Healthcare Management

45 entities and 239 agent-callable operations in healthcare. Each operation is addressed as {mega_tool}/healthcare/{entity}/{operation} and carries the same permission check over MCP and REST.

`agent_review`

Operation	Mega-tool	What it does
`create`	`smart_action`	Create an agent review item

`aging`

Operation	Mega-tool	What it does
`detail`	`report_query`	Get detailed AR aging report with individual claims
`summary`	`report_query`	Generate AR aging summary by aging buckets
`trend`	`report_query`	AR aging trend analysis over time

`authorization`

Operation	Mega-tool	What it does
`approve`	`workflow_action`	Mark authorization as approved (for manual payer response entry)
`create`	`entity_crud`	Create a new prior authorization
`deny`	`workflow_action`	Mark authorization as denied
`list`	`entity_crud`	List prior authorizations with filtering and pagination
`read`	`entity_crud`	Get detailed authorization information
`submit`	`workflow_action`	Submit authorization request to payer
`update`	`entity_crud`	Update authorization information
`use_units`	`workflow_action`	Record usage of authorized units

`claim`

Operation	Mega-tool	What it does
`create`	`entity_crud`	Create a new healthcare claim
`delete`	`entity_crud`	Soft delete a healthcare claim
`get_details`	`smart_action`	Get claim details
`list`	`entity_crud`	List healthcare claims with filtering and pagination
`read`	`entity_crud`	Get detailed claim information including line items and payments
`resubmit`	`workflow_action`	Resubmit a denied or voided claim
`search`	`entity_crud`	Search for claims with fuzzy matching (used for EOB matching and claim lookup)
`search`	`smart_action`	Search healthcare claims
`submit`	`workflow_action`	Submit a claim to clearinghouse for processing
`update`	`entity_crud`	Update an existing healthcare claim
`void`	`workflow_action`	Void a submitted claim

`claim_adjustment`

Operation	Mega-tool	What it does
`create`	`entity_crud`	Create a claim adjustment
`delete`	`entity_crud`	Soft delete a claim adjustment
`list`	`entity_crud`	List claim adjustments with filtering
`read`	`entity_crud`	Get claim adjustment details
`search`	`entity_crud`	Search claim adjustments
`update`	`entity_crud`	Update a claim adjustment

`claim_fix_template`

Operation	Mega-tool	What it does
`create`	`entity_crud`	Create a claim fix template
`delete`	`entity_crud`	Soft delete a claim fix template
`list`	`entity_crud`	List claim fix templates
`read`	`entity_crud`	Get claim fix template details
`search`	`entity_crud`	Search claim fix templates
`update`	`entity_crud`	Update a claim fix template

`claim_line_item`

Operation	Mega-tool	What it does
`create`	`entity_crud`	Create a new claim line item
`delete`	`entity_crud`	Delete a claim line item
`list`	`entity_crud`	List claim line items with filtering and pagination
`read`	`entity_crud`	Get claim line item details by ID
`update`	`entity_crud`	Update an existing claim line item

`clearinghouse`

Operation	Mega-tool	What it does
`batch_submit`	`integration_call`	Submit multiple claims to clearinghouse in batch
`check_status`	`integration_call`	Check claim status with clearinghouse
`get_remittance`	`integration_call`	Retrieve remittance advice (835) from clearinghouse
`submit_claim`	`integration_call`	Submit a claim to clearinghouse for payer processing

`clearinghouse_transaction`

Operation	Mega-tool	What it does
`create`	`entity_crud`	Create a clearinghouse transaction record
`delete`	`entity_crud`	Soft delete a clearinghouse transaction
`list`	`entity_crud`	List clearinghouse transactions
`read`	`entity_crud`	Get clearinghouse transaction details
`search`	`entity_crud`	Search clearinghouse transactions
`update`	`entity_crud`	Update a clearinghouse transaction

`coding`

Operation	Mega-tool	What it does
`suggest_diagnosis`	`smart_action`	Suggest diagnosis codes based on clinical description

`collections_action`

Operation	Mega-tool	What it does
`create`	`entity_crud`	Create a collections action
`delete`	`entity_crud`	Soft delete a collections action
`list`	`entity_crud`	List collections actions
`read`	`entity_crud`	Get collections action details
`search`	`entity_crud`	Search collections actions
`update`	`entity_crud`	Update a collections action

