Billing

Create billing encounter

Creates an INGESTED hospital billing encounter for the authenticated organization without running inline AI processing.

POSTPublic reference baselineLocal writeBillingoperationId: createBillingEncounterhttps://dev-api.quickintell.com/api/v1/billing/encounters

Public reference baselineLocal writeBilling and claims

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

Local write

May mutate QuickRCM records. It does not prove live payer, EHR, clearinghouse, payment, or communication execution.

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 billing and claims contract generated for POST /api/v1/billing/encounters. 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/billing/encounters contract as a local write 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	Not indicated by OpenAPI	No generic polling contract is published from this page.
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.

Billing public API.

Billing public API endpoints expose organization-scoped hospital billing encounters, coding review actions, physician query responses, batch imports, and Charge Description Master (CDM) maintenance. The surface is centered on `BillingEncounter` records and related review artifacts: code entries, POA indicators, DRG/E/M summaries, processing logs, physician queries, and CDM rate records. Tenant scope is resolved from the bearer API key. Read endpoints accept `billing:read` or `billing:write`; create, update, queue, finalize, code-edit, physician-response, and CDM mutation endpoints require `billing:write`. Callers should pass QuickRCM identifiers returned by prior reads, imports, or adjacent setup workflows; do not send organization IDs as an authority signal, raw EDI, payer portal credentials, transcripts, S3 keys, signed URLs, full vendor payloads, or unnecessary clinical narrative. The current Billing OpenAPI contract has detailed schemas for reads and queued workflows, but several mutation endpoints still use the generic mutation schema in generated OpenAPI while their handlers return concrete data. Client-facing docs should distinguish generated-schema guarantees from handler-observed runtime response fields, avoid promising unrelated Prisma columns as stable contract, and still recommend a follow-up read after queued workflows or state transitions when downstream processing is asynchronous.

What this endpoint does

Use case

Use this when an upstream EHR, document intake, or billing workflow needs to register an encounter before attaching files, running processing, editing codes, or finalizing.

Before calling

Resolve same-tenant `patientId` and `facilityId`. Optionally resolve appointment, payer configuration, patient insurance, attending provider, and existing file IDs.

Request and response behavior

Request guidance

Send required `patientId`, `facilityId`, `encounterType`, and ISO 8601 `dateOfService`. `fileIds` links existing organization-owned files and is capped at 25. Optional date and reference fields must point to same-tenant QuickRCM records where supplied.

`encounterType` must be INPATIENT, OUTPATIENT, EMERGENCY, or OBSERVATION.
`fileIds` references existing files; this is not a binary upload endpoint.
`appointmentId` is optional because Billing encounters can exist without appointments.
`externalEncounterId` should be an opaque external reference, not a raw EHR payload.

Response semantics

HTTP 201 returns the created encounter detail with status INGESTED, count fields, nullable assignment outputs, processing logs, and any linked source-file count. The generated default 200 mutation response is less specific than the concrete creation response.

New encounters are created with `status: INGESTED`.
`codedEntries`, `drgAssignment`, and `emLevelAssignment` may be empty or null immediately after creation.
Use addBillingEncounterFiles or reprocessBillingEncounter to queue later processing work where appropriate.

Errors and retries

After timeout, search by `externalEncounterId` or list recent encounters before retrying to avoid duplicates. Fix 404s for referenced patients, facilities, appointments, payer configs, insurance records, providers, or files before resubmitting.

After timeout, search by `externalEncounterId` or list recent encounters before retrying to avoid duplicates. Fix 404s for referenced patients, facilities, appointments, payer configs, insurance records, providers, or files before resubmitting.

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

This endpoint does not define path parameters.

