About io.github.edgeedgehq/coverageunlocked
io.github.edgeedgehq/coverageunlocked is an MCP server in the RAG category: aI-powered insurance denial appeals. Win probabilities, payer intelligence & regulatory leverage.
Install
claude mcp add io-github-edgeedgehq-coverageunlocked -- npx -y coverageunlocked-mcpnpx -y coverageunlocked-mcpThis server has no ConduID identity, so agent calls to it are not receipted. Pin the version you install and review the source before granting it credentials.
Tools (5)
analyze_denialFree
Parameters not published.
check_denial_riskFree
Parameters not published.
get_appeal_strategyPro
Parameters not published.
get_payer_intelligencePro
Parameters not published.
get_regulatory_leveragePro
Parameters not published.
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README
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
- 489+ CPT codes 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 full 489-code 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
README copy captured when this server was indexed; it may lag the repository. The original is authoritative.