Specialty Billing

Queue hospice claim submission

Queues a local hospice institutional claim submission marker and writes a local claim status check.

POSTNeeds publication reviewExternal or credentialedSpecialty BillingoperationId: submitHospiceClaimhttps://dev-api.quickintell.com/api/v1/specialty-billing/hospice/claims/{claimId}/submit

Needs publication reviewExternal or credentialedRevenue and specialty

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 revenue and specialty contract generated for POST /api/v1/specialty-billing/hospice/claims/{claimId}/submit. 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/specialty-billing/hospice/claims/{claimId}/submit, 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Do not publish this endpoint as an ordinary developer API until its unresolved decisions are closed.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	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.

Specialty Billing public API.

Specialty Billing APIs expose organization-scoped aggregate visibility across anesthesia, Ambulatory Surgical Center (ASC), Durable Medical Equipment (DME), laboratory, and behavioral-health billing records, plus safe public wrappers for home-health and hospice workflow state. The bearer API key selects the organization. Public callers should not send `organizationId`, `orgId`, or request signatures as tenant selectors in workflow request bodies; the API ignores those hints before authentication. The aggregate overview endpoint and the two local claim-status endpoints accept `specialty-billing:read` or `specialty-billing:write`. Workflow endpoints that create, update, validate, queue, acknowledge, or preview non-status records require `specialty-billing:write`. Linked patients, facilities, payer configs, patient insurance records, providers, episodes, payment periods, NOAs, referrals, authorizations, OASIS assessments, hospice elections, benefit periods, notices, census batches, claims, and denial cases must resolve inside the authenticated organization. This public surface is intentionally conservative. It can create or update local QuickRCM records such as home-health episodes, certifications, payment periods, referrals, authorizations, hospice elections, benefit periods, notices, acknowledgements, and queue/status markers. Submission endpoints return queued/local markers and do not call clearinghouse, payer, Electronic Health Record (EHR), Centers for Medicare & Medicaid Services (CMS), or Stedi/Availity adapters inline. Draft, Additional Documentation Request (ADR), appeal, and census preview endpoints validate or preview workflow state without creating Electronic Data Interchange (EDI) payloads, cross-module ADR cases, appeal packets, payer submissions, or EHR syncs unless a future contract explicitly says otherwise. Use synthetic examples. Endpoint examples are sanitized reference samples; when a response contains a local database object or submission-attempt snapshot, examples should either include the key returned object or explicitly say they are abbreviated. Do not include real Protected Health Information (PHI), raw EDI, transcripts, S3 keys, payer portal credentials, bearer tokens, clearinghouse payloads, EHR payloads, CMS payloads, or unnecessary patient-identifying notes in examples, metadata, payload, responsePayload, rows, message, or idempotency fields.

What this endpoint does

Use case

Use this when a hospice institutional claim already exists in QuickRCM and should be marked queued for downstream submission tracking.

Before calling

Authenticate with `specialty-billing:write` and use a same-organization claim id.

Request and response behavior

Request guidance

`queueOnly` is fixed to true and defaults to true. `adapterName` defaults to `STEDI` as local metadata. `idempotencyKey` may be stored as local correlation metadata but does not prove live Stedi submission.

No raw 837I payload is accepted or returned.
`adapterName` is a local marker.
`idempotencyKey` should not contain PHI or secrets.

Response semantics

HTTP 202 returns `externalRiskMode: QUEUED_ONLY`, status `queued`, `claimId`, and `adapterName`. The API can update the local claim to `QUEUED` and create a local queued `ClaimStatusCheck`.

`QUEUED_ONLY` means local queue/status state was recorded.
This endpoint does not return payer acceptance or adjudication.
Use checkHospiceClaimStatus for local status markers.

Errors and retries

A 404 means the claim was not found in the authenticated organization. After a timeout, check local claim status before retrying.

400 can indicate invalid queue flag or body shape.
404 can indicate missing or wrong-tenant claim.
Retry 429 and transient 5xx with backoff.

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
claimId	path	Yes	string	Claim identifier in the path; it must belong to the API-key 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
queueOnly	body	No	true	Required safety flag; must be true for public submission requests.	Enum values are declared in the Type column. Default: true.
idempotencyKey	body	No	string	Optional local correlation id, up to 160 characters.	Minimum length: 1. Maximum length: 160. Endpoint-specific compatibility key; universal Idempotency-Key header support is not declared.
adapterName	body	No	string	Optional local adapter label, defaulting to STEDI.	Minimum length: 1. Maximum length: 80. Default: STEDI. File, artifact, or raw-payload adjacent; keep examples metadata-only.

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.

{
  "queueOnly": true,
  "idempotencyKey": "example-idempotencykey",
  "adapterName": "STEDI"
}

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

Specialty billing workflow response.

Generated from the OpenAPI response schema.

{
  "success": true,
  "data": {},
  "meta": {
    "organizationId": "00000000-0000-4000-8000-000000000001",
    "externalRiskMode": "SAFE_WRITE_DB_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.