Risk Adjustment

Create risk adjustment job

Validates a patient-document pair and creates a queued risk adjustment job for the authenticated organization when not running validation only.

POSTPublic reference baselineFile or artifactRisk AdjustmentoperationId: createRiskAdjustmentJobhttps://dev-api.quickintell.com/api/v1/risk-adjustment/jobs

Public reference baselineFile or artifactPrior auth and clinical

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, E3 async and idempotency policy, and E4 file and artifact governance 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

File or artifact

Touches documents, reports, transcripts, PDFs, EDI, or generated artifacts. Metadata is safer than raw content.

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 prior auth and clinical contract generated for POST /api/v1/risk-adjustment/jobs. 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/risk-adjustment/jobs contract as a file or artifact 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	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	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	Potential file or artifact	Documents, PDFs, reports, transcripts, EDI, OCR, or generated artifacts need E4 classification before public examples.
Ownership and storage keys	Evidence required	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

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.
File and artifact examples must stay metadata-only until scanning, retention, ownership, and URL policy are approved.

Related platform rules

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

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.

Risk Adjustment public API.

Risk Adjustment APIs expose organization-scoped job workflow controls for patient-document risk adjustment processing and human review of Hierarchical Condition Category (HCC) code results. HCC outputs contribute to Risk Adjustment Factor (RAF) score fields, but the bearer API key selects the organization; public callers should not send an `organizationId` selector in these requests. All referenced jobs, patients, files, appointments, and HCC code review targets must belong to the authenticated organization. The public surface is job-oriented and asynchronous. Create, bulk-create, and reprocess endpoints validate local QuickRCM references and either return validation output or queue local work; the OpenAPI descriptions state that public callers do not directly invoke optical character recognition (OCR) or artificial intelligence (AI) processing. Read endpoints return sanitized job summaries, HCC result summaries, and a limited patient-summary object. They do not expose raw document chunks, raw evidence text, clinical note text, transcripts, raw electronic health record (EHR) payloads, raw payer payloads, signed storage URLs, review notes, protected health information (PHI) beyond the minimum documented identifiers, or raw electronic data interchange (EDI) payloads. These endpoints do not submit diagnoses to the Centers for Medicare & Medicaid Services (CMS), send Risk Adjustment Processing System (RAPS) files, send Encounter Data Processing System (EDPS) files, adjudicate claims, update a payer portal, write back to an EHR, or certify final RAF/HCC accuracy. Use `reviewRiskAdjustmentHccCode` only to record a human decision for one HCC code. Treat `finalizedRafScore` and review fields as downstream workflow inputs only when the job state actually includes them and required review has completed. Diagnosis code fields use International Classification of Diseases, 10th Revision (ICD-10) code values where the response schema names them.

What this endpoint does

Use case

Use this after an integration has uploaded or selected an organization-owned QuickRCM File that contains clinical-document evidence for an organization-owned QuickRCM Patient.

Before calling

Authenticate with `risk-adjustment:write`. Resolve `patientId` and `fileId` from QuickRCM records in the same tenant. Include `appointmentId` only when the document should be linked to a known QuickRCM appointment. Use `validateOnly: true` first when checking references, permissions, and estimated credits before queueing.

Request and response behavior

Request guidance

`patientId` and `fileId` are required non-empty strings. `appointmentId`, `validateOnly`, `queueOnly`, and `idempotencyKey` are optional. `queueOnly` defaults to true; for non-validation requests, public processing is queue-only and `queueOnly: false` should be treated as invalid. Do not include raw document contents, transcripts, payer payloads, S3 keys, presigned URLs, or EHR payloads in the request body.

`patientId` and `fileId` must refer to QuickRCM records in the API key organization.
`appointmentId` is optional because the risk adjustment job workflow can exist without the appointment hub link.
`idempotencyKey` is exposed by the schema and capped at 200 characters, but public docs should not promise server-side deduplication behavior beyond the contract.

Response semantics

HTTP 200 means the request was validated without queueing. HTTP 202 means a local risk adjustment job was created and queued for processing. The queued response returns the local job summary but does not mean completed risk scoring, human review completion, CMS submission, payer acceptance, claim adjudication, or EHR write-back.

Use the HTTP status code and `queued` flag together to distinguish validation from queued work.
A queued job starts with local workflow state such as `PENDING` and `Queued for processing`.
`estimatedCredits` appears in validation output; queued responses may omit it.

