Denial Management

Create denial appeal draft

Creates a local draft appeal for an organization-owned denial case, or returns the existing draft appeal for that case.

POSTNeeds publication reviewLocal writeDenial ManagementoperationId: createDenialAppealhttps://dev-api.quickintell.com/api/v1/denial-management/cases/{denialCaseId}/appeals

Needs publication reviewLocal writeClaims and denials

Route status

Needs publication review

The endpoint contract is visible, but QuickRCM has not approved it yet for normal production API use.

Publication status

Needs publication review

Requires product, security/compliance, tenancy, side-effect, or module-owner approval before production public API use. 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 claims and denials contract generated for POST /api/v1/denial-management/cases/{denialCaseId}/appeals. External use still depends on route classification, release evidence, and endpoint-specific side-effect approval.

What this does now

Shows the generated OpenAPI shape for POST /api/v1/denial-management/cases/{denialCaseId}/appeals, but keeps the route out of ordinary production API positioning until review is complete.

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

Do not publish this endpoint as an ordinary developer API until its unresolved decisions are closed.

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

This endpoint needs explicit product, security/compliance, tenancy, or side-effect approval before publication.
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	Needs publication review 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.

Denial Management public API.

Denial Management APIs expose organization-scoped denial case read models, local denial workflow writes, remittance association, draft appeal creation, denial queue routing configuration, explicit case rerouting, and safe document-extraction validation. The bearer API key selects the organization. Public requests should not send `organizationId` as a tenant selector. Read endpoints accept Denial Management read or write scope; mutation endpoints require Denial Management write scope. Referenced denial cases, queues, queue rules, remittances, draft appeals, users, and optional case links must resolve inside the authenticated organization. These endpoints operate on QuickRCM local workflow state. They do not submit appeals to payers, run OCR or LLM extraction, upload files, parse ERA payloads, post payments, adjudicate claims, call clearinghouses, or guarantee denial recovery. Use synthetic examples and keep notes, rule metadata, letter HTML, filenames, and search/filter values free of real PHI, raw EDI, payer portal credentials, tokens, S3 keys, transcripts, and vendor payloads. Iteration 2 adds complete queue-rule action and condition field semantics, common response-field glossary coverage, and PHI-safe synthetic request/response examples for all 10 Denial Management operations.

What this endpoint does

Use case

Use this when a denial case is ready for appeal preparation and the integration needs a QuickRCM draft appeal record before staff review, document gathering, letter editing, or downstream appeal submission handled elsewhere.

Before calling

Authenticate with `denial-management:write`. Confirm the denial case belongs to the tenant and decide whether optional `letterHtml` should seed or update the draft appeal content.

Request and response behavior

Request guidance

`letterHtml` is optional and capped at 100000 characters. If a draft appeal already exists, the current handler returns 200 with `idempotencyStatus: existing`; when `letterHtml` is supplied and the delegate supports `updateMany`, it updates the existing draft letter HTML before returning the existing draft summary.

Use `denialCaseId` from a trusted Denial Management response.
Keep `letterHtml` sanitized; do not include real PHI in examples, credentials, raw EDI, or raw payer portal content.
This endpoint does not expose appeal level selection in the public request body.

Response semantics

A 201 response means a local DRAFT appeal was created with level `LEVEL_1_RECONSIDERATION`; a 200 response means an existing DRAFT appeal was returned. Neither response submits an appeal, sends attachments, contacts a payer, or guarantees recovery.

`idempotencyStatus` is `created` for new drafts and `existing` when a draft already exists.
Returned appeal fields are limited to id, organizationId, denialCaseId, claimId, level, and status.
External appeal submission is outside this endpoint.

Errors and retries

Treat 404 as missing or wrong-tenant denial case context. After a timeout, call the endpoint or read local appeal state before creating other appeal records; the handler is draft-aware but does not expose a request idempotency key.

400 can indicate invalid body shape or overlong letterHtml.
404 means the denial case was not found for the authenticated organization.
Retry cautiously after checking for an existing draft.

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
denialCaseId	path	Yes	string	QuickRCM DenialCase identifier used to create or find a local draft appeal.	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
letterHtml	body	No	string	Optional HTML content to store on the local draft appeal. Keep examples synthetic and do not include credentials or raw payer payloads.	Maximum length: 100000. Sensitive credential or storage-adjacent value; use placeholders only.

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.

{
  "letterHtml": "example-letterhtml"
}

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

Existing draft appeal returned

Generated from the OpenAPI response schema.

{
  "success": true,
  "data": {
    "appeal": {
      "id": "00000000-0000-4000-8000-000000000001",
      "organizationId": "00000000-0000-4000-8000-000000000001",
      "denialCaseId": "00000000-0000-4000-8000-000000000001",
      "claimId": "00000000-0000-4000-8000-000000000001",
      "level": "example-level",
      "status": "active"
    },
    "idempotencyStatus": "created"
  },
  "meta": {
    "organizationId": "00000000-0000-4000-8000-000000000001"
  }
}

201

Draft appeal created

Generated from the OpenAPI response schema.

{
  "success": true,
  "data": {
    "appeal": {
      "id": "00000000-0000-4000-8000-000000000001",
      "organizationId": "00000000-0000-4000-8000-000000000001",
      "denialCaseId": "00000000-0000-4000-8000-000000000001",
      "claimId": "00000000-0000-4000-8000-000000000001",
      "level": "example-level",
      "status": "active"
    },
    "idempotencyStatus": "created"
  },
  "meta": {
    "organizationId": "00000000-0000-4000-8000-000000000001"
  }
}

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