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Production denial intelligence over MCP and HTTP. 17,440 CPT codes, 20+ payer behavioral profiles, OAuth 2.1 self-serve registration — no sales call to start.

Quick Start

1

Register a Client

One POST to /api/oauth/register (RFC 7591 dynamic client registration). You get a client_id on the Free tier immediately — no sales call, no approval queue.

2

Get an Access Token

Standard OAuth 2.1 authorization-code flow with PKCE (S256); consent approval is currently manual — same-day by email. Exchange the code at /api/oauth/token for a 1-hour bearer token plus a rotating refresh token.

3

Call the API

Hit the MCP endpoint at /api/mcp with your bearer token — JSON-RPC over HTTP, or connect any MCP-capable agent directly.

Example: look up denial data for a CPT code

Quick Start Example
curl -X POST https://app.coverageunlocked.com/api/mcp \
  -H "Authorization: Bearer YOUR_ACCESS_TOKEN" \
  -H "Content-Type: application/json" \
  -d '{
    "jsonrpc": "2.0",
    "id": 1,
    "method": "tools/call",
    "params": {
      "name": "denial_lookup",
      "arguments": {
        "cpt_code": "27447",
        "payer_id": "uhc"
      }
    }
  }'

Returns the national denial rate, payer-specific rate, top denial reasons with appeal success rates, overturn rate, and appeal cost data for CPT 27447 (total knee arthroplasty) at UnitedHealthcare.

What the API Serves

Two Production Tools

Two production MCP tools query the denial database directly. Same args, same result — closed-world data reads, not generative output.

  • denial_lookup — denial rates, top denial reasons, overturn rates, and appeal costs by CPT code and payer
  • appeal_economics — expected recovery, appeal cost, ROI, and net expected value for a denied claim

Data Coverage

Built from CMS HCPCS, PFS RVU, and NCCI public data plus 20 years of payer-side pattern knowledge. Every response carries provenance.

  • • 17,440 CPT codes across 9 procedure categories
  • • 482 hand-curated deep denial profiles
  • • 20+ payer behavioral profiles · 15 state regulatory profiles

Rate Limits & Pricing

Register a client via OAuth (no sales call) and you're on the Free tier immediately — 100 calls to probe the API for 30 days. Upgrade self-serve when you're ready to ship.

Free

100/mo
Free for 30 days
  • 100 API calls/month
  • 10 requests/min
  • Full 17,440-code denial database — no data paywall
  • 30-day trial window

Starter

1K/mo
$99/mo
  • 1,000 API calls/month
  • 30 requests/min
  • Both production tools (denial_lookup + appeal_economics)
  • 20+ payer profiles · 15 state regulatory profiles in every response

Pro

10K/mo
$199/mo
  • 10,000 API calls/month
  • 100 requests/min
  • Volume for production workloads
  • Priority email support

Scale

100K/mo
$499/mo
  • 100,000 API calls/month
  • 300 requests/min (negotiable)
  • Batch-scale appeal triage volume
  • 24h support SLA

Above 100K calls/month? Enterprise adds self-hosted deployment, white-label, BAA execution, and custom SLA.

License scope

Self-serve API tiers (Free, Starter, Pro, Scale) license you to call the API and use responses within your own applications and workflows — including embedding denial-intelligence features in your product. They do not license: (1) systematic extraction or replication of the denial-intelligence database — crawling endpoints to rebuild the dataset outside the API, (2) reselling or proxying direct API access to third parties (your application's end users receiving responses inside your product is fine), or (3) white-label redistribution where CoverageUnlocked intelligence constitutes the substance of a product you sell. Those require an Enterprise or white-label agreement — ned@coverageunlocked.com.

Upgrade your client

Registered via /api/oauth/register? Paste your client_id and pick a tier — checkout is Stripe, activation is automatic on payment.

Check usage anytime: GET /api/developer/usage with your bearer token.

Need Help?

Documentation

Guides and API references for every endpoint.

View Docs

Contact Support

Need help? Reach out to our integration team for technical support.

Email Us