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
externalEncounterId	body	No	string	Opaque external or EHR encounter reference stored on a Billing encounter; not a raw EHR payload.	Minimum length: 1. Maximum length: 255.
patientId	body	Yes	string	Required same-tenant QuickRCM patient identifier.	Minimum length: 1. Tenant context is selected by the API key; do not treat this as a public tenant selector.
facilityId	body	Yes	string	Required same-tenant QuickRCM facility identifier.	Minimum length: 1. Tenant context is selected by the API key; do not treat this as a public tenant selector.
encounterType	body	Yes	INPATIENT \| OUTPATIENT \| EMERGENCY \| OBSERVATION	Required hospital billing encounter type.	Enum values are declared in the Type column.
dateOfService	body	Yes	string (date-time)	Required ISO 8601 service date-time.	Format: date-time.
admitDate	body	No	string (date-time)	Optional nullable ISO 8601 admission date-time.	Format: date-time.
dischargeDate	body	No	string (date-time)	Optional nullable ISO 8601 discharge date-time.	Format: date-time. Financial value; preserve decimal precision and avoid real account details.
appointmentId	body	No	string	Nullable QuickRCM appointment identifier linked to the local claim when an appointment exists.	Minimum length: 1.
payerConfigId	body	No	string	QuickRCM payer configuration identifier used for routing, payer metadata, and organization-specific payer settings.	Minimum length: 1.
patientInsuranceId	body	No	string	QuickRCM patient insurance record identifier associated with the patient and claim.	Minimum length: 1. Potential PHI; use synthetic examples and avoid logging raw values.
attendingProviderId	body	No	string	OpenAPI description is missing; publication gap.	Minimum length: 1.
fileIds	body	No	string[]	Existing same-tenant QuickRCM file IDs to connect to the new encounter, maximum 25.	Default: . Tenant context is selected by the API key; do not treat this as a public tenant selector.

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.

{
  "patientId": "00000000-0000-4000-8000-000000000001",
  "facilityId": "00000000-0000-4000-8000-000000000001",
  "encounterType": "INPATIENT",
  "dateOfService": "2026-06-08T10:15:30Z",
  "externalEncounterId": "00000000-0000-4000-8000-000000000001",
  "admitDate": "2026-06-08T10:15:30Z",
  "dischargeDate": "2026-06-08T10:15:30Z",
  "appointmentId": "00000000-0000-4000-8000-000000000001",
  "payerConfigId": "00000000-0000-4000-8000-000000000001",
  "patientInsuranceId": "00000000-0000-4000-8000-000000000001",
  "attendingProviderId": "00000000-0000-4000-8000-000000000001",
  "fileIds": []
}

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

Billing public API operation completed.

Generated from the OpenAPI response schema.

{
  "success": true,
  "data": {}
}

201

Billing encounter created.

Generated from the OpenAPI response schema.

{
  "success": true,
  "data": {
    "id": "00000000-0000-4000-8000-000000000001",
    "organizationId": "00000000-0000-4000-8000-000000000001",
    "externalEncounterId": "00000000-0000-4000-8000-000000000001",
    "patientId": "00000000-0000-4000-8000-000000000001",
    "facilityId": "00000000-0000-4000-8000-000000000001",
    "encounterType": "INPATIENT",
    "dateOfService": "2026-06-08T10:15:30Z",
    "admitDate": "2026-06-08T10:15:30Z",
    "dischargeDate": "2026-06-08T10:15:30Z",
    "status": "INGESTED",
    "routingDecision": "FAST",
    "overallConfidence": 1.25,
    "overallComplexityScore": 1,
    "totalPages": 1,
    "totalTokensUsed": 1,
    "totalCostCents": 1,
    "codedEntriesCount": 1,
    "physicianQueriesCount": 1,
    "sourceFilesCount": 1,
    "claimId": "00000000-0000-4000-8000-000000000001",
    "createdAt": "2026-06-08T10:15:30Z",
    "updatedAt": "2026-06-08T10:15:30Z",
    "codedEntries": [
      {
        "id": "00000000-0000-4000-8000-000000000001",
        "codeType": "ICD10_CM",
        "code": "ERROR",
        "description": "Example billing_encounter note",
        "isPrincipal": true,
        "sequenceNumber": 1,
        "modifiers": [
          "example-modifiers"
        ],
        "confidence": 1.25,
        "assignedBy": "TIER1",
        "medicalNecessityStatus": "VERIFIED",
        "ncciStatus": "PASSED"
      }
    ],
    "drgAssignment": {
      "drgCode": "example-drgcode",
      "description": "Example billing_encounter note",
      "mdc": "example-mdc",
      "weight": 1.25,
      "confidence": 1.25
    },
    "emLevelAssignment": {
      "emCode": "example-emcode",
      "mdmComplexity": "example-mdmcomplexity",
      "confidence": 1.25,
      "assignedBy": "TIER1",
      "humanOverride": true
    },
    "processingLogs": [
      {
        "id": "00000000-0000-4000-8000-000000000001",
        "step": "example-step",
        "status": "active",
        "createdAt": "2026-06-08T10:15:30Z"
      }
    ]
  }
}

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.