ClaimRev Support Documentation

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ClaimRev MCP Server

Overview

ClaimRev provides a 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
Local Development: http://localhost:44002/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:

{
  "mcpServers": {
    "claimrev-payers": {
      "url": "https://api.claimrev.com/mcp"
    }
  }
}

Claude Code

Run from your project directory:

claude mcp add --transport http claimrev-payers https://api.claimrev.com/mcp

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.

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