EOB to ERA

Classify EOB to ERA conversion

Classifies caller-supplied safe Electronic Remittance Advice (ERA) summary fields for one organization-owned Explanation of Benefits (EOB) to ERA conversion and optionally persists only the resulting ERA status.

POSTPublic reference baselineValidate or simulateEOB to ERAoperationId: classifyEob2EraConversionhttps://dev-api.quickintell.com/api/v1/eob2era/conversions/{conversionId}/classify

Public reference baselineValidate or simulateClaims and remittances

Route status

Public reference baseline

Generated endpoint contract may be shown with caveats, but external publication still needs route registry and release evidence.

Publication status

Baseline reference only

Requires E6 route registry and E9 release evidence before external publication. Also requires E2 side-effect policy before production recipes, SDK inclusion, or try-out access.

Authentication

Bearer API key declared

OpenAPI declares bearer API-key security for this operation.

Tenant context

API-key organization

API-key organization context is authoritative; request organizationId is not a public tenant selector.

Side-effect summary

Validate or simulate

Produces validation, preview, dry-run, or simulation output. Treat results as local compatibility behavior.

Source artifact

docs/openapi/openapi.json

OpenAPI 3.1.0; API 1.0.0.

When to use this endpoint

Use this page as an internal baseline for the claims and remittances contract generated for POST /api/v1/eob2era/conversions/{conversionId}/classify. External use still depends on route classification, release evidence, and endpoint-specific side-effect approval.

What this does now

Documents the generated POST /api/v1/eob2era/conversions/{conversionId}/classify contract as a validate or simulate baseline endpoint.

What this does not do

Does not prove external GA readiness, SDK readiness, live production execution, or complete module behavior. Mutating behavior still needs side-effect and retry evidence.

Not public from this page

Live external side effects, file contents, credentials, webhooks, SDK promises, and production recipes are still gated.

Headers and tenancy

Current headers and tenant authority. Target headers stay labeled as future until OpenAPI and release evidence declare them.

Header	Required	Current status	Notes
Authorization	Yes	Current	Bearer <QUICKRCM_API_KEY>. OpenAPI security: bearerAuth.
Idempotency-Key	No	Target/future	Do not claim universal header support until E3 and OpenAPI metadata exist.
X-Request-Id	No	Target/future	Use for support correlation only after approved; not declared as a standard OpenAPI header today.

Required scopes

Unclassified until E6 route metadata exists; do not infer scopes from route names.

Wrong-org behavior

Tenant-safe 404, empty list, or 403 is endpoint-specific and remains an evidence gap until E1 is closed.

Actor and audit

No public actor, audit, or correlation contract is published from OpenAPI alone.

Idempotency and retries

Retry behavior is documented conservatively because universal idempotency headers are not declared.

Topic	Status	Guidance
Current idempotency	No idempotency mechanism is declared.	Do not retry blindly. Check resource, status, batch, or job state before repeating the request.
Universal header	Not declared	Do not document universal Idempotency-Key support until OpenAPI and E3 evidence declare it.
Conflict behavior	Unresolved	Same-key changed-payload, in-flight retry, fingerprint scope, and TTL behavior remain endpoint-specific evidence gaps.

Async jobs and polling

Queued work is accepted work, not proof of completed workflow execution.

Topic	Status	Guidance
Immediate response	No 202 response declared	OpenAPI does not declare HTTP 202 for this operation.
Polling and terminal states	Endpoint-specific	Use only operation-specific status endpoints visible in OpenAPI; generic job behavior, cancellation, retries, and retention are unresolved.
Later side effects	Not proven	Do not infer background execution beyond the documented response.

Files and artifacts

File-like routes need content-class, ownership, scanning, retention, and URL policy evidence before public recipes.

Topic	Status	Guidance
Content class	No file/artifact class inferred	OpenAPI text does not indicate file or artifact handling for this endpoint.
Ownership and storage keys	Not applicable unless a file field is present	Tenant ownership must be proven before retrieval or upload docs. Never expose storage keys as public identifiers.
URLs, scanning, and retention	Unresolved unless endpoint-specific evidence exists	Short-lived URLs, MIME limits, checksums, scanner status, retention, expiration, and legal hold behavior are not implied by OpenAPI examples.

Publication warnings

Universal Idempotency-Key header support is not declared; retry only after checking endpoint-specific state.

