Enhanced claim status

Start enhanced claim status search

Requires claim-status:write scope. Idempotency-Key is optional. If omitted, every submission creates a fresh inquiry with a generated UUID returned as idempotencyKey. Reuse the returned or supplied key for retries of the same request. The latest published mappingProfileId version is pinned at creation.

POSTNeeds publication reviewExternal or credentialedEnhanced claim statusoperationId: createEnhancedStatusApihttps://dev-api.quickintell.com/api/v1/claim-status/inquiries

Needs publication reviewExternal or credentialedUnclassified

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, E3 async and idempotency policy, and E7 credential, webhook, and vendor trust 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

External or credentialed

May touch credentials, webhooks, SFTP, EHRs, payers, portals, clearinghouses, or other external systems.

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 unclassified contract generated for POST /api/v1/claim-status/inquiries. 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/claim-status/inquiries, 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Do not publish this endpoint as an ordinary developer API until its unresolved decisions are closed.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	202	Treat the response as accepted or queued work, not completed workflow execution.
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	Possible	Queued work may later cause local or external effects only where endpoint evidence says so.

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.
HTTP 202 or queued behavior requires endpoint-specific polling, terminal-state, retry, and retention guidance.
Universal Idempotency-Key header support is not declared; retry only after checking endpoint-specific state.
External or credentialed behavior needs vendor trust, credential, webhook, and callback evidence before publication.

Related platform rules

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

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.

