===== ClaimRev MCP Server =====

==== Overview ====

ClaimRev provides a [[https://modelcontextprotocol.io|Model Context Protocol (MCP)]] server that allows AI assistants (Claude, ChatGPT, Copilot, etc.) to search payer data directly. This enables AI-assisted payer lookup, eligibility verification mapping, and cross-referencing between ClaimRev and SharpRevenue payer systems.

The MCP server is hosted alongside the ClaimRev API and requires no authentication for payer search tools.

==== Endpoint ====

  * **Production:** ''https://api.claimrev.com/mcp''


The server uses the **Streamable HTTP** transport.

==== Available Tools ====

=== search_claimrev_payers ===

Search ClaimRev's payer database for healthcare payers that support electronic transactions.

**Parameters (all optional):**

| **Parameter** | **Type** | **Description** |
| payerName | string | Payer name substring search (e.g. "Aetna", "Blue Cross") |
| payerNumber | string | Payer number substring search (e.g. "60054") |
| payerState | string | Two-letter state code (e.g. "TX", "CA") |
| transactionTypeIds | int[] | Filter by transaction type: 1=Professional, 2=Institutional, 3=Dental, 4=Eligibility, 6=BatchClaimStatus, 7=RtClaimStatus |
| payerTypeIds | int[] | Filter by payer type |

**Response fields:**

| **Field** | **Description** |
| inboundPayerNumber | ClaimRev payer ID — use this for claim submission |
| payerName | Primary payer name |
| payerTypeName | Payer type (Commercial, Medicare, Blue, etc.) |
| supportsProfessional | Supports 837P professional claims |
| supportsInstitutional | Supports 837I institutional claims |
| supportsDental | Supports 837D dental claims |
| supportsEligibility | Supports 270/271 eligibility verification |
| supportsRtClaimStatus | Supports real-time 278 claim status |
| supportsBatchClaimStatus | Supports batch claim status |
| enrollmentRequired | Whether provider enrollment is required before submitting |
| alternateNames | List of alternate names this payer is known by — useful for cross-referencing between systems |
| sharpRevenuePayerId | The outbound payer ID sent to the eligibility gateway (SharpRevenue/Zoll). Only populated when eligibility is supported. For Medicare payers, this typically routes to CMS (payer ''00472'') regardless of the specific Medicare plan |

=== search_sharp_revenue_payers ===

Search the SharpRevenue (Zoll) master payer list used for eligibility routing.

**Parameters:**

| **Parameter** | **Type** | **Description** |
| searchText | string | Searches both payer name and payer number. Leave empty to return all payers |

**Response fields:**

| **Field** | **Description** |
| payerId | SharpRevenue internal payer ID |
| payerName | Payer name (often different from ClaimRev name) |
| payerNumber | SharpRevenue payer number — this is what appears in the ''sharpRevenuePayerId'' field on ClaimRev payer results |

==== Connecting to the MCP Server ====

=== Claude Desktop ===

Add to your ''claude_desktop_config.json'':

<code json>
{
  "mcpServers": {
    "claimrev-payers": {
      "url": "https://api.claimrev.com/mcp"
    }
  }
}
</code>

=== Claude Code ===

Run from your project directory:

<code bash>
claude mcp add --transport http claimrev-payers https://api.claimrev.com/mcp
</code>

=== Other MCP Clients ===

Any MCP-compatible client can connect using the Streamable HTTP transport at the endpoint URL listed above.

==== Common Use Cases ====

=== Find a payer by name ===

Ask your AI assistant: //"Find the ClaimRev payer ID for Aetna and tell me if it supports eligibility."//

=== Cross-reference payer IDs between systems ===

Ask your AI assistant: //"I have payer ID 7450 in my system for Anthem Blue Cross. What's the matching ClaimRev payer ID?"//

The AI will search ClaimRev by name, find BCBS Montana (''00751''), and show the SharpRevenue ID (''00098'') for eligibility routing.

=== Bulk payer mapping ===

Paste a list of payer IDs and names and ask: //"Which of these payers support eligibility in ClaimRev, and what IDs should I use?"//

The AI will cross-reference both ClaimRev and SharpRevenue payer lists to find matches by name and ID, including alternate names.

=== Find eligibility routing ===

Ask: //"Where does eligibility for Medicare Railroad get routed?"//

The AI will find that Medicare Railroad (''00882'') routes to CMS (SharpRevenue ''00472'') via HETS, same as all Medicare payers.