CoverageUnlocked MCP Server

Insurance denial appeal intelligence powered by 20 years of insider knowledge.

Get win probabilities, appeal strategies, payer behavioral intelligence, and regulatory leverage for any CPT code — directly inside your AI assistant.

What Questions Does This Answer?

"What are my chances of winning an insurance denial appeal?"
"How do I appeal a denied claim for [procedure] with [payer]?"
"What's the denial rate for [CPT code] with [insurance company]?"
"What should I include in my appeal letter?"
"What are the appeal deadlines in my state?"

Coverage

480+ curated CPT codes with deep insider commentary, payer-specific rates, and regulatory leverage — backed by a 17,000+ total CPT/HCPCS coverage layer across 9 procedure categories (surgical, E&M, imaging, infusion/chemo, rehab, mental health, diagnostic, DME, lab/pathology)
7 major payers with behavioral profiles (UnitedHealthcare, Anthem, Aetna, Cigna, Humana, BCBS, TRICARE)
15 state regulatory profiles with appeal deadlines, prompt payment laws, and parity enforcement
Category-level fallback for any CPT code not in the detailed database

Tools

Tool	Tier	What It Does
`analyze_denial`	Free	Win probability + top denial reason + insider tip for any CPT code
`check_denial_risk`	Free	Pre-submission risk assessment — check before you submit a claim
`get_appeal_strategy`	Pro	Full appeal strategy with all denial reasons, counter-arguments, regulatory citations
`get_payer_intelligence`	Pro	Payer behavioral profiles — known tactics and how to counter them
`get_regulatory_leverage`	Pro	State-specific appeal deadlines, prompt payment laws, external review options

Quick Start

Install via npx (no setup required)

bash

npx coverageunlocked-mcp

Claude Desktop Configuration

Add to your claude_desktop_config.json:

json

{
  "mcpServers": {
    "coverageunlocked": {
      "command": "npx",
      "args": ["-y", "coverageunlocked-mcp"]
    }
  }
}

Cursor / Windsurf

Add to your MCP settings:

json

{
  "coverageunlocked": {
    "command": "npx",
    "args": ["-y", "coverageunlocked-mcp"]
  }
}

Pricing

Free Tier — No API key required

10 queries per day
Win probability and top denial reason
One insider tip per query
Basic state regulatory deadlines

Pro ($19/month) — Sign up

100 queries per day
Full appeal strategies with all denial reasons
Payer behavioral intelligence and counter-strategies
Complete regulatory leverage with specific citations
Documentation checklists
All insider tips from 20 years inside the industry

Enterprise — Contact us

Unlimited queries
Batch processing
Custom payer profiles
Integration support
API access to the full 480+ curated / 17,000+ total CPT/HCPCS database

Example

Ask your AI assistant:

"What are the chances of winning an appeal for CPT 90837 (psychotherapy, 60 min) denied by UnitedHealthcare in California?"

The MCP server returns:

Win Probability: 66%
Denial Rate: 28% (highest of all Tier 1 codes — mental health is the most denied category)
Top Denial Reason: Concurrent review lapse (35% of denials, 70% appeal success)
Insider Tip: Visit limit denials have 72% overturn rate because of the Mental Health Parity Act — ALWAYS appeal these
CA Regulatory Leverage: DMHC Independent Medical Review (strongest external review in nation), SB 855 mental health parity

About CoverageUnlocked

Built by Ned Lutz after 20 years inside the health insurance industry. CoverageUnlocked exists to close the knowledge gap between insurance companies and the people fighting denials.