Summary
Connects your AI assistant to insurance denial appeal intelligence built from 20 years of industry insider knowledge. Exposes tools like analyze_denial for win probabilities and top denial reasons, check_denial_risk for pre-submission assessment, and pro-tier endpoints for full appeal strategies, payer behavioral profiles, and state-specific regulatory leverage. Covers 480+ curated CPT codes with deep commentary plus 17,000+ total codes across major procedure categories, seven big payers including UnitedHealthcare and Anthem, and 15 state regulatory profiles. Reach for this when you need to evaluate appeal odds, craft denial responses, or understand payer-specific tactics. Free tier gives 10 queries daily with basic insights, pro tier unlocks full strategies and documentation checklists.
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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)
npx coverageunlocked-mcp
Claude Desktop Configuration
Add to your claude_desktop_config.json:
{
"mcpServers": {
"coverageunlocked": {
"command": "npx",
"args": ["-y", "coverageunlocked-mcp"]
}
}
}
Cursor / Windsurf
Add to your MCP settings:
{
"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.
- Website: coverageunlocked.com
- App: app.coverageunlocked.com
- Consulting: Book a session ($497)
- Newsletter: Denial Dispatch
License
MIT
Featured
Keep your Mac awake while Claude Code and 40+ AI agents run. Sleeps when they're idle.
One time payment $9 →Integrate web data into your AI product. One API to scrape website & brand data.
Get API Key Now →Agent, run crypto. Access onchain data & trade routes via 1inch.
Install now →On Capafy, your Skill runs online 24/7 as an agent product, and you get paid every time someone uses it.
Start earning →