Claim Lane
API Beta

Claim Lane API

Analyze denial text and return the likely failure pattern, wrong first move, one targeted question, and route basis.

One tool. Structured JSON. For agent builders, advocate workflows, and provider admin systems that need denial triage as a reusable decision step — not a one-off consumer product.

// POST /api/mcp { "jsonrpc": "2.0", "id": 1, "method": "tools/call", "params": { "name": "analyze_denial", "arguments": { "text": "Your claim for outpatient physical therapy has been denied. In-network providers are available for this service." } } }
Sample response
Pattern
Unverified in-network availability
Wrong first move
Generic appeal that argues medical necessity while leaving the insurer's network assumption untouched
Targeted question
"Can you identify the specific in-network provider you relied on, and confirm in writing that provider performs the requested service for this condition?"
Suggested sender
Member
Suggested route
Written — with transmission proof
Basis
case-specific
Built for

Agent builders who need denial triage inside a workflow. Patient advocate and case navigation systems. Provider admin teams handling repeated denial patterns. Anyone building tools that need one concrete next step, not a vague summary.

Not for

Legal advice automation. Emergency medical decisions. Replacing attorney review. Systems that need final coverage determinations. If you need a lawyer, this is not a substitute.

analyze_denial
Analyze denial text and return: likely failure pattern, wrong first move, one targeted written question, route basis, suggested sender, and suggested route. JSON response.
Endpoint
POST /api/mcp — JSON-RPC 2.0. See /api/tool-spec for the full OpenAPI spec.
Authentication
Requires API key. Send as Authorization: Bearer <key> or include api_key in the request body. Contact Claim Lane for access.
Rate limits
Based on tier. Dev: 10 calls. Indie: 25 calls. Workflow: 200 calls. Overages available on request.
Basis labels
documented — route supported by verified carrier data. case-specific — derived from denial facts. inferred — pattern-matched, not verified.
Beta pricing
Dev
Free
10 calls
  • Playground / demo only
  • Full JSON response
  • No support
  • Rate limited
Request access
Indie
$39
25 calls
  • Full JSON response
  • Email support
  • Production use
  • No expiration
Request access
Workflow
$99
200 calls
  • Full JSON response
  • Priority email support
  • Production use
  • Overage available
Request access
Request beta access
Beta keys are issued manually. You'll hear back within 48 hours.
Request received. We'll email your API key within 48 hours.
Charge for resolved administrative steps, not model output.
Claim Lane API provides pattern classification and administrative routing information. It is not legal advice and does not create an attorney-client relationship. API outputs are informational and do not replace review of denial notices, plan documents, or insurer correspondence. Beta pricing and availability are subject to change.

Three pillars · classification, coordination, record-building · how coordination works → · administrative record-building, not legal action.