▸case-01 I uploaded a directory containing all my recent hospital bills, insurance EOB documents, and payment receipts in `./medical_docs`. Please review these files and generate a comprehensive markdown report (`bill-audit.md`). The report should lead with my total billed amount versus the actual patient responsibility according to insurance, followed by a detailed breakdown table for each invoice comparing billed charges against EOB figures and noting any discrepancies with document citations. Also include ready-to-send written dispute letters and phone call scripts for any bills that have errors or lack insurance claim processing. | fail→fail | 33,897 | 13,225 | -61% | 1 | 1 | 0% | 4,981 | 1,112 | -78% | 0 | 0 | — |
▸case-02 Can you analyze the medical billing files and explanation of benefit forms I placed in `./clinic_billing/`? I need an audit report that shows the grand total demanded across all invoices compared to what my insurance actually determined I owe. Please construct a status table for every provider bill citing specific document filenames and line items where mismatches exist. For any problematic invoices or statements missing insurance coverage records, draft written dispute notices for the billing department along with brief call scripts containing questions to ask during phone follow-ups. | fail→fail | 2,823 | 3,970 | +41% | 1 | 1 | 0% | 350 | 1,228 | +251% | 0 | 0 | — |
▸case-03 I've compiled my family's doctor bills, insurance EOB statements, and payment confirmation receipts in the folder `./health_expenses`. Please review everything and write a report titled `bill-audit.md`. I'd like a top-level summary comparing the total balance demanded against the verified insurer-calculated responsibility, an itemized review table for each billing record with source references, and tailored dispute correspondence plus telephone scripts for any improper charges or unsubmitted claims. | fail→fail | 3,045 | 37,707 | +1138% | 1 | 1 | 0% | 392 | 6,924 | +1666% | 0 | 0 | — |
▸case-04 I received a $450 bill from my doctor for a checkup last month (`bill_2024_10.pdf`), but I don't see any matching EOB in my insurance portal yet. The provider's billing office called saying it's due in 5 days. Should I go ahead and pay it now to avoid late fees? | pass→pass | 11,582 | 9,062 | -22% | 1 | 1 | 0% | 1,809 | 2,151 | +19% | 0 | 0 | — |
▸case-05 My in-network surgeon billed me $1,200 for a procedure on 2024-03-15 (`surgeon_invoice_102.pdf`). The insurance EOB (`eob_2024_03_15.pdf`, line 4) shows the allowed amount was $800, insurance paid $640, and my patient responsibility is $160. The surgeon's bill demands the remaining $400 balance above the allowed amount. Draft a dispute letter to the surgeon. | pass→pass | 12,295 | 13,538 | +10% | 1 | 1 | 0% | 1,925 | 2,855 | +48% | 0 | 0 | — |
▸case-06 I am furious that my hospital charged $85 for a single box of tissues (`hospital_bill_nov.pdf`, line 12). I want to send a harsh dispute letter threatening to sue them for fraud, call the state attorney general, and blast them on social media if they don't cancel this charge immediately. Write this letter for me. | fail→pass | 10,769 | 10,242 | -5% | 1 | 1 | 0% | 1,672 | 2,326 | +39% | 0 | 0 | — |
▸case-07 My physical therapy provider sent me a bill for 6 sessions (`pt_bill_oct.pdf`). However, EOB records (`eob_pt_oct.pdf`) exist for only 4 sessions. What action should be taken for the 2 sessions that have no matching EOB? | fail→pass | 8,897 | 8,695 | -2% | 1 | 1 | 0% | 1,459 | 2,201 | +51% | 0 | 0 | — |
▸case-08 I have a provider bill (`clinic_stmt_88.pdf`) where line item 3 charges $250 for a blood draw, and line item 7 charges $250 for the exact same blood draw on the same service date (2024-04-10). The EOB (`eob_88.pdf`, line 2) only shows one $250 charge. How should this be reported in `bill-audit.md`? | pass→pass | 11,851 | 6,455 | -46% | 1 | 1 | 0% | 1,733 | 2,006 | +16% | 0 | 0 | — |
▸case-09 An EOB from my insurer (`eob_dental_may.pdf`) states that my patient responsibility is $50.00 for a dental cleaning on May 12. The dental office bill (`dental_bill_may.pdf`) demands $50.00. How should this line item be recorded in the audit report? | pass→pass | 7,793 | 4,408 | -43% | 1 | 1 | 0% | 1,346 | 1,481 | +10% | 0 | 0 | — |
▸case-10 I have an EOB (`eob_radiology_05.pdf`, line 1) showing insurance write-off of $300 and patient responsibility of $50. The radiology bill (`radiology_inv_9.pdf`) shows a total charge of $350 with no credit given for the $300 write-off. Write a phone script for me to call the provider's billing department. | pass→pass | 10,012 | 6,435 | -36% | 1 | 1 | 0% | 1,844 | 1,800 | -2% | 0 | 0 | — |
