Official Model Context Protocol (MCP) server for the Backwork API. It gives AI assistants controlled access to Medicare and payer medical policies, medical code intelligence, prior authorization checks, claim…
Backwork source profile. From the maintainer documentation: “Official Model Context Protocol (MCP) server for the Backwork API. It gives AI assistants controlled access to Medicare and payer medical policies, medical code intelligence, prior authorization checks, claim validation, compliance review, drug formulary evidence, and webhook operations.”
The documented npm package is @backwork/mcp. The configuration below comes from the maintainer’s example; adapt its paths and account values to your environment.
The example declares BACKWORK_API_KEY. Secret-looking values have been replaced with placeholders. Required and optional labels are shown only when the documentation states them.
Project documentation · Repository · Discovery listing. This profile records the public documentation checked on 2026-10-13.
Check the linked publisher documentation and your connected client's tool list. Names and availability can vary with the server version and account permissions.
| Tool | What it does |
|---|---|
| grounding | Meaning |
| grounded | Found in Backwork's retained source text |
| not_grounded | Read by the document pipeline, but not found in retained source text |
| no_source_text | No retained text was available to check |
| not_checked | Grounding was not checked, including codes inferred from a policy title |
| backwork_coverage_lookup | Look up procedure codes and combine code details, policy evidence, prior authorization, claim risk, jurisdiction comparison, and spending evidence. With… |
| backwork_policy_research | Search policies, fetch one policy, search extracted criteria, review policy changes, map MAC jurisdictions, or compare how MACs cover the same codes |
| backwork_claim_validation | Validate claim coverage, documentation requirements, denial risk, and optional policy-specific criteria |
| backwork_prior_auth_research | Check prior authorization from Backwork's policies (Medicare, or a named payer's), or start and poll a background job that searches public payer websites |
| backwork_drug_formulary_research | Search commercial pharmacy-benefit evidence from CVS Caremark, Express Scripts, and UnitedHealthcare / Optum Rx |
| backwork_compliance_review | Review compliance stats and list unreviewed policy changes; with an API key, also acknowledge changes |
| backwork_webhook_management | List, create, update, delete, or test webhook endpoints. Backwork sends one event, compliance.acknowledged; policy-change webhooks are not sent. Needs a… |
| backwork_system_health | Check Backwork API health and dependency status. API-key connections only |
{
"mcpServers": {
"backwork": {
"command": "npx",
"args": [
"-y",
"@backwork/mcp"
],
"env": {
"BACKWORK_API_KEY": "YOUR_BACKWORK_API_KEY"
}
}
}
}From the project documentation. Replace placeholders and example paths before connecting.
| Variable | Description | Required |
|---|---|---|
| BACKWORK_API_KEY | Declared in the maintainer’s client configuration. | Check documentation |
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