Appeal My Claim

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io.github.GoodTurnStudio/appealmyclaimv1.1.1

Appeal a denied US health insurance claim: denial codes, rights, deadlines and a draft letter.

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https://goodturn-mcp.pages.dev/appealmyclaim/mcp

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draft_appeal_letter Read-only

Draft an appeal letter for the user to review and send. For requests like "my insurer denied my MRI as not medically necessary, help me appeal" or "write an appeal letter for an out-of-network denial". Returns a letter as plain text with [brackets] for anything not given, a checklist of what to attach (denial notice, doctor's letter of medical necessity, records), and tips. It never sends or files anything.

datestring

Date of service.

namestring

Member's name.

planstring

Insurer or plan name.

claimstring

Claim or reference number.

doctorstring

Treating doctor's name.

reasonstring

Why the claim was denied: medical_necessity, emergency (said it wasn't an emergency), experimental, out_of_network, prior_auth, coding or generic. Required unless denial_code is given.

urgentstring

Set to yes to ask for an expedited review.

detailsstring

A sentence or two in the user's words on why the care should be covered.

servicestring

The care that was denied, like "MRI of the right knee".

providerstring

Hospital, clinic or provider name.

member_idstring

Member ID or Medicare number.

plan_typestring

Same values as plan_type in get_appeal_rights. Changes the wording for Medicare.

denial_codestring

The reason code on the notice, like CO-50 or PR-197. Picks the reason when reason is left out, and is quoted in the letter.

denial_datestring

Date on the denial notice.

Try it

Call this server's tools from your browser. Nothing to install.

https://goodturn-mcp.pages.dev/appealmyclaim/mcp

Requests go through mcptry because browsers can't call most MCP servers directly. Header values are sent to the server for that request only and are never stored or logged.

Tool list from our last check. Connect live to refresh it.

draft_appeal_letter Read-only

datestring

Date of service.

namestring

Member's name.

planstring

Insurer or plan name.

claimstring

Claim or reference number.

doctorstring

Treating doctor's name.

reasonstring

Why the claim was denied: medical_necessity, emergency (said it wasn't an emergency), experimental, out_of_network, prior_auth, coding or generic. Required unless denial_code is given.

urgentstring

Set to yes to ask for an expedited review.

detailsstring

A sentence or two in the user's words on why the care should be covered.

servicestring

The care that was denied, like "MRI of the right knee".

providerstring

Hospital, clinic or provider name.

member_idstring

Member ID or Medicare number.

plan_typestring

Same values as plan_type in get_appeal_rights. Changes the wording for Medicare.

denial_codestring

The reason code on the notice, like CO-50 or PR-197. Picks the reason when reason is left out, and is quoted in the letter.

denial_datestring

Date on the denial notice.

Tools (4)

draft_appeal_letter

read-only

Argument	Type	Description
date	string	Date of service.
name	string	Member's name.
plan	string	Insurer or plan name.
claim	string	Claim or reference number.
doctor	string	Treating doctor's name.
reason	string	Why the claim was denied: medical_necessity, emergency (said it wasn't an emergency), experimental, out_of_network, prior_auth, coding or generic. Required unless denial_code is given.
urgent	string	Set to yes to ask for an expedited review.
details	string	A sentence or two in the user's words on why the care should be covered.
service	string	The care that was denied, like "MRI of the right knee".
provider	string	Hospital, clinic or provider name.
member_id	string	Member ID or Medicare number.
plan_type	string	Same values as plan_type in get_appeal_rights. Changes the wording for Medicare.
denial_code	string	The reason code on the notice, like CO-50 or PR-197. Picks the reason when reason is left out, and is quoted in the letter.
denial_date	string	Date on the denial notice.

Input schema (JSON)

