`insurer_denial_profile`

Pack: insurance-denials · Endpoint: https://gateway.pipeworx.io/insurance-denials/mcp

Everything reported for ONE named health insurer: claims received and denied in and out of network, the denial rate, and both internal and external appeal outcomes, for plan year ${PLAN_YEAR}. Use when a caller names a company — “how often does Ambetter deny claims”, “Blue Cross denial rate in Texas”, “what happens if I appeal with Oscar”. Matches on the insurer’s name and is forgiving about punctuation, case and partial names; an issuer selling in several states returns one entry per state, since the figures are reported per state. Sourced from the CMS Transparency in Coverage Public Use File; covers HealthCare.gov states only.

Parameters

Name	Type	Required	Description
`insurer`	string	yes	Insurer name or part of one, e.g. “Ambetter”, “Blue Cross Blue Shield of Texas”, “oscar”.
`state`	string	no	Optional two-letter state code to narrow a multi-state insurer, e.g. “TX”.

Example call

Arguments

{
  "insurer": "ambetter"
}

curl

curl -X POST https://gateway.pipeworx.io/insurance-denials/mcp \
  -H 'Content-Type: application/json' \
  -d '{"jsonrpc":"2.0","id":1,"method":"tools/call","params":{"name":"insurer_denial_profile","arguments":{"insurer":"ambetter"}}}'

TypeScript (@pipeworx/sdk)

import { Pipeworx } from '@pipeworx/sdk';
const pipeworx = new Pipeworx();

const result = await pipeworx.call('insurer_denial_profile', {
  "insurer": "ambetter"
});

More examples

{
  "insurer": "Blue Cross",
  "state": "TX"
}

Connect

Add this to your MCP client config, or use one-click install buttons:

{
  "mcpServers": {
    "insurance-denials": {
      "url": "https://gateway.pipeworx.io/insurance-denials/mcp"
    }
  }
}

See Getting Started for client-specific install steps.

insurer_denial_profile