Related platform rules

Workflow Guide Route Status Tenant Context Errors Rate Limits PHI and Security Publication Readiness Side-Effect Modes Idempotency

Evidence

Evidence	Status	Caveat
OpenAPI artifact	docs/openapi/openapi.json; OpenAPI 3.1.0; API 1.0.0.	Generated baseline contract only.
Route registry	Public reference baseline from documentation classification overlay.	E6 route registry evidence is still required before external publication.
Example validation	Generated examples are internal baseline aids.	No external publication claim; examples must pass no-PHI/no-secret/no-raw-payload/no-storage-key checks.
Last reviewed	Implementation run 20260619T-docs-impl; source boardroom packet 20260619T064820Z.	Refresh this evidence for release workspaces.
Release evidence	E9 required.	No SDK readiness, production readiness, or expanded external docs claim from this endpoint page.

EOB to ERA public API.

Explanation of Benefits (EOB) to Electronic Remittance Advice (ERA) public APIs expose organization-scoped conversion tracking for EOB documents and safe local ERA classification workflow metadata. The bearer API key selects the organization; public requests should not include an `organizationId` tenant selector. The current public surface is intentionally conservative. Read endpoints return sanitized conversion summaries and file-presence booleans, not file names, storage keys, signed URLs, raw EOB text, raw X12 835 Electronic Remittance Advice transaction payloads, or parser output. Write endpoints validate requests, create local records from existing organization-owned `File` rows, perform safe local status updates, or classify caller-supplied ERA summary fields. These endpoints do not upload files, generate Amazon Simple Storage Service (S3) presigned URLs, enqueue Amazon Simple Queue Service (SQS) work, run optical character recognition (OCR) or large language model (LLM) extraction, parse raw payer payloads, submit claims, post payments, create denial records, or prove payer adjudication. Use synthetic examples and keep all notes, file names, and classification summaries free of real Protected Health Information (PHI), credentials, tokens, raw Electronic Data Interchange (EDI), transcripts, S3 keys, payer portal credentials, and vendor payloads.

What this endpoint does

Use case

Use this when an integration already has a sanitized remittance summary and wants QuickRCM's local ERA classification labels without submitting raw X12 835 Electronic Remittance Advice transaction content or invoking EOB extraction.

Before calling

Authenticate with `eob2era:write`, resolve `conversionId` from the same tenant, and build a strict `payload` using only the documented financial, adjustment, CARC, and capitation summary fields.

Request and response behavior

Request guidance

`payload` is required and rejects unknown properties. `dryRun` defaults to true, returning a classification without writing. Set `dryRun: false` only when you want the resulting `eraStatus` persisted to the conversion. Do not send raw X12 835 Electronic Remittance Advice transaction payloads, optical character recognition (OCR) text, payer payloads, Amazon Simple Storage Service (S3) keys, vendor responses, transcripts, or denial creation instructions.

`payload.adjustments` is capped at 100 entries; each adjustment allows only groupCode, reasonCode, and amount.
`carcCodes` is capped at 100 Claim Adjustment Reason Code (CARC) strings.
The classifier can return PAID_IN_FULL, PARTIALLY_PAID, DENIED_ZERO_PAYMENT, CAPITATED_PAYMENT, ADJUSTED_CLAIM, OVERPAYMENT, UNDERPAYMENT, or REVIEW_REQUIRED.

Response semantics

HTTP 200 returns mode SIMULATED_ONLY with `persisted: false` when dryRun is true, or mode SAFE_WRITE_DB_ONLY with `persisted: true` after an organization-scoped update when dryRun is false. The response includes only the derived `eraStatus` and safe workflow flags.

The endpoint does not read Amazon Simple Storage Service (S3), parse a raw X12 835 Electronic Remittance Advice transaction, run optical character recognition (OCR) or large language model (LLM) work, or create denial records.
Missing or zero financial summary inputs can classify as REVIEW_REQUIRED.
A zero paid amount with capitation context classifies before zero-payment denial logic.

Errors and retries

Treat 400 as invalid or unsafe payload shape, 404 as missing or wrong-organization conversion context, and 429 as a backoff signal. Unknown top-level body fields, unknown payload fields, and unknown adjustment fields should be corrected rather than retried unchanged.

400 should be expected for raw835, ocrText, payerPayload, s3Key, or any other undocumented payload fields.
404 can intentionally hide wrong-tenant conversions.
Use dry-run mode before enabling persistence in automated workflows.

