MCP Server 🏥

Streamline insurance workflows with AI assistance through the Model Context Protocol (MCP). Connect Claude to your healthcare systems for automated insurance card scanning, eligibility verification, and claims contact extraction.

Introduction

The Healthcare MCP Server provides HIPAA-compliant AI assistance for common healthcare administrative tasks. By connecting Claude to CardScan.ai's proven insurance processing APIs, healthcare practices can reduce manual verification work and streamline patient intake workflows.

Key Benefits:

  • Reduce Manual Work: Automate insurance verification and card data extraction

  • HIPAA Compliant: Secure processing with enterprise-grade data protection

  • Real-time Results: Instant eligibility checks and benefit information

  • Proven Accuracy: Built on CardScan.ai's battle-tested ML pipeline

Target Audience:

  • Healthcare practices and billing departments

  • Healthcare technology integrators

  • Medical practice management systems

  • Revenue cycle management companies

Use Cases & Workflows

Real-time Eligibility Verification

Business Impact: Staff can instantly verify patient coverage without logging into multiple insurance portals, reducing verification time from 5-10 minutes to under 30 seconds.

Insurance Card Scanning & Contact Extraction

Business Impact: Eliminates manual card data entry and reduces phone number lookup time. Perfect for prior authorization calls and claims inquiries.

Patient Card Update Requests

Business Impact: Streamlines patient card collection with secure, time-limited upload links. Reduces staff phone calls and improves patient experience.

Available Tools & Resources

Core Tools

eligibility_lookup

Real-time insurance eligibility verification with comprehensive benefit details.

Parameters:

  • member_id (string, required): Insurance member identification number

  • subscriber_first_name (string, required): Primary member first name

  • subscriber_last_name (string, required): Primary member last name

  • date_of_birth (string, required): Format YYYYMMDD (e.g., "19850315")

  • provider_npi (string, required): 10-digit National Provider Identifier

  • provider_name (string, optional): Provider first/last name or organization name

  • service_codes (array, optional): Specific medical service codes to check

Returns:

  • Coverage status (active/inactive)

  • Deductible information (individual/family, remaining amounts)

  • Co-pay amounts by service type

  • Co-insurance percentages

  • Out-of-pocket maximums

  • Prior authorization requirements

  • Network status for provider

extract_card_info

Scan insurance cards and extract structured data including contact information.

Parameters:

  • image_url (string, required): URL of insurance card image (front/back)

  • enable_backside_scan (boolean, optional): Process both card sides for complete data

  • enable_payer_match (boolean, optional): Match to canonical payer database

Returns:

  • Member information (name, ID, DOB, gender)

  • Payer details (name, address, phone numbers)

  • Plan information (group number, plan name, effective dates)

  • Prescription details (BIN, PCN, issuer, plan)

  • Claims contact phone numbers

  • Customer service contacts

  • Confidence scores for each extracted field

create_card_update_link

Generate secure, time-limited upload links for patients to submit new insurance cards.

Parameters:

  • patient_identifier (string, required): Internal patient ID or email

  • expiration_hours (integer, optional): Link expiration time (default: 24 hours, max: 168)

  • notification_method (string, optional): "email" or "sms" for automated delivery

  • custom_message (string, optional): Personalized message for the patient

Returns:

  • Secure upload URL (single-use)

  • Expiration timestamp

  • Magic link identifier for tracking

  • Optional notification confirmation

search_member_cards

Find existing insurance card records by member information or payer details.

Parameters:

  • query (string, required): Search term (member name, payer name, member ID)

  • limit (integer, optional): Maximum results to return (default: 20, max: 100)

  • date_range (object, optional): Filter by card scan date

    • start_date (string): ISO date format

    • end_date (string): ISO date format

Returns:

  • Array of matching card records

  • Card metadata (scan date, processing state)

  • Basic member and payer information

  • Card IDs for detailed data retrieval

Available Resources

eligibility/recent

Browse recent eligibility verification requests across your account.

Access Pattern: List recent verifications with pagination support.

eligibility/by_patient/{patient_id}

Retrieve eligibility verification history for a specific patient.

Access Pattern: Get all eligibility checks for a given patient identifier.

card_scans/pending

Monitor insurance card uploads currently being processed.

Access Pattern: Check status of pending card scans and processing queue.

Getting Started

Prerequisites

Before integrating the Healthcare MCP Server, ensure you have:

  • HIPAA Compliance: Your organization must have appropriate HIPAA safeguards in place

  • CardScan.ai Account: Active account with eligibility verification feature enabled

  • Provider Information: National Provider Identifier (NPI) for your practice

  • Patient Demographics: Basic patient information for eligibility requests

NPI Lookup: Find provider NPIs using the NPPES NPI Registry.

Integration Overview

The Healthcare MCP Server acts as a secure bridge between Claude and CardScan.ai's healthcare APIs:

  1. Authentication: Server-side API key management with JWT token generation

  2. Data Processing: HIPAA-compliant handling of protected health information

  3. Real-time Updates: WebSocket notifications for eligibility and card processing status

  4. Error Handling: Healthcare-specific error codes and retry logic

Security & Compliance

  • HIPAA Compliance: All data processing follows HIPAA requirements

  • Encryption: End-to-end encryption for all PHI transmission

  • Access Controls: Role-based access with audit logging

  • Data Retention: Configurable retention policies for different data types

Contact for Access

The Healthcare MCP Server is currently in limited preview. To request access:

Contact the CardScan team for integration details, pricing, and deployment assistance.

  • Include your use case and expected volume

  • Specify any custom requirements or integrations needed

  • We'll work with you to set up a pilot deployment

Early Access: We're actively seeking healthcare partners to help refine the MCP server capabilities. Contact us to discuss pilot opportunities.

Example Integration

Here's how the MCP server integrates with your existing workflow:

# Example: Staff uses Claude for eligibility check
claude_query = """
Check eligibility for Sarah Johnson, DOB 03/15/1985, 
member ID SJ123456789, using our main NPI 1234567890.
"""

# MCP server handles the API calls automatically
# Returns formatted eligibility summary in natural language

The MCP server abstracts away API complexity while providing rich, structured healthcare data that Claude can interpret and present in user-friendly formats.

PreviousAccessibility & WCAG Compliance 🌐NextAI Development 🤖

Last updated

Was this helpful?