Submit once
claim_status validates the universal identity, resolves the payer, and starts or resumes an idempotent inquiry.
Authenticated MCP · account required
Resolve healthcare claim status from your AI application.
Substrate Claim Status accepts a minimal claim identity, resolves the payer, collects payer-specific requirements, and returns a durable operation that an MCP client can poll to completion.
Streamable HTTP
https://mcp.substrateai.com/claim-statusProtected health information: use this connector only with an approved Substrate account and an AI product configuration appropriate for PHI. Do not place PHI in URLs, operation IDs, or idempotency keys.
Overview
A deliberately small asynchronous contract.
Supply payer requirements
Known missing fields return structured input_required requests before durable work is created.
Poll one handle
claim_status_get retrieves the complete current state for an opaque, account-scoped operation ID.
Receive normalized results
Claim found, claim not found, and payer rejection outcomes use a compact common result shape.
Connect
OAuth links the client to your Substrate account.
- Add the Streamable HTTP endpoint to ChatGPT, Codex, Claude, or another MCP client.
- Complete the OAuth 2.1 authorization-code flow with PKCE.
- Sign in to Substrate and select an account you can access.
- Approve the claim-status submit and read scopes.
name: Substrate Claim Status
transport: streamable-http
url: https://mcp.substrateai.com/claim-status
authentication: OAuth 2.1The connector requests claim_status:submit for intake and claim_status:read for polling. An operation ID is never authorization; every lookup is re-authorized against the selected account.
Request contract
Minimum v0 claim identity.
The v0 patient must be the subscriber. Nullable fields may be omitted. Use a random or internal retry token for idempotency_key, never a patient or claim identifier.
{
"idempotency_key": "retry-01JEXAMPLE7Y8Q2J5M",
"payer": { "name": "Aetna", "payer_id": "60054" },
"patient": {
"first_name": "Jane",
"last_name": "Doe",
"date_of_birth": "1990-01-31",
"gender": "female"
},
"subscriber": { "member_id": "M123" },
"provider": {
"billing_npi": "1234567890",
"tax_id": null,
"rendering_npi": null
},
"claim": {
"service_date": "2026-03-20",
"submitted_amount": null
}
}| Object | Required | Optional in v0 |
|---|---|---|
| Payer | Name | Published payer ID |
| Patient | First name, last name, date of birth, gender | — |
| Subscriber | Member ID | — |
| Provider | Billing NPI | Tax ID, rendering NPI |
| Claim | Single service date | Submitted amount |
Tools
Two tools, one operation.
claim_status
Use when the user asks to initiate or continue a claim-status inquiry. It creates no duplicate work when the same idempotency key and claim identity are retried.
claim_status_get
Use after submission to retrieve the complete current state. It accepts only the opaque operation_id.
working — retain the operation ID and poll again.requires_input — collect the requested payer field and resubmit the complete payload with the same idempotency key.completed — inspect the normalized claim_found, claim_not_found, or payer_rejected outcome.unable_to_process — no supported route exists, v0 cannot accept a required field, or execution failed.Testing
Use synthetic data before live claims.
Validate discovery, OAuth, tool schemas, scope challenges, required-input behavior, and polling in MCP Inspector before connecting a production account.
npx @modelcontextprotocol/inspector@latest \
https://mcp.substrateai.com/claim-statusMarketplace reviewers can use the published positive and negative acceptance cases. Test credentials and synthetic claim fixtures are supplied privately during review.
Data handling
Account-scoped healthcare operations.
- Patient, subscriber, provider, and claim fields are stored in the existing Substrate account domain records and governed by the customer agreement and retention policy.
- Substrate may transmit the minimum required claim-status fields to configured clearinghouses, payer services, and workflow providers, including Stedi where applicable.
- The Cloudflare MCP gateway does not persist or log request and response bodies.
- Operational logs and metrics use account, token, request, and opaque operation identifiers rather than patient identity.
- Contact support for account access, correction, retention, or deletion requests.
Troubleshooting
Recover through polling and OAuth discovery.
| 401 | Reconnect the account. The response advertises protected-resource metadata and required scopes. |
|---|---|
| Additional authorization required | Approve the specific scope required by the selected tool. |
| 429 | Honor Retry-After before polling again. |
| requires_input | Collect the requested field and resubmit with the original idempotency key. |
| operation_not_found | Confirm the operation belongs to the currently connected Substrate account. |
Trust and support