com.coverage-rights/coverage-rights

Est-ce que com.coverage-rights/coverage-rights est sûr ?

Au dernier audit MCP Hub, le serveur MCP « com.coverage-rights/coverage-rights » est classé « Non encore testé ». Référencé dans l'annuaire. Seul le pentest comportemental fait foi, et il n'a pas encore été exécuté sur ce serveur. Le verdict est réévalué en continu ; consultez la fiche pour l'état à jour.

Méthode : MCP Hub analyse la description de chaque outil (couche 1) et, pour le verdict fort, exécute le serveur dans une micro-VM isolée avec leurres et réseau bloqué (couche 2). On publie des noms et des compteurs, jamais le contenu brut renvoyé par un outil.

Les 9 outils

• get_appeal_rights≈ 680 tokens

  Deterministically resolve the governing appeal route, missing facts, filing recipient, deadlines, current external-review status, and verified grounds. Distinguishes Original Medicare, Medicare Advantage medical benefits, Part D pharmacy benefits, employer funding/governance, ACA, Medicaid, FEHB, TRICARE, and unknown coverage; unsupported or ambiguous routes fail closed.

  Paramètres, retour & exemple (11)

  Paramètres

  • state · string · optionnel
    Two-letter state code, e.g. 'ca'
  • program · string · requis · medicare-advantage | original-medicare | medicare-part-d | erisa-employer-plans | aca-marketplace | medicaid | fehb | tricare
    Plan type
  • appeal_stage · string · optionnel · initial-denial | internal-appeal-filed | first-internal-denial | final-internal-denial | external-review-filed | unknown
  • drug_channel · string · optionnel · not-a-drug | medical-benefit | pharmacy-benefit | unknown
    For a drug denial, whether the medical or pharmacy benefit applies
  • insurer_slug · string · optionnel
    Insurer slug for insurer-specific stats
  • denial_reason · string · requis · medical-necessity | experimental-investigational | prior-authorization | out-of-network | not-covered-benefit | coding-billing-error | prescription-drug
    Denial reason category. Use 'prescription-drug' for medication denials — formulary exclusion, step therapy, quantity limits, or drug prior authorization — which return the formulary-exception grounds and their short decision deadlines.
  • employer_type · string · optionnel · private | government | church | union | unknown
    Required to resolve job-based coverage
  • current_status · string · optionnel · awaiting-service | receiving-service | service-ended | post-service-claim | unknown
  • funding_status · string · optionnel · fully-insured | self-funded | unknown
    Required to resolve job-based state versus federal governance
  • regulatory_marker · string · optionnel · state-regulated | federal-or-self-funded | unknown
  • regulatory_state_basis · string · optionnel · denial-letter | insurance-card | plan-document | residence-only | unknown

  Exemple d'appel

  {"name": "get_appeal_rights", "arguments": {"program": "medicare-advantage", "denial_reason": "medical-necessity"}}

  Exemple de retour

  {"content": [{"type": "text", "text": "…"}]}

• get_condition_outcomes≈ 156 tokens

  External-review outcomes for a medical condition: how often insurance denials involving this condition were overturned, plus the most-fought treatments for it.

  Paramètres, retour & exemple (1)

  Paramètres

  • slug · string · requis
    Condition slug, e.g. 'obesity', 'autism', 'hepatitis-c'

  Exemple d'appel

  {"name": "get_condition_outcomes", "arguments": {"slug": "texte"}}

  Exemple de retour

  {"content": [{"type": "text", "text": "…"}]}

• get_drug_playbook≈ 246 tokens

  Drug-specific denial patterns and appeal strategy for the medications plans fight hardest over: GLP-1s (Wegovy, Zepbound, Mounjaro, Ozempic, Saxenda) and IBD biologics (Humira, Skyrizi, Stelara, Entyvio, Remicade, Rinvoq). Returns FDA-approved indications stated conservatively, why plans deny that specific drug, what winning appeals argue, and the step-therapy exception framing — plus the published external-review record for the drug when the corpus has it. Accepts a brand or generic name.

