Denial Management

Create denial queue rule

Creates a local Denial Management routing rule after validating that the target queue and any action references belong to the authenticated organization.

POSTNeeds publication reviewLocal writeDenial ManagementoperationId: createDenialQueueRulehttps://dev-api.quickintell.com/api/v1/denial-management/queue-rules

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/queue-rules. 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/queue-rules, 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Do not publish this endpoint as an ordinary developer API until its unresolved decisions are closed.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	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

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 configuring how future or manually evaluated denial cases should be routed by category, severity, payer, code, dollar range, age, facility, deadline, or other documented rule conditions.

Before calling

Authenticate with `denial-management:write`. Retrieve queue identifiers with listDenialQueueRules, and confirm any `assignToUserId` or `notifyUserIds` are active organization members.

Request and response behavior

Request guidance

`queueId` and `name` are required. Top-level `priority` is an integer sort order from 0 through 10000 and defaults to 100. `isActive` defaults to true, `conditions` defaults to an empty object, and `actions` defaults to `{ "queueId": body.queueId }` when omitted. If `actions` is provided, its `queueId` is required by the create schema. The schema allows pass-through keys, but public docs should emphasize documented fields and avoid relying on extra keys.

`name` is capped at 255 characters and `description` at 2000 characters.
Top-level `priority` is numeric rule ordering. Nested `actions.priority` is a string action label capped at 64 characters.
Keep rule names, descriptions, tags, and pattern values free of PHI, credentials, and raw payer payloads.

Response semantics

A 201 response returns the created local routing rule and `meta.organizationId`. This creates configuration only; it does not automatically reroute existing denial cases or contact external systems.

The returned rule stores local conditions and actions JSON.
Rule creation does not run the routing engine against existing cases.
`meta.organizationId` is derived from the API key.

Errors and retries

A 404 can mean the main queueId, actions.queueId, assignToUserId, or notifyUserIds cannot be resolved in the authenticated organization. After a timeout, list queue rules before retrying to avoid duplicate rule names or priorities.

400 can indicate missing required fields, invalid enum values, or out-of-range numeric fields.
404 can indicate referenced queues or users are unavailable to the tenant.
Retry only after checking whether the rule was already created.