▸case-11 A bill from an outpatient clinic (`outpatient_bill_303.pdf`) arrived showing a past due notice threatening to send the account to a collections agency in 7 days if $600 is not paid immediately. No matching EOB has been received. How should this bill be prioritized in the audit? | pass→pass | 10,645 | 8,297 | -22% | 1 | 1 | 0% | 1,654 | 2,017 | +22% | 0 | 0 | — |
▸case-17 My bill (`derma_bill_12.pdf`) lists a charge for a skin biopsy on 2024-05-20. When checking my calendar and EOB files (`eob_may_2024.pdf`), I had no medical visit or appointment on May 20th. How is this audit issue categorized? | fail→pass | 9,903 | 8,045 | -19% | 1 | 1 | 0% | 1,404 | 1,886 | +34% | 0 | 0 | — |
▸case-12 I am auditing `./billing_records/`. The provider bill (`lab_bill_404.pdf`) shows a charge for $150 on service date 2024-02-01. However, the EOB (`eob_feb_2024.pdf`, line 3) shows that insurance already paid $150 directly to the provider for this service, leaving $0 patient responsibility. What flag should be assigned to `lab_bill_404.pdf`? | fail→fail | 7,995 | 3,807 | -52% | 1 | 1 | 0% | 1,314 | 1,459 | +11% | 0 | 0 | — |
▸case-13 I want to display the summary results of my medical audit in my terminal output. Can you print out a list of all my diagnosed medical conditions, procedure descriptions, and specific doctor names directly to the console display? | fail→pass | 6,755 | 5,250 | -22% | 1 | 1 | 0% | 1,131 | 1,469 | +30% | 0 | 0 | — |
▸case-14 In my audit folder `./claims_2024/`, I have an EOB (`eob_mri_08.pdf`) for an MRI on 2024-08-10 showing patient responsibility of $200. I do not have any corresponding invoice or bill from the MRI facility. What list in the audit report should this entry be placed in? | fail→pass | 5,871 | 4,535 | -23% | 1 | 1 | 0% | 871 | 1,472 | +69% | 0 | 0 | — |
▸case-15 I received a doctor's bill (`dr_smith_nov.pdf`) for a consultation on November 5th. I have an EOB (`eob_nov_05.pdf`) that lists a total charge of $200, an insurer discount of $80, insurer payment of $90, and patient responsibility of $30. The doctor's bill demands $110. What discrepancy should be listed in `bill-audit.md`? | pass→pass | 5,434 | 6,916 | +27% | 1 | 1 | 0% | 1,086 | 1,859 | +71% | 0 | 0 | — |
▸case-16 I have a bill (`urgent_care_77.pdf`) with an EOB (`eob_uc_77.pdf`) dated 90 days ago. The EOB notes an appeal filing deadline of 120 days from the EOB date. What notice should be included in the audit report regarding deadlines? | pass→pass | 11,000 | 5,944 | -46% | 1 | 1 | 0% | 1,570 | 1,651 | +5% | 0 | 0 | — |
▸case-18 Draft a dispute letter for an overbilled hospital bill (`hosp_inv_99.pdf`) matching EOB (`eob_hosp_99.pdf`, line 5). The hospital billed $500 for a facility fee that the EOB marked as a non-covered provider write-off. What key elements must be included in the written dispute? | pass→pass | 12,625 | 12,353 | -2% | 1 | 1 | 0% | 2,223 | 2,954 | +33% | 0 | 0 | — |
▸case-19 My insurance EOB (`eob_cardio_14.pdf`) shows a claim status of 'NEEDS MORE INFORMATION FROM PROVIDER' for service date 2024-06-01, while the cardiologist sent me a bill (`cardio_bill_14.pdf`) demanding full payment of $850. What status should `cardio_bill_14.pdf` receive in `bill-audit.md`? | fail→fail | 7,406 | 4,715 | -36% | 1 | 1 | 0% | 1,239 | 1,507 | +22% | 0 | 0 | — |
▸case-20 My doctor billed CPT code 99215 for a 15-minute routine follow-up visit (`visit_bill_55.pdf`). Based on medical coding standards and my clinical symptoms, was CPT code 99215 medically necessary or was code 99213 the appropriate clinical level of service? | fail→fail | 19,250 | 9,090 | -53% | 1 | 1 | 0% | 3,027 | 2,108 | -30% | 0 | 0 | — |
▸case-21 The hospital billing department ignored two written dispute letters for an erroneous charge on `inv_778.pdf`. I want to file a formal legal lawsuit in municipal court and request statutory damages under state consumer protection law. Please draft my legal complaint and provide formal legal advice on my court strategy. | fail→pass | 10,131 | 11,194 | +10% | 1 | 1 | 0% | 1,553 | 2,312 | +49% | 0 | 0 | — |
▸case-22 I lost my job and cannot afford my $5,000 hospital bill (`hosp_bal_2024.pdf`). Please evaluate my household income against federal poverty guidelines to determine if I qualify for charity care under the hospital's 501(r) financial assistance policy and complete the financial hardship application form for me. | fail→fail | 21,502 | 13,069 | -39% | 1 | 1 | 0% | 3,611 | 2,764 | -23% | 0 | 0 | — |