Denial Management

Update denial queue rule

Updates one organization-owned Denial Management routing rule after validating the rule exists and any merged action references remain organization-scoped.

PUTNeeds publication reviewLocal writeDenial ManagementoperationId: updateDenialQueueRulehttps://dev-api.quickintell.com/api/v1/denial-management/queue-rules/{ruleId}

Needs publication reviewLocal writeClaims and denials

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

Local write

May mutate QuickRCM records. It does not prove live payer, EHR, clearinghouse, payment, or communication execution.

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 claims and denials contract generated for PUT /api/v1/denial-management/queue-rules/{ruleId}. 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 PUT /api/v1/denial-management/queue-rules/{ruleId}, 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Do not publish this endpoint as an ordinary developer API until its unresolved decisions are closed.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	Endpoint-specific	Use only operation-specific status endpoints visible in OpenAPI; generic job behavior, cancellation, retries, and retention are unresolved.
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.

Denial Management public API.

Denial Management APIs expose organization-scoped denial case read models, local denial workflow writes, remittance association, draft appeal creation, denial queue routing configuration, explicit case rerouting, and safe document-extraction validation. The bearer API key selects the organization. Public requests should not send `organizationId` as a tenant selector. Read endpoints accept Denial Management read or write scope; mutation endpoints require Denial Management write scope. Referenced denial cases, queues, queue rules, remittances, draft appeals, users, and optional case links must resolve inside the authenticated organization. These endpoints operate on QuickRCM local workflow state. They do not submit appeals to payers, run OCR or LLM extraction, upload files, parse ERA payloads, post payments, adjudicate claims, call clearinghouses, or guarantee denial recovery. Use synthetic examples and keep notes, rule metadata, letter HTML, filenames, and search/filter values free of real PHI, raw EDI, payer portal credentials, tokens, S3 keys, transcripts, and vendor payloads. Iteration 2 adds complete queue-rule action and condition field semantics, common response-field glossary coverage, and PHI-safe synthetic request/response examples for all 10 Denial Management operations.

What this endpoint does

Use case

Use this when changing a rule name, description, priority, active flag, matching conditions, or routing/assignment actions.

Before calling

Authenticate with `denial-management:write`. Load the existing rule first so the caller understands current conditions and actions, especially because action updates are merged with existing actions.

Request and response behavior

Request guidance

At least one editable field is required. `conditions` accepts the same shape as createDenialQueueRule and replaces the stored conditions object when supplied. `actions` accepts the same documented action fields as createDenialQueueRule, is partial on update, and is merged with the existing actions object before queue and user references are validated.

`ruleId` selects the route rule in the path.
Send only intended fields; `conditions` is not merged.
Top-level `priority` is numeric rule ordering. Nested `actions.priority` is a string action label capped at 64 characters.

Response semantics

A 200 response returns the local rule projection after applying the update and `meta.organizationId`. Existing denial cases are not automatically rerouted by this endpoint.

The response is local routing configuration.
Updated actions may include existing action fields plus the supplied patch.
No denial case status, owner, or queue is changed by this endpoint alone.

Errors and retries

Treat 400 as an empty or invalid update body. Treat 404 as missing or wrong-tenant rule, action queue, or action user context. After a timeout, re-read the rule before retrying to avoid overwriting concurrent admin edits.

400 can mean the body contains no editable fields.
404 can mean the rule or referenced action target is outside the authenticated organization.
Retry after refreshing current rule 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

