Insurance Denials

live Health

US health-insurance claim denials and appeal outcomes, by insurer.

4 tools
0ms auth
free tier 50 calls/day

Tools

insurer_denial_rates

Which health insurers deny the most claims — US marketplace issuers ranked by the share of in-network claims they denied, for plan year ${PLAN_YEAR}. Answers "what percentage of claims does my insuran

No parameters required.

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insurer_appeal_outcomes

Does appealing a denied health-insurance claim work? Marketplace issuers ranked by the share of appeals that were OVERTURNED in the patient's favour, plan year ${PLAN_YEAR}. Answers "is it worth appea

No parameters required.

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insurer_denial_profile

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 whe

No parameters required.

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insurer_denial_coverage

What this data covers before you rely on it: the plan year, how many issuers and states are present, which states are included, and the counts of issuers whose denial or appeal figures CMS suppressed.

No parameters required.

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Test with curl

The gateway speaks JSON-RPC 2.0 over HTTP POST. You can test any pack directly from the terminal.

List available tools
bash 
curl -X POST https://gateway.pipeworx.io/insurance-denials/mcp \
  -H "Content-Type: application/json" \
  -d '{"jsonrpc":"2.0","id":1,"method":"tools/list"}'
Call a tool
bash 
curl -X POST https://gateway.pipeworx.io/insurance-denials/mcp \
  -H "Content-Type: application/json" \
  -d '{"jsonrpc":"2.0","id":2,"method":"tools/call","params":{"name":"insurer_denial_rates","arguments":{}}}'

Use with the SDK

Install @pipeworx/sdk to call tools from any TypeScript/Node project.

TypeScript 
import { Pipeworx } from '@pipeworx/sdk';
const px = new Pipeworx();
const result = await px.call("insurer_denial_rates", {});
ask_pipeworx 
// Or ask in plain English:
const answer = await px.ask("us health-insurance claim denials and appeal outcomes, by insurer");