  Paramètres, retour & exemple (1)

  Paramètres

  • drug · string · requis
    Brand or generic drug name, e.g. 'Zepbound', 'ustekinumab'

  Exemple d'appel

  {"name": "get_drug_playbook", "arguments": {"drug": "texte"}}

  Exemple de retour

  {"content": [{"type": "text", "text": "…"}]}

• get_insurer_metrics≈ 173 tokens

  Get an insurer's verified CY2025 prior-authorization metrics (denial rate, appeal overturn rate, decision times) from its own CMS-0057-F disclosure, plus contract/plan-level rows where collected. Includes source URLs and scope notes.

  Paramètres, retour & exemple (1)

  Paramètres

  • slug · string · requis
    Insurer slug from list_insurers, e.g. 'unitedhealthcare'

  Exemple d'appel

  {"name": "get_insurer_metrics", "arguments": {"slug": "texte"}}

  Exemple de retour

  {"content": [{"type": "text", "text": "…"}]}

• get_state_external_review≈ 176 tokens

  How a state's external review process works: filing deadline, regulator contact, and key facts. Verified detail currently covers 10 states (CA, TX, FL, NY, PA, IL, OH, GA, NC, MI); other states return the covered list.

  Paramètres, retour & exemple (1)

  Paramètres

  • state · string · requis
    Two-letter state code, e.g. 'ca', 'ny', 'fl'

  Exemple d'appel

  {"name": "get_state_external_review", "arguments": {"state": "texte"}}

  Exemple de retour

  {"content": [{"type": "text", "text": "…"}]}

• get_treatment_outcomes≈ 200 tokens

  External-review outcomes for a treatment: how often insurer denials of this treatment/drug/procedure were overturned by independent reviewers (42,749 published CA IMR decisions, 2001–2026). Accepts a category slug (e.g. 'pharmacy') or specific treatment slug (e.g. 'zepbound', 'speech-therapy').

  Paramètres, retour & exemple (1)

  Paramètres

  • slug · string · requis
    Treatment slug, e.g. 'zepbound', 'pharmacy', 'speech-therapy'. Use search_outcomes to find slugs.

  Exemple d'appel

  {"name": "get_treatment_outcomes", "arguments": {"slug": "texte"}}

  Exemple de retour

  {"content": [{"type": "text", "text": "…"}]}

• list_insurers≈ 102 tokens

  List tracked U.S. health insurers with whether verified CMS-0057-F prior-authorization metrics are available for each.

  Paramètres, retour & exemple (0)

  Exemple d'appel

  {"name": "list_insurers", "arguments": {}}

  Exemple de retour

  {"content": [{"type": "text", "text": "…"}]}

• rank_denial_rates≈ 137 tokens

  Insurer prior-authorization denial rates (CY2025), ranked only within compatible reporting cohorts. Each row includes its cohort, rank within that cohort, exact source scope, calculation method, and source link. Never compare ranks across cohorts.

  Paramètres, retour & exemple (0)

  Exemple d'appel

  {"name": "rank_denial_rates", "arguments": {}}

  Exemple de retour

  {"content": [{"type": "text", "text": "…"}]}

• search_outcomes≈ 187 tokens

  Search treatments (categories + specific drugs/procedures) and conditions by name. Returns slugs for get_treatment_outcomes / get_condition_outcomes plus headline overturn rates.

  Paramètres, retour & exemple (2)

  Paramètres

  • limit · integer · optionnel
    Max results per type (default 10)
  • query · string · requis
    Search text, e.g. 'wegovy', 'back pain', 'imaging'

  Exemple d'appel

  {"name": "search_outcomes", "arguments": {"query": "texte"}}

  Exemple de retour

  {"content": [{"type": "text", "text": "…"}]}

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Source

https://www.coverage-rights.com/api/mcp