Revenue Integrity

Create a charge reconciliation session

Creates a local charge reconciliation session and explicit source procedure items after validating the facility and each patient belongs to the authenticated organization.

POSTNeeds publication reviewPayment or creditRevenue IntegrityoperationId: createRevenueIntegrityChargeReconciliationhttps://dev-api.quickintell.com/api/v1/revenue-integrity/charge-reconciliations

Needs publication reviewPayment or creditRevenue integrity

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

Payment or credit

May affect payments, credits, refunds, voids, or financial posting. Requires explicit product approval before publication.

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 revenue integrity contract generated for POST /api/v1/revenue-integrity/charge-reconciliations. 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/revenue-integrity/charge-reconciliations, 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Do not publish this endpoint as an ordinary developer API until its unresolved decisions are closed.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	Request body exposes an endpoint-specific idempotencyKey compatibility field.	Retry only with the documented key location and after checking endpoint state; 409 behavior and retention still need release evidence.
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.

Revenue Integrity public API.

Revenue Integrity APIs expose organization-scoped controls for dashboard metrics, underpayment recovery case lists, charge reconciliation, charge lag reporting, charge capture audits, operating room reconciliation, coding validation, contract rate validation, implant recovery tracking, underpayment appeal tracking, recovery recording, contract setup, and manual underpayment checks. The bearer API key selects the organization. Public callers should not send an `organizationId` selector in these requests. Read endpoints accept `revenue-integrity:read` or `revenue-integrity:write`; write endpoints require `revenue-integrity:write`. Referenced claims, patients, facilities, billing encounters, payer configurations, contracts, charge reconciliation sessions, charge reconciliation items, and underpayment cases must belong to the authenticated organization. This public surface is conservative. Some endpoints create or update local Revenue Integrity records. Other endpoints return `202 Accepted` for queued, validated, or dry-run local workflows. Those responses do not mean QuickRCM made a direct payer call, contacted a payer portal, submitted an appeal externally, changed an Electronic Health Record (EHR), posted cash, adjudicated a claim, or received a payer decision. Use synthetic examples and keep notes, descriptions, invoice identifiers, source record identifiers, and appeal references free of unnecessary Protected Health Information (PHI), raw Electronic Data Interchange (EDI), raw Electronic Remittance Advice (ERA), payer payloads, transcripts, credentials, tokens, S3 keys, and payer portal secrets. Queued workflow controls are consistent across the public Revenue Integrity endpoints that expose them: `validateOnly` validates ownership and request shape without creating a queued workflow; `dryRun` simulates the workflow when `validateOnly` is false; otherwise the API records a queued local workflow request. `queueOnly: false` by itself is not a request for direct payer, clearinghouse, or EHR execution.

What this endpoint does

Use case

Use this endpoint when an external scheduling, procedure, or charge-capture feed needs QuickRCM to compare performed procedures against local charge activity.

Before calling

Authenticate with `revenue-integrity:write`. Resolve `facilityId` and each `patientId` from QuickRCM for the same tenant. Prepare a bounded procedures array with minimum-necessary procedure context.

Request and response behavior

Request guidance

`facilityId`, `dateRangeStart`, `dateRangeEnd`, and at least one procedure are required. `procedures` accepts 1 to 1000 entries. Each procedure requires `patientId`, `procedureDate`, and `procedureDesc`; `procedureCode`, `encounterId`, performing provider, room, source system, and source record id are optional.

`dateRangeStart`, `dateRangeEnd`, and `procedureDate` must be ISO datetimes.
`departmentCode` and `departmentName` are optional labels for the reconciliation session and should identify the source department without embedding PHI.
Avoid embedding raw Electronic Health Record responses, operative transcripts, or payer payloads in source fields.

Response semantics

HTTP 201 returns a local session id when available, status `IN_PROGRESS`, mode `created`, and `meta.organizationId`. Created items start as local pending reconciliation items. No claim correction, payer submission, or external charge posting occurs.

`mode` is `created` on success.
The response does not include the created item list.
Downstream discrepancy resolution is handled by `resolveRevenueIntegrityChargeReconciliationItem`.

