langcare-insurance-coverage

langcare-insurance-coverage is a skill for Claude Code, Codex from langcare/langcare-mcp-fhir. It costs 56 tokens per session (572 once invoked), scanned A, original, MIT.

An insurance-coverage lookup and analysis tool built around FHIR, a standard format for exchanging healthcare data. It gathers coverage records and payer details for a patient.

In plain words
What is it for?
It helps staff verify eligibility information, review active and inactive insurance, check coordination of benefits, and find coverage gaps.
Why use it?
It brings insurance plans, coverage periods, benefit details, and primary or secondary payer order into one summary, making gaps easier to spot.

Skill for Claude CodeCodex

Written for no agent in particular: nothing here depends on one.

Good fit It helps staff verify eligibility information, review active and inactive insurance, check coordination of benefits, and find coverage gaps.

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Install with agentmods
npx agentmods add skills/langcare/langcare-mcp-fhir/insurance-coverage
Install

Getting it into your agent

One page per mod, every tool's command on it. A separate URL per tool would split the same page into five that compete with each other.

Any agent
npx skills add langcare/langcare-mcp-fhir --skill insurance-coverage
Clone the repo
git clone --depth 1 https://github.com/langcare/langcare-mcp-fhir

Made for: Claude Code, Codex.

Wrote this? Show the measurements

A badge with what this costs and how it scanned, read live from this page, so it follows the numbers instead of freezing them. Markdown for a README, HTML for a documentation site or a project page.

agentmods badge for langcare-insurance-coverage

README.md
[![agentmods](https://agentmods.dev/badge/skills/langcare/langcare-mcp-fhir/insurance-coverage/github.svg)](https://agentmods.dev/skills/langcare/langcare-mcp-fhir/insurance-coverage)
Your own site
<a href="https://agentmods.dev/skills/langcare/langcare-mcp-fhir/insurance-coverage"><img src="https://agentmods.dev/badge/skills/langcare/langcare-mcp-fhir/insurance-coverage/github.svg" alt="Measured on agentmods" height="20"></a>

Or the 80×15 button, for a site that already has a row of RSS and ATOM ones. Only the verdict fits; the numbers stay here.

agentmods 80×15 button for langcare-insurance-coverage

Your own site · 80×15
<a href="https://agentmods.dev/skills/langcare/langcare-mcp-fhir/insurance-coverage"><img src="https://agentmods.dev/badge/skills/langcare/langcare-mcp-fhir/insurance-coverage.svg" alt="Reviewed on agentmods" width="80" height="20"></a>
Per session 56 Skills are progressive disclosure: only the name and description are preloaded; the body loads when the skill is used.
When invoked 572 The whole file, excluding the scripts and references it only reads on demand.
Security scan A 0 findings. A grade says what 26 rules found in the file — not that it is safe.
Origin original No closer match found in the catalogue.
Token cost

What it costs to keep this loaded

Counted locally with the o200k_base tokenizer, which is exact for GPT models; Claude uses its own tokenizer and its counts differ. Treat this as one consistent yardstick across the catalogue rather than a bill. Prices are per million input tokens.

ModelPer sessionOnce invoked
Fable 5.1 $0.00056 $0.00572
Opus 5 $0.00028 $0.00286
Sonnet 5 $0.00011 $0.00114
Haiku 4.5 $0.00006 $0.00057

Measured 12d ago against content hash b1ebc9f46172, method: parsed. Prices are Anthropic first-party input rates as of 2026-09-12, from the pricing page.

Security

Grade A, and why

langcare-insurance-coverage scanned grade A with 0 findings against 26 rules in 11 categories — prompt injection, anti-refusal, data exfiltration, privilege escalation, supply chain, agent snooping, system-prompt leakage, SSRF and excessive agency — measured 12d ago.

A static scan of the body, not an audit. Every finding is printed with the line that produced it so you can judge whether it matters here. A mod is markdown that instructs an agent; that is exactly why what it instructs is worth reading.

Nothing flagged

None of the 26 patterns this scan looks for appear in this file: no shell pipes, no recursive deletes, no credential paths, no hidden text, no instruction-override or anti-refusal phrasing, no agent-config snooping. That is not a guarantee, it is the absence of the things that are checkable.

cma/skills/patient-data/insurance-coverage/SKILL.md · 63 lines

How it starts

The opening of the file, as written. The whole thing — 63 lines — stays where its author put it; the contents beside it link to each section on GitHub.

Insurance Coverage Summary

When to Use This Skill

Use when a clinician or administrative staff needs detailed insurance coverage information including primary/secondary coordination, coverage periods, subscriber details, and payer contacts.

Clinical Workflow

  1. Use fhir_search to retrieve all Coverage resources for the patient (active and inactive)
  2. Use fhir_read to retrieve referenced Organization resources (payers) for contact details
  3. Organize by coverage order: primary (order=1), secondary (order=2), tertiary
  4. Extract plan details from class array: plan name, group number, RX BIN/PCN
  5. Identify coverage gaps: periods without active coverage, upcoming coverage end dates
  6. Present coordination of benefits summary

FHIR Resources

  • Coverage -- Insurance entries: status, type, subscriberId, beneficiary, payor, period, class, order, network
  • Organization -- Payer organization details: name, telecom, address
  • Patient -- Subscriber vs dependent relationship

FHIR Query Examples

Pull All Coverage

fhir_search(resourceType="Coverage", queryParams="patient=[patient-id]")

Pull Active Coverage Only

fhir_search(resourceType="Coverage", queryParams="patient=[patient-id]&status=active")

Retrieve Payer Organization

fhir_read(resourceType="Organization", id="[payer-organization-id]")

Clinical Guidelines

  • CMS requires verification of insurance eligibility before service delivery
  • Coordination of benefits rules: primary coverage pays first, secondary covers remaining eligible expenses
  • Medicare Secondary Payer rules apply when patient has employer coverage and Medicare

Interpretation Guide

  • Present primary coverage first with full plan details, then secondary
  • For each coverage: plan name, group number, subscriber ID, coverage period, payer name and phone
  • Extract pharmacy benefits separately: RX BIN, RX PCN, RX Group from class array
  • Flag: coverage ending within 30 days, no active coverage found, subscriber ID discrepancies between coverages
  • Calculate coverage duration and identify any gap periods

Read the full file on GitHub · 63 lines

Changes

What this file has done since we first saw it

Hashed on every crawl. A supply-chain change to an agent config is a question of when, not whether, so the history is kept rather than the latest state alone.

  1. 12d ago First seen · 63 lines · 56 tokens per session scan A b1ebc9f46172

Subscribe to this mod's changes

langcare-insurance-coverage is a skill published in the GitHub repository langcare/langcare-mcp-fhir (55 stars, last pushed 5mo ago), licensed MIT. It adds 56 tokens to every session and 572 once invoked, about $0.0003 per session on Opus 5. A static security scan graded it A with 0 findings. No closer match exists in the catalogue, so it is treated as the original; first seen 2026-08-30.

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