MCP server · Research
Backwork MCP server
by tylergibbs1
Lets your AI look up Medicare and insurance medical policies, check prior authorization, and validate claims with cited sources.
Backwork is a helper that connects your AI assistant to a library of medical policies from Medicare and commercial insurers. You can ask plain questions about coverage, codes, and prior authorization, and get answers with sources you can check. It is handy for people who work with billing, coding, or insurance paperwork and want quick answers without digging through policy documents.
What is an MCP server? The 30-second version
On its own, your AI can only chat with you using what it already knows. An MCP server is a small helper program that gives your AI a new skill or a connection to an app or service. This one connects your AI to Backwork, a service that holds medical policies, code information, and claim checks. Once connected, when you ask a question, your AI can go look things up in Backwork for you instead of guessing.
What this MCP server does
You ask your AI a question, like whether a certain medical code is covered in your state or whether it needs prior authorization. Your AI passes that question to this helper, which talks to the Backwork service. Backwork searches its policy library and returns the matching policies, codes, and notes. Your AI then turns that into a clear answer for you, with links and citations so you can check the source. Some answers also come back as a small card in the chat showing the details side by side.
What you can do with it
- Check whether a medical code is covered by Medicare or a commercial payer
- Find out if a service needs prior authorization and what documents to gather
- Compare how different Medicare contractors treat the same codes
- Look up details about a specific medical code
- Search recent changes to medical policies
- See which Medicare contractor covers which states
- Validate a claim and review it for compliance issues
Try asking your AI
- “Is CPT 76942 covered in Texas, and does it need prior auth?”
- “Compare coverage for these three codes across Medicare contractors.”
- “What documents do I need to gather for prior authorization on this procedure?”
- “Show me recent policy changes for this code.”
What it gives back to you
You get a written answer in the chat, often with a short sources block at the end listing the policy documents used. In ChatGPT, some answers also show a small card with the determination, codes, and links to the policies. For comparisons, you may see the codes side by side across contractors. Everything comes with citations so you can open the original policy and confirm.
Before you start
What you need
- A Backwork account with request credits
- For the hosted version: just sign in with OAuth in your browser, no key to copy
- For the local version: a Backwork API key (a kind of password for apps, which Backwork gives you)
- Node.js 18.14.1 or newer if you run the local version
Good to know
The hosted version is read-only, but the local version with a full key can make changes, and every call uses your organization's request credits, so keep an eye on usage.
Install it with your AI
Add Backwork MCP server to your AI, no technical skills needed
You don't install anything by hand. You copy one prompt, paste it into an AI that can work on your computer, and it checks, installs and connects the server for you, asking you when it needs something.
Sign in to get the install prompt
Members get a ready-made prompt that lets the Claude desktop app check Backwork MCP server, install it and connect it for them, step by step. You don't need any technical skills: you copy, paste and answer a few questions. Your connected AI can also find and install any of the 4,361 MCP servers here for you.
Who it's for
Medical billers, coders, prior authorization specialists, and anyone who works with insurance policies and needs quick, sourced answers.