Name	Location	Required	Type	Description	Validation and safety notes
ruleId	path	Yes	string	QuickRCM DenialQueueRule identifier in the path. It 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
name	body	No	string	Optional replacement routing rule name, capped at 255 characters.	Minimum length: 1. Maximum length: 255.
description	body	No	string	Optional replacement routing rule description, nullable and capped at 2000 characters.	Maximum length: 2000.
priority	body	No	integer	Optional replacement top-level rule ordering integer from 0 through 10000.	Minimum value: 0. Maximum value: 10000.
isActive	body	No	boolean	Optional replacement active flag.	OpenAPI does not declare additional validation metadata.
conditions	body	No	object	Optional replacement conditions object for the rule. It accepts the same fields as createDenialQueueRule conditions.	OpenAPI does not declare additional validation metadata.
conditions.denialCategories	body	No	ELIGIBILITY \| AUTHORIZATION \| CODING \| MEDICAL_NECESSITY \| TIMELY_FILING \| COB \| BENEFIT_EXHAUSTED \| DUPLICATE \| BUNDLING \| OTHER[]	Optional replacement array of denial category enum values to match.	OpenAPI does not declare additional validation metadata.
conditions.severities	body	No	LOW \| MEDIUM \| HIGH \| CRITICAL[]	Optional replacement array of denial severity enum values to match.	OpenAPI does not declare additional validation metadata.
conditions.denialTypes	body	No	string[]	Optional replacement array of denial type labels, each capped at 128 characters.	OpenAPI does not declare additional validation metadata.
conditions.preventabilityClasses	body	No	string[]	Optional replacement array of preventability classification labels, each capped at 128 characters.	OpenAPI does not declare additional validation metadata.
conditions.rootCauseDepartments	body	No	string[]	Optional replacement array of root-cause department labels, each capped at 128 characters.	OpenAPI does not declare additional validation metadata.
conditions.payerIds	body	No	string[]	Optional replacement array of payer identifiers, each capped at 128 characters.	OpenAPI does not declare additional validation metadata.
conditions.payerNamePatterns	body	No	string[]	Optional replacement payer-name pattern strings, each capped at 255 characters.	OpenAPI does not declare additional validation metadata.
conditions.cptCodePatterns	body	No	string[]	Optional replacement CPT-code pattern strings, each capped at 64 characters.	OpenAPI does not declare additional validation metadata.
conditions.carcCodes	body	No	string[]	Optional replacement Claim Adjustment Reason Code strings, each capped at 16 characters.	OpenAPI does not declare additional validation metadata.
conditions.dollarRange	body	No	object	Optional minimum/maximum denied-dollar range used in a routing condition.	OpenAPI does not declare additional validation metadata.
conditions.dollarRange.min	body	No	number	Optional replacement minimum denied-dollar threshold. Values are numbers and must be at least 0.	Minimum value: 0.
conditions.dollarRange.max	body	No	number	Optional replacement maximum denied-dollar threshold. Values are numbers and must be at least 0.	Minimum value: 0.
conditions.ageDaysRange	body	No	object	Optional minimum/maximum denial-age range in days used in a routing condition.	OpenAPI does not declare additional validation metadata.
conditions.ageDaysRange.min	body	No	integer	Optional replacement minimum denial age in days. Values are integers and must be at least 0.	Minimum value: 0.
conditions.ageDaysRange.max	body	No	integer	Optional replacement maximum denial age in days. Values are integers and must be at least 0.	Minimum value: 0.
conditions.facilityIds	body	No	string[]	Optional replacement array of organization-scoped facility identifiers, each capped at 128 characters.	OpenAPI does not declare additional validation metadata.
conditions.hasAppealDeadline	body	No	boolean	Optional replacement boolean condition indicating whether a case has an appeal deadline.	OpenAPI does not declare additional validation metadata.
conditions.daysUntilAppealDeadline	body	No	object	Optional minimum/maximum range for days remaining until appeal deadline.	OpenAPI does not declare additional validation metadata.
conditions.daysUntilAppealDeadline.min	body	No	integer	Optional replacement lower bound for days until appeal deadline. Values are integers and must be at least 0.	Minimum value: 0.
conditions.daysUntilAppealDeadline.max	body	No	integer	Optional replacement upper bound for days until appeal deadline. Values are integers and must be at least 0.	Minimum value: 0.
actions	body	No	object	Optional partial action update. The handler merges it with existing actions before validation.	OpenAPI does not declare additional validation metadata.
actions.queueId	body	No	string	Optional action queue identifier on update, but if supplied it must belong to the authenticated organization.	Minimum length: 1.
actions.priority	body	No	string	Optional string action priority or label capped at 64 characters. Do not confuse it with top-level numeric rule priority.	Minimum length: 1. Maximum length: 64.
actions.assignToUserId	body	No	string	Optional action assignee user identifier capped at 128 characters. It must be an active member of the organization.	Minimum length: 1. Maximum length: 128. Potential PHI; use synthetic examples and avoid logging raw values.
actions.assignToRole	body	No	string	Optional role label capped at 128 characters for local assignment logic.	Minimum length: 1. Maximum length: 128.
actions.assignmentMethod	body	No	string	Optional local assignment method label capped at 128 characters.	Minimum length: 1. Maximum length: 128.
actions.slaHours	body	No	integer	Optional positive integer SLA override in hours.	OpenAPI does not declare additional validation metadata.
actions.autoEscalateAfterHours	body	No	integer	Optional positive integer auto-escalation threshold in hours.	OpenAPI does not declare additional validation metadata.
actions.notifyUserIds	body	No	string[]	Optional notification user identifiers. Every user must be an active organization member.	Potential PHI; use synthetic examples and avoid logging raw values.
actions.tags	body	No	string[]	Optional array of local routing tags, each capped at 128 characters.	OpenAPI does not declare additional validation metadata.

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.

{
  "name": "Example denial_queue_rule",
  "description": "Example denial_queue_rule note",
  "priority": 1,
  "isActive": true,
  "conditions": {
    "denialCategories": [
      "ELIGIBILITY"
    ],
    "severities": [
      "LOW"
    ],
    "denialTypes": [
      "example-denialtypes"
    ],
    "preventabilityClasses": [
      "example-preventabilityclasses"
    ],
    "rootCauseDepartments": [
      "example-rootcausedepartments"
    ],
    "payerIds": [
      "example-payerids"
    ],
    "payerNamePatterns": [
      "Example denial_queue_rule"
    ],
    "cptCodePatterns": [
      "example-cptcodepatterns"
    ]
  },
  "actions": {
    "queueId": "00000000-0000-4000-8000-000000000001",
    "priority": "example-priority",
    "assignToUserId": "00000000-0000-4000-8000-000000000001",
    "assignToRole": "example-assigntorole",
    "assignmentMethod": "example-assignmentmethod",
    "slaHours": 1,
    "autoEscalateAfterHours": 1,
    "notifyUserIds": [
      "example-notifyuserids"
    ]
  }
}

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

Denial queue rule updated

Generated from the OpenAPI response schema.

{
  "success": true,
  "data": {
    "rule": {
      "id": "00000000-0000-4000-8000-000000000001",
      "organizationId": "00000000-0000-4000-8000-000000000001",
      "queueId": "00000000-0000-4000-8000-000000000001",
      "name": "Example denial_queue_rule",
      "description": "Example denial_queue_rule note",
      "priority": 1,
      "isActive": true,
      "conditions": "example-conditions",
      "actions": "example-actions"
    }
  },
  "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