nx_medbill_civic.nx

nx_medbill_civic.nx -- ADV5 of the MEDICAL BILLING & PATIENT ADVOCACY ladder: CIVIC ESCALATION with MEASURED ACCOUNTABILITY. When the direct tools (dispute/appeal/charity/NSA) hit a wall, the patient can CHOOSE to escalate to the oversight body that owns the problem. This organ (1) routes an issue to its channel, (2) renders the complaint/pattern letter, (3) keeps an additive CASE LEDGER of what the user actually sent, and (4) computes a per-channel ACCOUNTABILITY SCORECARD -- responded/resolved/ OVERDUE against each channel's expected-response window -- so "are they moving to fix this" is a MEASURED verdict, never an assertion. STRICTLY OPT-IN + FAIL-SAFE: letters are placeholder text in a caller buffer, the ledger records only what the user says they sent, nothing is ever transmitted. NEUTRALITY: letters state facts and request action/answers; they push no narrative and no party. Issues: 1=insurer claim-handling/denial misconduct -> DOI · 2=surprise-billing protection violation -> CMS-NSA · 3=charity-care/501(r) obligations not honored -> IRS 13909 · 4=abusive collection or credit reporting on disputed debt -> CFPB · 5=suspected billing fraud (duplicates/unbundling/upcoding) -> HHS-OIG · 6=systemic-reform story to an elected representative -> REP. Channels + expected-response windows are DATA (knowledge/medbill/civic_channels.list, #11). Case records live on the sovereign seg-store (additive, latest-wins; segid=now_us). Deadlines reuse the shared leap-safe calendar (DRY). license_tier: ORIGINAL