`collections_agency`

Operation	Mega-tool	What it does
`create`	`entity_crud`	Create a collections agency
`delete`	`entity_crud`	Soft delete a collections agency
`list`	`entity_crud`	List collections agencies
`read`	`entity_crud`	Get collections agency details
`search`	`entity_crud`	Search collections agencies
`update`	`entity_crud`	Update a collections agency

`collections_placement`

Operation	Mega-tool	What it does
`create`	`entity_crud`	Create a collections placement
`delete`	`entity_crud`	Soft delete a collections placement
`list`	`entity_crud`	List collections placements
`read`	`entity_crud`	Get collections placement details
`search`	`entity_crud`	Search collections placements
`update`	`entity_crud`	Update a collections placement

`cpt_code`

Operation	Mega-tool	What it does
`create`	`entity_crud`	Create a new CPT code
`delete`	`entity_crud`	Delete (deactivate) a CPT code
`list`	`entity_crud`	List CPT codes with filtering and pagination
`read`	`entity_crud`	Get CPT code details by ID
`search`	`entity_crud`	Search CPT codes by code or description
`update`	`entity_crud`	Update an existing CPT code

`denial`

Operation	Mega-tool	What it does
`analyze_root_cause`	`smart_action`	Analyze denial root cause
`appeal_analysis`	`report_query`	Analyze appeal success rates and patterns
`get_work_queue`	`smart_action`	Get denial work queue
`payer_patterns`	`smart_action`	Analyze payer denial patterns
`predict_risk`	`smart_action`	Predict denial risk for a claim
`prepare_fix`	`smart_action`	Prepare denial fix/appeal
`root_cause`	`report_query`	Analyze denial root causes and patterns
`summary`	`report_query`	Generate denial analytics summary
`trend`	`report_query`	Analyze denial trends over time

`denial_analysis`

Operation	Mega-tool	What it does
`create`	`entity_crud`	Create a new denial analysis
`list`	`entity_crud`	List denial analyses with filtering and pagination
`read`	`entity_crud`	Get detailed denial analysis information

`denial_code`

Operation	Mega-tool	What it does
`create`	`entity_crud`	Create a new denial code
`delete`	`entity_crud`	Delete (deactivate) a denial code
`list`	`entity_crud`	List denial codes with filtering and pagination
`read`	`entity_crud`	Get denial code details by ID
`update`	`entity_crud`	Update an existing denial code

`denial_root_cause`

Operation	Mega-tool	What it does
`create`	`entity_crud`	Create a denial root cause
`delete`	`entity_crud`	Soft delete a denial root cause
`list`	`entity_crud`	List denial root causes
`read`	`entity_crud`	Get denial root cause details
`search`	`entity_crud`	Search denial root causes
`update`	`entity_crud`	Update a denial root cause

`documentation_submission`

Operation	Mega-tool	What it does
`create`	`entity_crud`	Create a documentation submission record
`delete`	`entity_crud`	Soft delete a documentation submission
`list`	`entity_crud`	List documentation submissions
`read`	`entity_crud`	Get documentation submission details
`search`	`entity_crud`	Search documentation submissions
`update`	`entity_crud`	Update a documentation submission

`eligibility`

Operation	Mega-tool	What it does
`batch_check`	`integration_call`	Check eligibility for multiple patients
`check`	`integration_call`	Check patient insurance eligibility with payer
`get_benefits`	`integration_call`	Get detailed benefit information for a patient
`history`	`smart_action`	Get eligibility verification history for a patient

`eligibility_verification`

Operation	Mega-tool	What it does
`create`	`entity_crud`	Create an eligibility verification record
`delete`	`entity_crud`	Soft delete an eligibility verification
`list`	`entity_crud`	List eligibility verifications
`read`	`entity_crud`	Get eligibility verification details
`search`	`entity_crud`	Search eligibility verifications
`update`	`entity_crud`	Update an eligibility verification

`encounter`

Operation	Mega-tool	What it does
`create`	`entity_crud`	Create a new patient encounter
`list`	`entity_crud`	List healthcare encounters with filtering and pagination
`read`	`entity_crud`	Get detailed encounter information
`update`	`entity_crud`	Update encounter information