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
source	body	Yes	standalone	Short source label for an ADR document reference. Do not place credentials, signed URLs, raw payloads, or storage keys in this field.	Enum values are declared in the Type column. Sensitive credential or storage-adjacent value; use placeholders only.
enrichment	body	No	auto \| none \| required	OpenAPI description is missing; publication gap.	Enum values are declared in the Type column. Default: auto.
mappingProfileId	body	No	string	OpenAPI description is missing; publication gap.	Minimum length: 1. Maximum length: 128. File, artifact, or raw-payload adjacent; keep examples metadata-only.
payerId	body	Yes	string	QuickRCM payer configuration identifier used as a filter in Appeals public APIs.	Minimum length: 1. Maximum length: 128.
provider	body	Yes	object	Rendering, billing, or service provider context. Provider identifiers can be sensitive and must be scoped to the organization.	OpenAPI does not declare additional validation metadata.
provider.npi	body	Yes	string	National Provider Identifier. Use a valid 10-digit provider NPI when the payer workflow requires provider identity.	Pattern constraint declared in OpenAPI.
provider.taxId	body	No	string	Provider or organization tax identifier. Treat as sensitive and use placeholders in examples.	Pattern constraint declared in OpenAPI.
provider.organizationName	body	Yes	string	OpenAPI description is missing; publication gap.	Minimum length: 1. Maximum length: 128.
subscriber	body	Yes	object	Insurance subscriber context. Treat nested subscriber values as PHI.	Potential PHI; use synthetic examples and avoid logging raw values.
subscriber.memberId	body	Yes	string	Coverage member/subscriber identifier. Treat as sensitive patient coverage data.	Minimum length: 1. Maximum length: 128. Potential PHI; use synthetic examples and avoid logging raw values.
subscriber.firstName	body	Yes	string	Person first name. Treat as PHI when the person is a patient, subscriber, or contact tied to a patient account.	Minimum length: 1. Maximum length: 128. Potential PHI; use synthetic examples and avoid logging raw values.
subscriber.lastName	body	Yes	string	Person last name. Treat as PHI when the person is a patient, subscriber, or contact tied to a patient account.	Minimum length: 1. Maximum length: 128. Potential PHI; use synthetic examples and avoid logging raw values.
patient	body	Yes	object	Patient demographic context. Treat nested patient values as PHI and use synthetic examples only.	Potential PHI; use synthetic examples and avoid logging raw values.
patient.sameAsSubscriber	body	Yes	boolean	OpenAPI description is missing; publication gap.	Potential PHI; use synthetic examples and avoid logging raw values.
patient.firstName	body	No	string	Person first name. Treat as PHI when the person is a patient, subscriber, or contact tied to a patient account.	Minimum length: 1. Maximum length: 128. Potential PHI; use synthetic examples and avoid logging raw values.
patient.lastName	body	No	string	Person last name. Treat as PHI when the person is a patient, subscriber, or contact tied to a patient account.	Minimum length: 1. Maximum length: 128. Potential PHI; use synthetic examples and avoid logging raw values.
patient.memberId	body	No	string	Coverage member/subscriber identifier. Treat as sensitive patient coverage data.	Minimum length: 1. Maximum length: 128. Potential PHI; use synthetic examples and avoid logging raw values.
patient.birthDate	body	Yes	string	OpenAPI description is missing; publication gap.	Pattern constraint declared in OpenAPI. Potential PHI; use synthetic examples and avoid logging raw values.
serviceDates	body	Yes	object	OpenAPI description is missing; publication gap.	OpenAPI does not declare additional validation metadata.
serviceDates.from	body	Yes	string	OpenAPI description is missing; publication gap.	Pattern constraint declared in OpenAPI.
serviceDates.to	body	Yes	string	OpenAPI description is missing; publication gap.	Pattern constraint declared in OpenAPI.
claimNumber	body	No	string	Human-facing or payer-facing claim number used for reconciliation. It is not always the same as QuickRCM claimId.	Minimum length: 1. Maximum length: 128.
claimAmount	body	No	string	OpenAPI description is missing; publication gap.	Pattern constraint declared in OpenAPI. Financial value; preserve decimal precision and avoid real account details.
source	body	Yes	existing_claim	Short source label for an ADR document reference. Do not place credentials, signed URLs, raw payloads, or storage keys in this field.	Enum values are declared in the Type column. Sensitive credential or storage-adjacent value; use placeholders only.
enrichment	body	No	auto \| none \| required	OpenAPI description is missing; publication gap.	Enum values are declared in the Type column. Default: auto.
mappingProfileId	body	No	string	OpenAPI description is missing; publication gap.	Minimum length: 1. Maximum length: 128. File, artifact, or raw-payload adjacent; keep examples metadata-only.
claimId	body	Yes	string	QuickRCM claim identifier. The claim must belong to the organization selected by the bearer API key.	Minimum length: 1. Maximum length: 128. Sensitive credential or storage-adjacent value; use placeholders only.
subscriber	body	No	object	Insurance subscriber context. Treat nested subscriber values as PHI.	Potential PHI; use synthetic examples and avoid logging raw values.
subscriber.memberId	body	Yes	string	Coverage member/subscriber identifier. Treat as sensitive patient coverage data.	Minimum length: 1. Maximum length: 128. Potential PHI; use synthetic examples and avoid logging raw values.
subscriber.firstName	body	Yes	string	Person first name. Treat as PHI when the person is a patient, subscriber, or contact tied to a patient account.	Minimum length: 1. Maximum length: 128. Potential PHI; use synthetic examples and avoid logging raw values.
subscriber.lastName	body	Yes	string	Person last name. Treat as PHI when the person is a patient, subscriber, or contact tied to a patient account.	Minimum length: 1. Maximum length: 128. Potential PHI; use synthetic examples and avoid logging raw values.

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.

{
  "source": "standalone",
  "payerId": "87726",
  "provider": {
    "npi": "1234567893",
    "organizationName": "Example enhanced_status_api",
    "taxId": "12-3456789"
  },
  "subscriber": {
    "memberId": "W123456789",
    "firstName": "John",
    "lastName": "Smith"
  },
  "patient": {
    "sameAsSubscriber": true,
    "birthDate": "1984-03-22",
    "firstName": "John",
    "lastName": "Smith",
    "memberId": "W123456789"
  },
  "serviceDates": {
    "from": "example-from",
    "to": "example-to"
  },
  "enrichment": "auto",
  "mappingProfileId": "00000000-0000-4000-8000-000000000001",
  "claimNumber": "example-claimnumber",
  "claimAmount": "example-claimamount"
}

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.

202

Inquiry accepted or idempotently returned. Poll resultUrl; acceptance does not mean payer success.

Generated from the OpenAPI response schema.

{
  "inquiryId": "00000000-0000-4000-8000-000000000001",
  "idempotencyKey": "example-idempotencykey",
  "processingState": "example-processingstate",
  "mappingProfileVersion": 1,
  "resultUrl": "https://example.quickintell.com/resource"
}

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: invalid body, query, or invalid supplied Idempotency-Key