Fake hospital or out-of-network billing claiming a surprise medical bill requires immediate payment or insurance verification via email link to avoid collections — credential-harvest and payment-diversion fraud; real medical billing goes through authenticated patient portals or postal mail.
medical-billing-surprise-phish
What this tier means
High-confidence threat indicator — phishing, impersonation, BEC, or scam pattern. Strong contributor to the trash decision.
How Gorganizer detects this
Fake hospital, out-of-network provider, or billing clearinghouse claiming a surprise medical bill or balance billing amount requires immediate payment via email link or that insurance details must be updated to avoid collections — credential-harvest and payment-diversion fraud. Real medical billing goes through authenticated patient portals (Epic MyChart, Cerner), paper statements, or phone contact; cold emails demanding credit card or insurance credentials via link to pay a medical bill are unauthorized billing attacks. Distinct from healthcare-prior-auth-denial-phish (CMS PA denial) and healthcare-insurance-sbc (SBC document). Detection: medical bill/hospital bill/out-of-network balance billing + pay now/avoid collections/verify insurance vocabulary + no List-Unsubscribe + no In-Reply-To + not protected sender. Trash score: +3. Source: GC1-R24; CMS No Surprises Act patient protections; FTC medical billing fraud advisory 2025.
False-positive guard
Every signal in Gorganizer feeds a multi-module score — never a sole verdict. This is a threat-tier signal — it adds a strong contribution to the trash score. The full pipeline still requires convergence across multiple modules + a margin over the safety floor before deletion happens, and Gmail's trash (30-day recovery) is always used — never permanent delete.
About the scoring engine
Gorganizer's scoring engine emits 2,143+ signals across six modules — headers, sender, subject, body, attachments, and structural metadata. Every email is scored by every module independently; the final verdict requires multiple modules to agree and the trash score to beat the safety floor by a margin.
Sacred safety guards — never delete starred emails, replies, calendar invites, receipts/invoices, or attachments — apply unconditionally regardless of any signal.
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