`eob`

Operation	Mega-tool	What it does
`create`	`entity_crud`	Create a new EOB record
`find_matches`	`workflow_action`	Find potential claim matches for an unmatched EOB
`get_details`	`smart_action`	Get EOB details
`list`	`entity_crud`	List EOBs with filtering and pagination
`match_line_to_claim`	`smart_action`	Match an EOB line to a claim
`match_to_claim`	`workflow_action`	Match an EOB to an existing claim
`read`	`entity_crud`	Get detailed EOB information including line items
`reconcile`	`workflow_action`	Reconcile EOB line items with claim line items
`search`	`entity_crud`	Search EOBs with fuzzy matching for claim matching workflow
`unmatch`	`workflow_action`	Remove EOB-to-claim match

`eob_line_item`

Operation	Mega-tool	What it does
`create`	`entity_crud`	Create a new EOB line item
`delete`	`entity_crud`	Delete an EOB line item
`list`	`entity_crud`	List EOB line items with filtering and pagination
`read`	`entity_crud`	Get EOB line item details by ID
`update`	`entity_crud`	Update an existing EOB line item

`era`

Operation	Mega-tool	What it does
`download`	`smart_action`	Download ERA file
`get_pending`	`smart_action`	Get pending ERA files
`process_file`	`smart_action`	Process an ERA/835 file
`reconciliation_summary`	`smart_action`	Get ERA reconciliation summary

`insurance_policy`

Operation	Mega-tool	What it does
`create`	`entity_crud`	Create a new insurance policy
`list`	`entity_crud`	List insurance policies with filtering and pagination
`read`	`entity_crud`	Get detailed insurance policy information
`update`	`entity_crud`	Update insurance policy information

`patient`

Operation	Mega-tool	What it does
`create`	`entity_crud`	Create a new patient
`list`	`entity_crud`	List healthcare patients with filtering and pagination
`read`	`entity_crud`	Get detailed patient information
`search`	`entity_crud`	Search patients with fuzzy matching
`update`	`entity_crud`	Update patient information

`patient_payment_method`

Operation	Mega-tool	What it does
`create`	`entity_crud`	Create a patient payment method
`delete`	`entity_crud`	Soft delete a patient payment method
`list`	`entity_crud`	List patient payment methods
`read`	`entity_crud`	Get patient payment method details
`search`	`entity_crud`	Search patient payment methods
`update`	`entity_crud`	Update a patient payment method

`patient_statement`

Operation	Mega-tool	What it does
`create`	`entity_crud`	Create a patient statement
`delete`	`entity_crud`	Soft delete a patient statement
`list`	`entity_crud`	List patient statements
`read`	`entity_crud`	Get patient statement details
`search`	`entity_crud`	Search patient statements
`update`	`entity_crud`	Update a patient statement

`payer`

Operation	Mega-tool	What it does
`create`	`entity_crud`	Create a new insurance payer
`delete`	`entity_crud`	Soft delete an insurance payer
`list`	`entity_crud`	List insurance payers with filtering and pagination
`read`	`entity_crud`	Get detailed payer information
`search`	`entity_crud`	Search insurance payers by name, payer_id, phone, email, or website
`update`	`entity_crud`	Update payer information

`payer_contract_rate`

Operation	Mega-tool	What it does
`create`	`entity_crud`	Create a payer contract rate
`delete`	`entity_crud`	Soft delete a payer contract rate
`list`	`entity_crud`	List payer contract rates
`read`	`entity_crud`	Get payer contract rate details
`search`	`entity_crud`	Search payer contract rates
`update`	`entity_crud`	Update a payer contract rate

`payment`

Operation	Mega-tool	What it does
`apply`	`entity_crud`	Apply a payment to a claim
`create`	`entity_crud`	Create a new payment record
`list`	`entity_crud`	List payments with filtering and pagination
`read`	`entity_crud`	Get detailed payment information

`payment_plan`

Operation	Mega-tool	What it does
`create`	`entity_crud`	Create a payment plan
`delete`	`entity_crud`	Soft delete a payment plan
`list`	`entity_crud`	List payment plans
`read`	`entity_crud`	Get payment plan details
`search`	`entity_crud`	Search payment plans
`update`	`entity_crud`	Update a payment plan