Errors and retries

Fix validation errors before retrying. A 404 can mean the facility or a patient did not resolve in the authenticated organization. The API accepts `idempotencyKey` but does not guarantee duplicate suppression, so check local sessions before recreating after a timeout.

404 can indicate wrong-tenant facility or patient identifiers.
Duplicate sessions are possible if a caller retries a timed-out request without checking local state.

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
facilityId	body	Yes	string	Required QuickRCM facility identifier scoped to the API-key organization.	Minimum length: 1.
dateRangeStart	body	Yes	string (date-time)	Required ISO datetime lower bound for the reconciliation window.	Format: date-time.
dateRangeEnd	body	Yes	string (date-time)	Required ISO datetime upper bound for the reconciliation window; it should be on or after `dateRangeStart`.	Format: date-time.
departmentCode	body	No	string	Optional department code, capped at 40 characters, used to label the local session.	Minimum length: 1. Maximum length: 40.
departmentName	body	No	string	Optional department display name, capped at 200 characters, used to label the local session.	Minimum length: 1. Maximum length: 200.
procedures	body	Yes	object[]	Array of performed procedure source entries used to seed local reconciliation items. Minimum 1, maximum 1000.	OpenAPI does not declare additional validation metadata.
procedures[].patientId	body	Yes	string	Required QuickRCM patient identifier for each procedure. It must belong to the same organization.	Minimum length: 1. Potential PHI; use synthetic examples and avoid logging raw values.
procedures[].encounterId	body	No	string	Optional source encounter identifier for the procedure. Use the QuickRCM or source-system reference expected by the integration contract.	Minimum length: 1.
procedures[].procedureDate	body	Yes	string (date-time)	Required ISO datetime for when the procedure was performed.	Format: date-time.
procedures[].procedureCode	body	No	string	Optional procedure code, such as Current Procedural Terminology (CPT), Healthcare Common Procedure Coding System (HCPCS), ICD-10-PCS, or a local code.	Minimum length: 1.
procedures[].procedureDesc	body	Yes	string	Required procedure description for each source procedure. Keep it minimum necessary.	Minimum length: 1.
procedures[].performingProvider	body	No	string	Optional provider display string from the source feed. Avoid unnecessary demographics.	Minimum length: 1.
procedures[].roomNumber	body	No	string	Optional room or location label from the source feed.	Minimum length: 1.
procedures[].sourceSystem	body	No	string	Optional source label for the procedure entry. Use a short integration name, not a raw payload.	Minimum length: 1.
procedures[].sourceRecordId	body	No	string	Optional caller-side correlation identifier. Do not include raw vendor payloads, S3 keys, signed URLs, or secrets.	Minimum length: 1. Sensitive credential or storage-adjacent value; use placeholders only.
idempotencyKey	body	No	string	Optional caller retry marker capped at 200 characters. The public contract does not guarantee server-side duplicate suppression.	Minimum length: 1. Maximum length: 200. Endpoint-specific compatibility key; universal Idempotency-Key header support is not declared.

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.

{
  "facilityId": "00000000-0000-4000-8000-000000000001",
  "dateRangeStart": "2026-06-08T10:15:30Z",
  "dateRangeEnd": "2026-06-08T10:15:30Z",
  "procedures": [
    {
      "patientId": "00000000-0000-4000-8000-000000000001",
      "procedureDate": "2026-06-08T10:15:30Z",
      "procedureDesc": "example-proceduredesc",
      "encounterId": "00000000-0000-4000-8000-000000000001",
      "procedureCode": "example-procedurecode",
      "performingProvider": "example-performingprovider",
      "roomNumber": "example-roomnumber",
      "sourceSystem": "example-sourcesystem",
      "sourceRecordId": "00000000-0000-4000-8000-000000000001"
    }
  ],
  "departmentCode": "example-departmentcode",
  "departmentName": "Example revenue_integrity_charge_reconciliation",
  "idempotencyKey": "example-idempotencykey"
}

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

Charge reconciliation session created.

Generated from the OpenAPI response schema.

{
  "success": true,
  "data": {
    "id": "00000000-0000-4000-8000-000000000001",
    "status": "active",
    "mode": "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 parameters.