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
queueId	body	Yes	string	Required Denial Management queue identifier. The queue must belong to the authenticated organization.	Minimum length: 1.
name	body	Yes	string	Required routing rule name, capped at 255 characters. Keep it operational and PHI-minimal.	Minimum length: 1. Maximum length: 255.
description	body	No	string	Optional routing rule description, nullable and capped at 2000 characters.	Maximum length: 2000.
priority	body	No	integer	Optional top-level rule ordering integer from 0 through 10000. Lower values sort earlier in the current list handler.	Minimum value: 0. Maximum value: 10000.
isActive	body	No	boolean	Optional flag indicating whether the rule is active. Defaults to true on create.	OpenAPI does not declare additional validation metadata.
conditions	body	No	object	Optional structured matching criteria for denial routing. Defaults to an empty object.	Default: [object Object].
conditions.denialCategories	body	No	ELIGIBILITY \| AUTHORIZATION \| CODING \| MEDICAL_NECESSITY \| TIMELY_FILING \| COB \| BENEFIT_EXHAUSTED \| DUPLICATE \| BUNDLING \| OTHER[]	Optional array of denial category enum values to match.	OpenAPI does not declare additional validation metadata.
conditions.severities	body	No	LOW \| MEDIUM \| HIGH \| CRITICAL[]	Optional array of denial severity enum values to match.	OpenAPI does not declare additional validation metadata.
conditions.denialTypes	body	No	string[]	Optional array of denial type labels to match. Each string is capped at 128 characters.	OpenAPI does not declare additional validation metadata.
conditions.preventabilityClasses	body	No	string[]	Optional array of preventability classification labels to match. Each string is capped at 128 characters.	OpenAPI does not declare additional validation metadata.
conditions.rootCauseDepartments	body	No	string[]	Optional array of root-cause department labels to match. Each string is capped at 128 characters.	OpenAPI does not declare additional validation metadata.
conditions.payerIds	body	No	string[]	Optional array of payer identifiers to match. Each string is capped at 128 characters.	OpenAPI does not declare additional validation metadata.
conditions.payerNamePatterns	body	No	string[]	Optional payer-name pattern strings, each capped at 255 characters. Avoid storing unnecessary PHI or secrets.	Sensitive credential or storage-adjacent value; use placeholders only.
conditions.cptCodePatterns	body	No	string[]	Optional CPT-code pattern strings, each capped at 64 characters.	OpenAPI does not declare additional validation metadata.
conditions.carcCodes	body	No	string[]	Optional Claim Adjustment Reason Code strings, each capped at 16 characters.	OpenAPI does not declare additional validation metadata.
conditions.dollarRange	body	No	object	Optional minimum/maximum denied-dollar range used in a routing condition.	OpenAPI does not declare additional validation metadata.
conditions.dollarRange.min	body	No	number	Optional minimum denied-dollar threshold for the rule condition. Values are numbers and must be at least 0.	Minimum value: 0.
conditions.dollarRange.max	body	No	number	Optional maximum denied-dollar threshold for the rule condition. Values are numbers and must be at least 0.	Minimum value: 0.
conditions.ageDaysRange	body	No	object	Optional minimum/maximum denial-age range in days used in a routing condition.	OpenAPI does not declare additional validation metadata.
conditions.ageDaysRange.min	body	No	integer	Optional minimum denial age in days. Values are integers and must be at least 0.	Minimum value: 0.
conditions.ageDaysRange.max	body	No	integer	Optional maximum denial age in days. Values are integers and must be at least 0.	Minimum value: 0.
conditions.facilityIds	body	No	string[]	Optional array of organization-scoped facility identifiers. Each string is capped at 128 characters.	OpenAPI does not declare additional validation metadata.
conditions.hasAppealDeadline	body	No	boolean	Optional boolean condition indicating whether a case has an appeal deadline.	OpenAPI does not declare additional validation metadata.
conditions.daysUntilAppealDeadline	body	No	object	Optional minimum/maximum range for days remaining until appeal deadline.	OpenAPI does not declare additional validation metadata.
conditions.daysUntilAppealDeadline.min	body	No	integer	Optional lower bound for days until appeal deadline. Values are integers and must be at least 0.	Minimum value: 0.
conditions.daysUntilAppealDeadline.max	body	No	integer	Optional upper bound for days until appeal deadline. Values are integers and must be at least 0.	Minimum value: 0.
actions	body	No	object	Optional structured routing actions. When omitted, the handler stores an action that routes to the request queueId.	OpenAPI does not declare additional validation metadata.
actions.queueId	body	Yes	string	Required action queue identifier when actions is provided on create. It must belong to the authenticated organization.	Minimum length: 1.
actions.priority	body	No	string	Optional string action priority or label capped at 64 characters. This is not the same field as the top-level numeric rule priority.	Minimum length: 1. Maximum length: 64.
actions.assignToUserId	body	No	string	Optional QuickRCM user identifier capped at 128 characters. The user must be an active member of the authenticated organization.	Minimum length: 1. Maximum length: 128. Potential PHI; use synthetic examples and avoid logging raw values.
actions.assignToRole	body	No	string	Optional role label capped at 128 characters for local assignment logic.	Minimum length: 1. Maximum length: 128.
actions.assignmentMethod	body	No	string	Optional local assignment method label capped at 128 characters.	Minimum length: 1. Maximum length: 128.
actions.slaHours	body	No	integer	Optional positive integer SLA override in hours.	OpenAPI does not declare additional validation metadata.
actions.autoEscalateAfterHours	body	No	integer	Optional positive integer auto-escalation threshold in hours.	OpenAPI does not declare additional validation metadata.
actions.notifyUserIds	body	No	string[]	Optional array of QuickRCM user identifiers. Each user must be an active member of the authenticated organization.	Potential PHI; use synthetic examples and avoid logging raw values.
actions.tags	body	No	string[]	Optional array of local routing tags, each capped at 128 characters.	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.

{
  "queueId": "00000000-0000-4000-8000-000000000001",
  "name": "Example denial_queue_rule",
  "description": "Example denial_queue_rule note",
  "priority": 1,
  "isActive": true,
  "conditions": {},
  "actions": {
    "queueId": "00000000-0000-4000-8000-000000000001",
    "priority": "example-priority",
    "assignToUserId": "00000000-0000-4000-8000-000000000001",
    "assignToRole": "example-assigntorole",
    "assignmentMethod": "example-assignmentmethod",
    "slaHours": 1,
    "autoEscalateAfterHours": 1,
    "notifyUserIds": [
      "example-notifyuserids"
    ],
    "tags": [
      "example-tags"
    ]
  }
}

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.

201

Denial queue rule created

Generated from the OpenAPI response schema.

{
  "success": true,
  "data": {
    "rule": {
      "id": "00000000-0000-4000-8000-000000000001",
      "organizationId": "00000000-0000-4000-8000-000000000001",
      "queueId": "00000000-0000-4000-8000-000000000001",
      "name": "Example denial_queue_rule",
      "description": "Example denial_queue_rule note",
      "priority": 1,
      "isActive": true,
      "conditions": "example-conditions",
      "actions": "example-actions"
    }
  },
  "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