Contract Management

Detect underpayments

Runs an organization-scoped local scan of paid claims for potential underpayment cases, using `dryRun` by default.

POSTNeeds publication reviewValidate or simulateContract ManagementoperationId: detectContractManagementUnderpaymentshttps://dev-api.quickintell.com/api/v1/contract-management/underpayments/detect

Needs publication reviewValidate or simulateRevenue 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

Validate or simulate

Produces validation, preview, dry-run, or simulation output. Treat results as local compatibility behavior.

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/contract-management/underpayments/detect. 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/contract-management/underpayments/detect, 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Do not publish this endpoint as an ordinary developer API until its unresolved decisions are closed.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.

Contract Management public API.

Contract Management APIs expose organization-scoped insurance contract inventory and local revenue-integrity workflow controls for contract list, detail, create, and update operations; what-if rate simulation drafts; fee schedule validation/import; underpayment detection; dispute-letter request recording; assignment; and resolution. The bearer API key selects the organization. Public callers should not send `organizationId` as a tenant selector. Every referenced payer configuration, facility, contract, claim, underpayment case, assignee, fee schedule, rate schedule, simulation, activity, and audit row must resolve inside the authenticated organization. These endpoints manage QuickRCM local state and audit evidence. They do not call payer systems, prove payer acceptance, upload or return contract files, generate or transmit live dispute letters, post cash, adjudicate claims, update Electronic Health Record (EHR) billing resources, or guarantee external recovery. Use synthetic examples and keep names, notes, rate-change context, dispute text, and import data free of real protected health information (PHI), credentials, tokens, raw Electronic Data Interchange (EDI), payer portal payloads, S3 keys, and vendor responses.

What this endpoint does

Use case

Use this endpoint to estimate or create local underpayment case candidates from recently paid claims before staff review and dispute workflows.

Before calling

Authenticate with `contract-management:write`. Start with `dryRun: true`. Decide whether to narrow by payer configuration, days-back window, and variance threshold. Do not use this endpoint as a full contract-rate resolver.

Request and response behavior

Request guidance

`dryRun` defaults to true. `payerId` is optional and is applied as a QuickRCM payer configuration filter in the current handler. `daysBack` defaults to 90 and must be 1 through 365. `threshold` defaults to 5 and must be 0 through 100.

Use `dryRun: true` unless explicitly creating local underpayment cases.
The handler currently caps the claim scan at 500 records.
`payerId` is a QuickRCM payer configuration id/filter in the current handler.
Do not describe this endpoint as a full contract-rate resolver, fee-schedule adjudicator, or payer audit.

Response semantics

The current handler scans up to 500 tenant-owned claims with status `PAID`, positive `totalPaid`, and `datesOfServiceStart` within the selected lookback window. For each claim it compares `totalCharges` and `totalPaid`, computes `((totalCharges - totalPaid) / totalCharges) * 100`, and counts candidates whose variance percent is greater than `threshold` and that do not already have an active underpayment case. The response returns whether the call was a dry run, how many paid claims were analyzed, how many cases would be created, and how many cases were created. When `dryRun` is false, the handler creates local `IDENTIFIED` cases with `underpaymentType: CONTRACT_VARIANCE`, `expectedAmount` equal to `totalCharges`, `paidAmount` equal to `totalPaid`, and `varianceAmount` equal to `totalCharges - totalPaid`.

`casesWouldCreate` counts candidates after threshold and active-case checks.
`casesCreated` should be interpreted with the returned `dryRun` flag.
Created cases are local QuickRCM workflow records, not payer-submitted disputes.
The generated OpenAPI example can show `dryRun: true` with nonzero `casesCreated`; endpoint docs should define field semantics instead of treating that generated example as a behavioral guarantee.

Errors and retries

Treat 400 as invalid scan parameters, 401/403 as credential or scope failures, and 429 as a backoff signal. If `dryRun` is false and the request times out, inspect underpayment cases before retrying to avoid duplicate operational work.

400 can indicate invalid `daysBack` or `threshold` values.
Retry non-dry-run calls only after checking current case 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
dryRun	body	No	boolean	Boolean side-effect control. Defaults to true and returns scan counts without creating cases.	Default: true.
payerId	body	No	string	Optional endpoint-specific payer selector. In the current handler this is applied as a QuickRCM `Claim.payerConfigId` filter for the authenticated organization.	Minimum length: 1.
daysBack	body	No	integer	Number of days of paid claims to scan, from 1 through 365. Defaults to 90.	Minimum value: 1. Maximum value: 365. Default: 90.
threshold	body	No	number	Variance percentage threshold, from 0 through 100. The current handler creates/counts only candidates with variance percent greater than this value.	Minimum value: 0. Maximum value: 100. Default: 5.

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.

{
  "dryRun": true,
  "payerId": "87726",
  "daysBack": 90,
  "threshold": 5
}

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

Underpayment detection result.

Generated from the OpenAPI response schema.

{
  "success": true,
  "data": {
    "dryRun": true,
    "claimsAnalyzed": 1,
    "casesWouldCreate": 1,
    "casesCreated": 1
  }
}

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.