claims_validate
Validates healthcare claims pre-submission to detect errors, missing fields, and code mismatches. Provides actionable fix suggestions to avoid claim rejections.
Instructions
Pre-submission claims validation. Checks for errors, missing fields, code mismatches, and provides fix suggestions before you submit to the payer.
Input Schema
| Name | Required | Description | Default |
|---|---|---|---|
| claim | Yes | Claim data to validate |
Implementation Reference
- src/tools.js:88-98 (schema)Zod schema for claims_validate input. Expects a claim object with patientId, providerId, dateOfService, diagnosisCodes, procedureCodes, and optional modifiers/placeOfService fields.
schema: { claim: z.object({ patientId: z.string(), providerId: z.string(), dateOfService: z.string().describe('YYYY-MM-DD'), diagnosisCodes: z.array(z.string()), procedureCodes: z.array(z.string()), modifiers: z.array(z.string()).optional(), placeOfService: z.string().optional(), }).describe('Claim data to validate'), }, - src/tools.js:83-99 (registration)Tool registration entry in MCP_TOOLS array. Defines name, description, price, endpoint URL, and schema for the claims_validate tool.
{ name: 'claims_validate', description: 'Pre-submission claims validation. Checks for errors, missing fields, code mismatches, and provides fix suggestions before you submit to the payer.', price: '$0.05', endpoint: '/agent/v1/claims/validate', schema: { claim: z.object({ patientId: z.string(), providerId: z.string(), dateOfService: z.string().describe('YYYY-MM-DD'), diagnosisCodes: z.array(z.string()), procedureCodes: z.array(z.string()), modifiers: z.array(z.string()).optional(), placeOfService: z.string().optional(), }).describe('Claim data to validate'), }, }, - src/index.js:20-60 (handler)Generic async handler registered via s.tool() that calls the external REST API endpoint /agent/v1/claims/validate. Handles payment errors (402), non-ok responses, and attaches billing info from response headers.
s.tool(tool.name, tool.description, tool.schema, async (params) => { const toolDef = getToolByName(tool.name); if (!toolDef) { return { content: [{ type: 'text', text: `Unknown tool: ${tool.name}` }], isError: true }; } try { const response = await fetch(`${API_BASE_URL}${toolDef.endpoint}`, { method: 'POST', headers: { 'Content-Type': 'application/json', ...(API_KEY && { 'X-API-Key': API_KEY }), 'X-Agent-ID': 'mcp-client', 'User-Agent': '@mymedi-ai/mcp-server/1.2.1', }, body: JSON.stringify(params), }); if (response.status === 402) { const paymentInfo = await response.json(); return { content: [{ type: 'text', text: JSON.stringify({ error: 'payment_required', message: `This tool costs ${toolDef.price} per call. Register at ${API_BASE_URL}/bot-marketplace/register for an API key with 10 free starter credits, or pay per call with on-chain USDC (no signup) via the x402 protocol.`, price: toolDef.price, register: `${API_BASE_URL}/bot-marketplace/register`, ...paymentInfo, }, null, 2) }], isError: true, }; } if (!response.ok) { const error = await response.json().catch(() => ({ message: response.statusText })); return { content: [{ type: 'text', text: JSON.stringify({ error: true, status: response.status, ...error }, null, 2) }], isError: true }; } const data = await response.json(); const creditsSpent = response.headers.get('X-Credits-Spent'); const creditsRemaining = response.headers.get('X-Credits-Remaining'); if (creditsSpent) { data._billing = { creditsSpent: parseInt(creditsSpent, 10), creditsRemaining: creditsRemaining ? parseInt(creditsRemaining, 10) : undefined, priceUSD: toolDef.price }; } return { content: [{ type: 'text', text: JSON.stringify(data, null, 2) }] }; } catch (err) { return { content: [{ type: 'text', text: JSON.stringify({ error: true, message: err.message, hint: 'Ensure MCP_API_BASE_URL and MCP_API_KEY environment variables are set.' }, null, 2) }], isError: true }; } });