`payment_plan_template`

Operation	Mega-tool	What it does
`create`	`entity_crud`	Create a payment plan template
`delete`	`entity_crud`	Soft delete a payment plan template
`list`	`entity_crud`	List payment plan templates
`read`	`entity_crud`	Get payment plan template details
`search`	`entity_crud`	Search payment plan templates
`update`	`entity_crud`	Update a payment plan template

`payment_transaction`

Operation	Mega-tool	What it does
`list`	`entity_crud`	List payment_transactions with filtering and pagination
`read`	`entity_crud`	Get detailed payment transaction information
`search`	`entity_crud`	Search payment_transactions with fuzzy matching

`provider`

Operation	Mega-tool	What it does
`create`	`entity_crud`	Create a new healthcare provider
`delete`	`entity_crud`	Soft delete a healthcare provider
`list`	`entity_crud`	List healthcare providers with filtering and pagination
`read`	`entity_crud`	Get detailed provider information
`search`	`entity_crud`	Search healthcare providers by name, NPI, or specialty
`update`	`entity_crud`	Update provider information

`reminder_schedule`

Operation	Mega-tool	What it does
`create`	`entity_crud`	Create a reminder schedule
`delete`	`entity_crud`	Soft delete a reminder schedule
`list`	`entity_crud`	List reminder schedules
`read`	`entity_crud`	Get reminder schedule details
`search`	`entity_crud`	Search reminder schedules
`update`	`entity_crud`	Update a reminder schedule

`statement_batch`

Operation	Mega-tool	What it does
`create`	`entity_crud`	Create a statement batch
`delete`	`entity_crud`	Soft delete a statement batch
`list`	`entity_crud`	List statement batches
`read`	`entity_crud`	Get statement batch details
`search`	`entity_crud`	Search statement batches
`update`	`entity_crud`	Update a statement batch

`statement_reminder`

Operation	Mega-tool	What it does
`list`	`entity_crud`	List statement_reminders with filtering and pagination
`read`	`entity_crud`	Get detailed statement reminder information

`statement_template`

Operation	Mega-tool	What it does
`create`	`entity_crud`	Create a statement template
`delete`	`entity_crud`	Soft delete a statement template
`list`	`entity_crud`	List statement templates
`read`	`entity_crud`	Get statement template details
`search`	`entity_crud`	Search statement templates
`update`	`entity_crud`	Update a statement template

`systemic_issue`

Operation	Mega-tool	What it does
`create`	`entity_crud`	Create a systemic issue
`delete`	`entity_crud`	Soft delete a systemic issue
`list`	`entity_crud`	List systemic issues
`read`	`entity_crud`	Get systemic issue details
`search`	`entity_crud`	Search systemic issues
`update`	`entity_crud`	Update a systemic issue

`tasks`

Operation	Mega-tool	What it does
`create_auth_followup`	`smart_action`	Create authorization follow-up task
`create_claim_correction`	`smart_action`	Create claim correction task
`create_eligibility_worklist`	`smart_action`	Create eligibility worklist
`create_payment_review`	`smart_action`	Create payment review items
`create_submission_error`	`smart_action`	Create submission error task

`treatment`

Operation	Mega-tool	What it does
`create`	`entity_crud`	Create a new treatment/service record
`list`	`entity_crud`	List treatments/services with filtering and pagination
`list_unbilled`	`entity_crud`	List unbilled treatments ready for claim submission
`read`	`entity_crud`	Get detailed treatment information
`update`	`entity_crud`	Update treatment information

`worklist`

Operation	Mega-tool	What it does
`aging_buckets`	`smart_action`	Get aging bucket summary
`collection_effectiveness`	`smart_action`	Collection effectiveness report
`contract_variances`	`smart_action`	Detect contract variance issues
`high_value_claims`	`smart_action`	Track high value claims
`payer_scorecard`	`smart_action`	Payer performance scorecard
`service_payment_history`	`smart_action`	Service-level payment history
`write_off_candidates`	`smart_action`	Identify write-off candidates

`writeoff`

Operation	Mega-tool	What it does
`create`	`smart_action`	Create a write-off

Parameter schemas and permission codenames are in the full reference — sign in — or call prism_introspect(dimension="capability_search", query="…") with your key.

In the full reference this application appears under entity_crud, integration_call, report_query, smart_action, workflow_action.