{"uid":"cap_jsdEHkfPG7CkDDJm6fDC9","slug":"automatedrcm-denial-decode-dex-70dfc72f","name":"AutomatedRCM Denial Decode (Dex)","description":"Claim-denial intelligence for a CARC code (e.g. CO-50, PR-204, CO-197). Returns plain-English meaning, category, whether it is appealable, the concrete next action, and how to prevent it. Unknown codes still get group-level (CO/PR/OA/PI) guidance. (AutomatedRCM agent: Dex)","url":"https://x402.getautomatedrcm.com/denial-decode","method":"POST","headers":{},"bodySchema":{"type":"object","properties":{"code":{"type":"string","description":"CARC denial code, e.g. CO-50, PR-204, or bare number 50"}}},"responseSchema":null,"example":null,"exampleRequest":null,"tags":["x402"],"displayCostAmount":"0.02","displayCostAsset":"USDC","priceDynamic":false,"priceHint":null,"priceStatus":"priced","priceSource":"probe","requiresHandshake":false,"reviewCount":0,"rating":{"score":"0.00","successRate":"0.00","reviews":0,"stars":null,"state":"unrated"},"availabilityStatus":"unknown","priceObserved":null,"sessionDeposit":null,"pricing":{"kind":"static","summary":"$0.02/call","primary":{"kind":"static","protocol":"x402","network":"base","amountUsd":"0.02","per":"call","confidence":"exact"},"accepted":[{"kind":"static","protocol":"x402","network":"base","amountUsd":"0.02","per":"call","confidence":"exact"}]},"paymentMethods":[{"uid":"pm_SjLDPwSeHqLy94mSF4ZeT","protocol":"x402","methodType":"crypto","chain":"base","mode":"charge","costAmount":"0.02","costPer":"request","priority":0,"asset":"0x833589fCD6eDb6E08f4c7C32D4f71b54bdA02913","unit":"request","depositMicros":null,"planRef":null}],"brandName":null,"brandSlug":null,"brandBaseUrl":null,"brandDocsUrl":null,"whatItDoes":"Returns plain-English explanation, category, appealability, next action, and prevention guidance for a CARC claim-denial code","exampleAgentPrompt":"I just got a claim denial with code CO-50 — can you decode that CARC code for me and tell me what it means, whether it's appealable, what I should do next, and how to prevent it?","exampleUseCases":[{"title":"Billing team denial triage workflow","prompt":"Our billing team got a batch of denials today including CO-197 — decode that CARC code and tell us what it means, if we can appeal it, and what the next concrete step should be."},{"title":"Prevent recurring claim denials","prompt":"We keep getting PR-204 denials on our claims. Can you explain what that CARC code means and tell me exactly how to prevent it from happening again?"},{"title":"Unknown denial code guidance","prompt":"I received a denial with code OA-109 and I'm not sure what it means — can you look that up and give me whatever guidance is available, even if it's just group-level?"}],"resultDescription":"A structured response containing: the plain-English meaning of the CARC code, its denial category, a boolean or flag indicating whether the denial is appealable, a concrete recommended next action the biller should take, and prevention advice. For unrecognized codes, group-level (CO/PR/OA/PI) guidance is returned as a fallback.","failureModes":["Completely unrecognized code format (not a valid CARC prefix or number) may return only generic guidance or an error","Missing 'code' field in request body returns validation error","Network timeout if the rules engine is under load","Ambiguous bare numeric codes without prefix may be resolved to a best-guess mapping"],"whenToPreferThis":"Use this endpoint when you need structured, actionable guidance on a specific CARC denial code in a healthcare revenue cycle or medical billing context. Prefer this over general-purpose LLMs or payer portals when you want structured appealability and prevention data alongside the denial meaning. Especially useful when integrating denial handling into automated RCM workflows where consistent, machine-readable outputs are required.","instructions":null,"reviewSummary":null,"reviewSummaryHighlights":null,"reviewSummaryConcerns":null,"reviewSummaryGeneratedAt":null,"activationCount":0,"lastUsedAt":null,"lastSuccessfullyRanAt":null,"lastHealthCheckAt":"2026-09-14T00:36:38.550Z","isFirstParty":false}