EHR

Queue appointment eligibility check

Creates a local queued eligibility-check record for an organization-scoped appointment and patient insurance record without calling a payer or clearinghouse synchronously.

POSTNeeds publication reviewExternal or credentialedEHRoperationId: queueEhrAppointmentEligibilityCheckhttps://dev-api.quickintell.com/api/v1/ehr/appointments/{appointmentId}/eligibility/check

Needs publication reviewExternal or credentialedIntegrations

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 integrations contract generated for POST /api/v1/ehr/appointments/{appointmentId}/eligibility/check. 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/ehr/appointments/{appointmentId}/eligibility/check, 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Do not publish this endpoint as an ordinary developer API until its unresolved decisions are closed.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.

EHR public API.

The Electronic Health Record (EHR) public API exposes organization-scoped QuickRCM patient, appointment, patient-insurance, and appointment eligibility queueing endpoints. These endpoints are local QuickRCM API wrappers: patient, appointment, and insurance writes persist local database records; bulk patient import accepts inline JSON and stays database-only; and appointment eligibility creates a queued local eligibility-check record with `queueOnly: true` instead of contacting a payer, clearinghouse, or external EHR synchronously. Use these endpoints with a tenant-scoped bearer API key. The API key selects the organization; callers should not send `organizationId` as a tenant selector. Lookup/list endpoints require `ehr:read` or `ehr:write`, while create/update/queue endpoints require `ehr:write`. organizationId`. Public responses do not return address JSON, contact JSON, raw EHR payloads, raw payer payloads, raw EDI, credentials, transcripts, uploaded file contents, or other sensitive payloads. Patient names, dates of birth, Medical Record Numbers (MRNs), member identifiers, policy numbers, and contact details are Protected Health Information (PHI) or sensitive coverage data and should be logged only in redacted form. Patient matching behavior differs by endpoint. `findEhrPatientByDemographics` is a narrow lookup by exact trimmed first name, exact trimmed last name, and date-of-birth day. Patient create and bulk create use duplicate-detection helpers that can match same-organization demographics case-insensitively and also consider Medical Record Number (MRN) when supplied.

What this endpoint does

Use case

Use this endpoint when an integration wants QuickRCM to record an appointment-level eligibility check request for later processing or workflow visibility while keeping the public API call safe and non-vendor-submitting.

Before calling

Authenticate with an API key that has `ehr:write`. Ensure the appointment belongs to the authenticated organization and either supply a patient insurance ID for the appointment's patient or rely on the endpoint to select the first matching insurance by priority.

Request and response behavior

Request guidance

`appointmentId` is required in the path. `queueOnly` is literal `true` and defaults to true; public callers cannot request a live clearinghouse call. `serviceType` defaults to `30`; `dateOfService` defaults to the appointment start date when omitted.

This endpoint does not call Availity, Stedi, a payer portal, or an external EHR inline.
`queueOnly` must be true; no unsafe live mode is exposed.
Do not log member IDs or payer-related coverage identifiers used to select insurance.

Response semantics

A 202 response returns a queued local eligibility-check summary plus `meta.mode: SIMULATED_ONLY`. The created row has `status: QUEUED`, `statusCode: null`, and `queueOnly: true`. The response is not payer eligibility, benefits, or clearinghouse acceptance evidence.

`meta.mode` is `SIMULATED_ONLY` for this public wrapper.
`eligibilityCheck.queueOnly` is always true.
`eligibilityCheck.status` is `QUEUED` and `eligibilityCheck.statusCode` is null when the public endpoint creates the row.

Errors and retries

Treat 400 as invalid date or request shape, 401/403 as credential or tenant authorization issues, 404 as appointment or patient insurance not found in the authenticated organization, and 429 as rate limiting. Reconcile existing eligibility checks before retrying after ambiguous timeouts.

404 can mean the appointment does not exist in the tenant or no suitable patient insurance record was found.
400 can indicate invalid `dateOfService`.
Use client backoff for 429 and normal retry limits for transient 5xx responses.

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

Name	Location	Required	Type	Description	Validation and safety notes
appointmentId	path	Yes	string	QuickRCM appointment identifier from the path. The appointment must belong to the authenticated organization.	Minimum length: 1.

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
patientInsuranceId	body	No	string	Optional QuickRCM patient insurance identifier. If omitted, the endpoint selects the patient's first matching insurance ordered by priority.	Minimum length: 1. Potential PHI; use synthetic examples and avoid logging raw values.
serviceType	body	No	string	Optional eligibility service type code. Defaults to `30` and is capped at 20 characters.	Minimum length: 1. Maximum length: 20. Default: 30.
dateOfService	body	No	string	Optional service date as `YYYY-MM-DD` or an ISO date string. Defaults to the appointment start date and is returned as an ISO date-time string.	Minimum length: 1.
queueOnly	body	No	true	Required safe-mode flag. The public endpoint only accepts true and does not call a clearinghouse inline.	Enum values are declared in the Type column. Default: true.

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.

{
  "patientInsuranceId": "00000000-0000-4000-8000-000000000001",
  "serviceType": "30",
  "dateOfService": "2026-06-08",
  "queueOnly": true
}

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

Queued local eligibility check summary.

Generated from the OpenAPI response schema.

{
  "success": true,
  "data": {
    "eligibilityCheck": {
      "id": "00000000-0000-4000-8000-000000000001",
      "organizationId": "00000000-0000-4000-8000-000000000001",
      "patientId": "00000000-0000-4000-8000-000000000001",
      "appointmentId": "00000000-0000-4000-8000-000000000001",
      "patientInsuranceId": "00000000-0000-4000-8000-000000000001",
      "serviceType": "30",
      "dateOfService": "2026-06-08T10:15:30Z",
      "status": "queued",
      "statusCode": "example-statuscode",
      "queueOnly": true,
      "createdAt": "2026-06-08T10:15:30Z"
    }
  },
  "meta": {
    "organizationId": "00000000-0000-4000-8000-000000000001",
    "mode": "SIMULATED_ONLY"
  }
}

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.