step 01 / 02·select scenario or paste EOB

Triage a Medicare Advantage denial EOB

Pick a curated scenario or paste your own. The next screen streams the AI’s triage with citations to public CARC/RARC dictionaries and 42 CFR §422 Subpart M.

galleryclick a card to select8 hand-curated MA denial scenarios

or paste your own EOBoverrides gallery selection

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Paste-in is best-effort. The gallery scenarios above are the canonical demo path.

$ claims-summarizer triage --plan ma --source gallery [awaiting selection]

Triage a Medicare Advantage denial EOB

Medical Necessity — Outpatient PT (10 sessions billed, 4 denied)

Prior Auth Not Obtained — Outpatient MRI

Out-of-Network — Cardiology consult outside the plan's network

Step Therapy / Part D — Brand drug denied; tier-1 trial required

SNF — Skilled benefit ended; custodial days denied

DME — Continuous Glucose Monitor denied (eligibility criteria not met)

Duplicate Claim — Office visit billed twice in error (NOT appealable)

COB — Other coverage primary; file with primary first (NOT appealable)