Skip to main content
Glama
edgeedgehq

CoverageUnlocked MCP Server

by edgeedgehq

analyze_denial

Analyze insurance denials to receive win probability, top denial reasons, and appeal guidance for any CPT code.

Instructions

Analyze an insurance denial and get win probability, top denial reasons, and appeal guidance. Covers 489+ CPT codes across 9 procedure categories with data from 20 years of industry experience. Use this when someone asks about insurance denials, claim denials, appeal chances, or how to fight a denied claim.

Input Schema

TableJSON Schema
NameRequiredDescriptionDefault
payerNoInsurance company name (e.g., "UnitedHealthcare", "Anthem", "Aetna", "Cigna", "Humana", "BCBS")
stateNoTwo-letter state code (e.g., "CA", "TX", "NY") for state-specific regulatory leverage
api_keyNoCoverageUnlocked API key for Pro access. Free tier: 10 queries/day with basic results. Get Pro at https://app.coverageunlocked.com/mcp
cpt_codeYesThe CPT or HCPCS code that was denied (e.g., "99214", "70553", "E0601")
denial_reasonNoThe reason given for the denial, if available
Behavior3/5

Does the description disclose side effects, auth requirements, rate limits, or destructive behavior?

No annotations are provided, so the description carries the full burden. It discloses the tool's analytical nature and broad coverage, but omits behavioral details such as API key requirements, rate limits (free tier vs Pro), or authentication needs. It adequately conveys non-destructive intent but falls short on full transparency.

Agents need to know what a tool does to the world before calling it. Descriptions should go beyond structured annotations to explain consequences.

Conciseness5/5

Is the description appropriately sized, front-loaded, and free of redundancy?

The description is three sentences, each valuable. It front-loads the main action and includes relevant scope details without unnecessary words or tangents. Perfectly concise for the information provided.

Shorter descriptions cost fewer tokens and are easier for agents to parse. Every sentence should earn its place.

Completeness3/5

Given the tool's complexity, does the description cover enough for an agent to succeed on first attempt?

With 5 parameters (1 required), no output schema, and no annotations, the description could be more complete. It explains the tool's purpose and coverage but does not describe the return format (e.g., win probability structure) or clarify how api_key relates to access tiers. Missing some context needed for full understanding.

Complex tools with many parameters or behaviors need more documentation. Simple tools need less. This dimension scales expectations accordingly.

Parameters3/5

Does the description clarify parameter syntax, constraints, interactions, or defaults beyond what the schema provides?

Schema description coverage is 100% with detailed descriptions for all 5 parameters. The tool description adds high-level context but does not enhance parameter-specific meaning beyond the schema. Baseline score of 3 is appropriate as the schema already carries the semantic load.

Input schemas describe structure but not intent. Descriptions should explain non-obvious parameter relationships and valid value ranges.

Purpose5/5

Does the description clearly state what the tool does and how it differs from similar tools?

The description clearly states the tool's purpose: 'Analyze an insurance denial and get win probability, top denial reasons, and appeal guidance.' It specifies the verb, resource, and outputs, and adds scope details (489+ CPT codes, 9 categories, 20 years data) making it specific and unambiguous.

Agents choose between tools based on descriptions. A clear purpose with a specific verb and resource helps agents select the right tool.

Usage Guidelines4/5

Does the description explain when to use this tool, when not to, or what alternatives exist?

The description explicitly states when to use: 'Use this when someone asks about insurance denials, claim denials, appeal chances, or how to fight a denied claim.' It provides good context for invocation, though it lacks explicit when-not-to-use guidance or alternatives due to no sibling tools.

Agents often have multiple tools that could apply. Explicit usage guidance like "use X instead of Y when Z" prevents misuse.

Install Server

Other Tools

Latest Blog Posts

MCP directory API

We provide all the information about MCP servers via our MCP API.

curl -X GET 'https://glama.ai/api/mcp/v1/servers/edgeedgehq/coverageunlocked-mcp'

If you have feedback or need assistance with the MCP directory API, please join our Discord server