":"Compares payer requirements against FHIR clinical evidence. Returns STRONG / WEAK / DO NOT APPEAL verdict with chain-of-thought reasoning.","tags":["gap-analysis","appeal","revenue-cycle"]},{"id":"check_claim_policy","name":"check_claim_policy","description":"Checks a claim draft (CPT code + ICD-10 diagnosis + payer + place of service) against CMS LCD/NCD coverage policies and historical payer denial patterns to identify denial risks before submission. Returns overall risk level, specific risk flags with policy citations, and payer intelligence.","tags":["prevention","prior-auth","billing","revenue-cycle"]}],"securitySchemes":{"apiKey":{"apiKeySecurityScheme":{"name":"X-API-Key","location":"header","description":"API key required to access DenialGPT."}}},"security":[{"apiKey":[]}]}