Template boundary before examples

The route class, authentication state, tenancy rule, side-effect mode, idempotency status, async behavior, file policy, warnings, links, and evidence above are part of the endpoint contract. Treat generated examples below as internal baseline aids until release evidence closes.

Path parameters

Name	Location	Required	Type	Description	Validation and safety notes
conversionId	path	Yes	string	QuickRCM EOB to ERA conversion identifier from the path.	Minimum length: 1.

Query parameters

This endpoint does not define query parameters.

OpenAPI-declared header parameters

Standard platform header guidance appears in the governance panel. This table only lists operation-specific headers declared in OpenAPI.

This endpoint does not define operation-specific header parameters.

Request body

JSON fields from the generated OpenAPI schema with pilot enrichment applied where available. Nested object fields are shown with dotted paths.

Name	Location	Required	Type	Description	Validation and safety notes
dryRun	body	No	boolean	Defaults to true for classification. When true, returns the derived ERA status without persisting it.	Default: true.
payload	body	Yes	object	Strict safe Electronic Remittance Advice (ERA) summary object. Raw X12 835 Electronic Remittance Advice transaction content, optical character recognition (OCR) text, payer payloads, Amazon Simple Storage Service (S3) keys, and unknown fields are not accepted.	Sensitive credential or storage-adjacent value; use placeholders only.
payload.paidAmount	body	No	number	Amount paid by the payer in the summarized ERA data.	Financial value; preserve decimal precision and avoid real account details.
payload.allowedAmount	body	No	number	Allowed amount used by the classifier to compare payment coverage.	Financial value; preserve decimal precision and avoid real account details.
payload.patientResponsibility	body	No	number	Patient responsibility amount included in total received for classification.	Potential PHI; use synthetic examples and avoid logging raw values.
payload.billedAmount	body	No	number	Billed amount used to identify overpayment and adjusted-claim cases.	Financial value; preserve decimal precision and avoid real account details.
payload.expectedContractAmount	body	No	number	Optional expected contracted amount used for underpayment classification.	Financial value; preserve decimal precision and avoid real account details.
payload.adjustments	body	No	object[]	Optional array of safe adjustment summaries; maximum 100 entries.	OpenAPI does not declare additional validation metadata.
payload.adjustments[].groupCode	body	No	string	Adjustment group code such as a contractual or payer-responsibility grouping.	Minimum length: 1. Maximum length: 10.
payload.adjustments[].reasonCode	body	No	string	Adjustment reason code or CARC-like reason value in the safe summary.	Minimum length: 1. Maximum length: 20.
payload.adjustments[].amount	body	No	number	Adjustment amount for a safe adjustment summary entry.	Financial value; preserve decimal precision and avoid real account details.
payload.carcCodes	body	No	string[]	Optional array of CARC code strings used by classification rules; maximum 100 entries.	OpenAPI does not declare additional validation metadata.
payload.capitationFlag	body	No	boolean	Optional boolean indicating capitation context. CARC code 24 also indicates capitation context in the classifier.	OpenAPI does not declare additional validation metadata.

Generated request example

Generated examples are baseline contract aids only. They are not external publication evidence and must not include real PHI, credentials, raw vendor payloads, raw EDI, transcripts, storage keys, or signed URLs.

{
  "dryRun": true,
  "payload": {
    "paidAmount": 125.5,
    "allowedAmount": 125.5,
    "patientResponsibility": 0,
    "billedAmount": 125.5,
    "adjustments": [],
    "carcCodes": []
  }
}

Successful responses

Generated response examples show the baseline OpenAPI contract. Tenant identifier echo, PHI redaction, pagination, money, date/time, and enum semantics remain endpoint-specific publication checks.

200

Classification result for the supplied safe summary.

Generated from the OpenAPI response schema.

{
  "success": true,
  "data": {
    "mode": "SIMULATED_ONLY",
    "conversionId": "eob_job_example_1",
    "eraStatus": "PAID_IN_FULL",
    "persisted": false,
    "simulated": true
  },
  "meta": {
    "organizationId": "org_example_1"
  }
}

Error responses

Errors must remain sanitized. Do not include raw payer, EHR, SFTP, SMTP, Stripe, LLM/OCR, browser automation, file, transcript, EDI, worker, or vendor payloads.

400

Invalid request parameters.