{
  "type": "object",
  "required": [],
  "properties": {
    "date": {
      "type": "string",
      "description": "Date of service."
    },
    "name": {
      "type": "string",
      "description": "Member's name."
    },
    "plan": {
      "type": "string",
      "description": "Insurer or plan name."
    },
    "claim": {
      "type": "string",
      "description": "Claim or reference number."
    },
    "doctor": {
      "type": "string",
      "description": "Treating doctor's name."
    },
    "reason": {
      "enum": [
        "medical_necessity",
        "emergency",
        "experimental",
        "out_of_network",
        "prior_auth",
        "coding",
        "generic"
      ],
      "type": "string",
      "description": "Why the claim was denied: medical_necessity, emergency (said it wasn't an emergency), experimental, out_of_network, prior_auth, coding or generic. Required unless denial_code is given."
    },
    "urgent": {
      "enum": [
        "yes",
        "no"
      ],
      "type": "string",
      "description": "Set to yes to ask for an expedited review."
    },
    "details": {
      "type": "string",
      "description": "A sentence or two in the user's words on why the care should be covered."
    },
    "service": {
      "type": "string",
      "description": "The care that was denied, like \"MRI of the right knee\"."
    },
    "provider": {
      "type": "string",
      "description": "Hospital, clinic or provider name."
    },
    "member_id": {
      "type": "string",
      "description": "Member ID or Medicare number."
    },
    "plan_type": {
      "type": "string",
      "description": "Same values as plan_type in get_appeal_rights. Changes the wording for Medicare."
    },
    "denial_code": {
      "type": "string",
      "description": "The reason code on the notice, like CO-50 or PR-197. Picks the reason when reason is left out, and is quoted in the letter."
    },
    "denial_date": {
      "type": "string",
      "description": "Date on the denial notice."
    }
  },
  "additionalProperties": false
}

explain_denial_code

Explain the denial codes on an Explanation of Benefits. For requests like "my EOB says CO-50, what does that mean?", "what is denial code PR 204?" or "what does N130 mean?". Returns each code in plain words, who usually fixes it (the provider's billing office, an appeal, or the user), whether the provider can bill the user for it (from the group code CO, PR, OA or PI), and a letter link when an appeal fits.

read-only

Argument	Type	Description
code*	string	One to four codes from the notice, like CO-50, PR 204, 197 or N130.
plan_type	string	Same values as plan_type in get_appeal_rights. Carried into the letter link.

Input schema (JSON)

{
  "type": "object",
  "required": [
    "code"
  ],
  "properties": {
    "code": {
      "type": "string",
      "description": "One to four codes from the notice, like CO-50, PR 204, 197 or N130."
    },
    "plan_type": {
      "type": "string",
      "description": "Same values as plan_type in get_appeal_rights. Carried into the letter link."
    }
  },
  "additionalProperties": false
}

get_appeal_deadlines

How long someone has to appeal, and how fast the plan must decide. For requests like "how long do I have to appeal?", "when is my appeal due?" or "how fast does my insurer have to answer?". With the date on the denial notice, gives an approximate file-by date. The date on the user's own notice is the one that counts.

read-only

Argument	Type	Description
urgent	string	Set to yes if waiting could seriously harm the person's health.
plan_type	string	Same values as plan_type in get_appeal_rights. Default: most private plans.
denial_date	string	Date on the denial notice, like 2026-09-01, 09/01/2026 or September 1, 2026.

Input schema (JSON)

{
  "type": "object",
  "required": [],
  "properties": {
    "urgent": {
      "enum": [
        "yes",
        "no"
      ],
      "type": "string",
      "description": "Set to yes if waiting could seriously harm the person's health."
    },
    "plan_type": {
      "type": "string",
      "description": "Same values as plan_type in get_appeal_rights. Default: most private plans."
    },
    "denial_date": {
      "type": "string",
      "description": "Date on the denial notice, like 2026-09-01, 09/01/2026 or September 1, 2026."
    }
  },
  "additionalProperties": false
}

get_appeal_rights

Appeal rights, steps and free help for a plan type and state. For requests like "what are my appeal rights in California?", "my insurer denied my claim, what can I do?" or "how do Medicare appeals work?". Returns who decides, the steps (internal appeal, external review, Medicare levels or Medicaid fair hearing), deadlines, and where to get free help, including the state insurance department. If the plan type is not known, leave it out to get the rules for most private plans.

read-only

Argument	Type	Description
state	string	US state name or two-letter code, like California or CA. Puerto Rico works too.
plan_type	string	Plan type: marketplace, employer, employer_insured, employer_self_funded, medicare, medicare_advantage, part_d or medicaid. Everyday words work too, like "job", "Obamacare" or "Medi-Cal". Default: most private plans.

Input schema (JSON)

{
  "type": "object",
  "required": [],
  "properties": {
    "state": {
      "type": "string",
      "description": "US state name or two-letter code, like California or CA. Puerto Rico works too."
    },
    "plan_type": {
      "type": "string",
      "description": "Plan type: marketplace, employer, employer_insured, employer_self_funded, medicare, medicare_advantage, part_d or medicaid. Everyday words work too, like \"job\", \"Obamacare\" or \"Medi-Cal\". Default: most private plans."
    }
  },
  "additionalProperties": false
}