Errors and retries

Fix 400 validation failures before retrying. A 402 means insufficient credits for the estimated workflow. A 404 can mean the patient, file, or appointment was not found in the authenticated organization. A 409 indicates an active same-tenant job already exists for the patient/file pair; the duplicate check excludes only FAILED and CANCELLED jobs. If a network timeout occurs after a non-validation request, check for an existing job before creating another one, even when an `idempotencyKey` was supplied.

400 can indicate missing required IDs, invalid safety flags, or an overlong `idempotencyKey`.
402 is declared for insufficient credits.
409 should be surfaced as an existing active workflow rather than retried blindly.

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
patientId	body	Yes	string	Required QuickRCM patient identifier in the authenticated organization.	Minimum length: 1. Potential PHI; use synthetic examples and avoid logging raw values.
fileId	body	Yes	string	Required QuickRCM file identifier for the clinical-document evidence to process.	Minimum length: 1. Potential PHI; use synthetic examples and avoid logging raw values.
appointmentId	body	No	string	Optional QuickRCM appointment identifier to link the job to encounter context.	Minimum length: 1.
validateOnly	body	No	boolean	When true, validates the request and returns validation output without queueing a job.	Default: false.
queueOnly	body	No	boolean	Safety flag that defaults to true. Non-validation public requests queue local workflow work instead of directly invoking OCR or AI processing.	Default: true.
idempotencyKey	body	No	string	Optional caller-provided key capped at 200 characters. Do not document stronger deduplication guarantees than the OpenAPI contract provides.	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.

{
  "patientId": "00000000-0000-4000-8000-000000000001",
  "fileId": "00000000-0000-4000-8000-000000000001",
  "appointmentId": "00000000-0000-4000-8000-000000000001",
  "validateOnly": false,
  "queueOnly": true,
  "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.

200

Risk adjustment job request validated without queueing.

Generated from the OpenAPI response schema.

{
  "success": true,
  "data": {
    "queued": true,
    "queueOnly": true,
    "valid": true,
    "estimatedCredits": 1,
    "job": {
      "id": "00000000-0000-4000-8000-000000000001",
      "organizationId": "00000000-0000-4000-8000-000000000001",
      "patientId": "00000000-0000-4000-8000-000000000001",
      "fileId": "00000000-0000-4000-8000-000000000001",
      "appointmentId": "00000000-0000-4000-8000-000000000001",
      "status": "PENDING",
      "currentStage": "example-currentstage",
      "progress": 1,
      "totalPages": 1,
      "totalChunks": 1,
      "relevantChunks": 1,
      "tier1AcceptedChunks": 1,
      "tier2EscalatedChunks": 1,
      "discardedChunks": 1,
      "totalConditions": 1,
      "confirmedHccCodes": 1,
      "rafScore": 1.25,
      "totalCostUsd": 1,
      "creditsCost": 1,
      "requiresHumanReview": true,
      "humanReviewCompleted": true,
      "finalizedRafScore": 1.25,
      "startedAt": "2026-06-08T10:15:30Z",
      "completedAt": "2026-06-08T10:15:30Z",
      "createdAt": "2026-06-08T10:15:30Z",
      "updatedAt": "2026-06-08T10:15:30Z"
    }
  },
  "meta": {
    "organizationId": "00000000-0000-4000-8000-000000000001"
  }
}

202

Risk adjustment job created and queued for processing.

Generated from the OpenAPI response schema.

{
  "success": true,
  "data": {
    "queued": true,
    "queueOnly": true,
    "valid": true,
    "estimatedCredits": 1,
    "job": {
      "id": "00000000-0000-4000-8000-000000000001",
      "organizationId": "00000000-0000-4000-8000-000000000001",
      "patientId": "00000000-0000-4000-8000-000000000001",
      "fileId": "00000000-0000-4000-8000-000000000001",
      "appointmentId": "00000000-0000-4000-8000-000000000001",
      "status": "PENDING",
      "currentStage": "example-currentstage",
      "progress": 1,
      "totalPages": 1,
      "totalChunks": 1,
      "relevantChunks": 1,
      "tier1AcceptedChunks": 1,
      "tier2EscalatedChunks": 1,
      "discardedChunks": 1,
      "totalConditions": 1,
      "confirmedHccCodes": 1,
      "rafScore": 1.25,
      "totalCostUsd": 1,
      "creditsCost": 1,
      "requiresHumanReview": true,
      "humanReviewCompleted": true,
      "finalizedRafScore": 1.25,
      "startedAt": "2026-06-08T10:15:30Z",
      "completedAt": "2026-06-08T10:15:30Z",
      "createdAt": "2026-06-08T10:15:30Z",
      "updatedAt": "2026-06-08T10:15:30Z"
    }
  },
  "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.