Appeals

Update appeal compliance rule by id

Updates an organization-scoped appeal compliance rule by rule id.

PUTPublic reference baselineLocal writeAppealsoperationId: upsertAppealComplianceRuleByIdhttps://dev-api.quickintell.com/api/v1/appeals/compliance-rules/{ruleId}
Public reference baselineLocal writeClaims and denials

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 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/appeals/compliance-rules/{ruleId}. External use still depends on route classification, release evidence, and endpoint-specific side-effect approval.

What this does now

Documents the generated PUT /api/v1/appeals/compliance-rules/{ruleId} contract as a local write 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.

HeaderRequiredCurrent statusNotes
AuthorizationYesCurrentBearer <QUICKRCM_API_KEY>. OpenAPI security: bearerAuth.
Idempotency-KeyNoTarget/futureDo not claim universal header support until E3 and OpenAPI metadata exist.
X-Request-IdNoTarget/futureUse 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.

TopicStatusGuidance
Current idempotencyNo idempotency mechanism is declared.Do not retry blindly. Check resource, status, batch, or job state before repeating the request.
Universal headerNot declaredDo not document universal Idempotency-Key support until OpenAPI and E3 evidence declare it.
Conflict behaviorUnresolvedSame-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.

TopicStatusGuidance
Immediate responseNo 202 response declaredOpenAPI does not declare HTTP 202 for this operation.
Polling and terminal statesNot indicated by OpenAPINo generic polling contract is published from this page.
Later side effectsNot provenDo 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.

TopicStatusGuidance
Content classNo file/artifact class inferredOpenAPI text does not indicate file or artifact handling for this endpoint.
Ownership and storage keysNot applicable unless a file field is presentTenant ownership must be proven before retrieval or upload docs. Never expose storage keys as public identifiers.
URLs, scanning, and retentionUnresolved unless endpoint-specific evidence existsShort-lived URLs, MIME limits, checksums, scanner status, retention, expiration, and legal hold behavior are not implied by OpenAPI examples.

Publication warnings

  • Universal Idempotency-Key header support is not declared; retry only after checking endpoint-specific state.

Evidence

EvidenceStatusCaveat
OpenAPI artifactdocs/openapi/openapi.json; OpenAPI 3.1.0; API 1.0.0.Generated baseline contract only.
Route registryPublic reference baseline from documentation classification overlay.E6 route registry evidence is still required before external publication.
Example validationGenerated examples are internal baseline aids.No external publication claim; examples must pass no-PHI/no-secret/no-raw-payload/no-storage-key checks.
Last reviewedImplementation run 20260619T-docs-impl; source boardroom packet 20260619T064820Z.Refresh this evidence for release workspaces.
Release evidenceE9 required.No SDK readiness, production readiness, or expanded external docs claim from this endpoint page.

Appeals public API.

Appeals APIs manage QuickRCM denial appeal records, supporting document workflows, peer-to-peer reviews, deadlines, reminders, analytics, and compliance tracking. All endpoints are scoped to the organization selected by the bearer API key; callers do not provide a public organization selector. Use these endpoints after a denial case, claim, supporting document, reminder, peer-to-peer review, compliance event, or compliance rule already exists in QuickRCM. Read endpoints accept `appeals:read` or `appeals:write`; write endpoints require `appeals:write`. The public API exposes local workflow state and sanitized metadata. It intentionally avoids returning raw payer payloads, PHI-heavy activity metadata, S3 object keys, raw EDI, transcripts, or vendor credentials. Electronic portal appeal submission is validate-only through the public API and returns a simulated validation response rather than transmitting a payer payload.

What this endpoint does

Use case
Use this when the caller already knows the exact rule to revise.
Before calling
Read the rule and confirm it belongs to the authenticated organization. The PUT request is a complete rule payload, not a partial patch.

Request and response behavior

Request guidance
Pass `ruleId` in the path and send the same complete rule body used by upsertAppealComplianceRule: required `payerType`, `appealLevel`, `providerFilingDays`, `payerResponseDays`, and `regulatoryReference`; optional `jurisdictionState`, `expeditedFilingHours`, `expeditedResponseHours`, `description`, `penaltyForViolation`, and `isActive`.
  • `ruleId` selects the existing organization-specific rule.
  • Use the POST upsert endpoint when identifying a rule by payer type, jurisdiction, and level instead.
Response semantics
The response returns the updated organization-scoped compliance rule.
  • Returns the updated compliance rule.
  • The request uses PUT semantics with a complete rule payload.

Errors and retries

404 means the rule does not exist for the organization. After a timeout, read/list rules before retrying.
  • 404 means the rule id is missing or not owned by the organization.
  • 400 means body validation failed.

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

NameLocationRequiredTypeDescriptionValidation and safety notes
ruleIdpathYesstringTenant-scoped QuickRCM appeal compliance rule identifier selected from the path.Minimum length: 1. Tenant context is selected by the API key; do not treat this as a public tenant selector.

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.

NameLocationRequiredTypeDescriptionValidation and safety notes
payerTypebodyYesstringRequired payer category for the compliance rule, such as a configured payer class or payer type string.Minimum length: 1. Maximum length: 100.
jurisdictionStatebodyNostringOptional nullable two-letter state code for state-specific rules; null or omitted means not state-specific.Minimum length: 2. Maximum length: 2.
appealLevelbodyYesLEVEL_1_RECONSIDERATION | LEVEL_2_FORMAL_APPEAL | LEVEL_3_EXTERNAL_REVIEW | LEVEL_4_ALJ_HEARING | LEVEL_5_COUNCIL_REVIEW | LEVEL_6_FEDERAL_COURT | STATE_FAIR_HEARING | INDEPENDENT_REVIEW_ORG | STATE_INSURANCE_DEPTRequired appeal level enum value the rule applies to.Enum values are declared in the Type column.
providerFilingDaysbodyYesintegerRequired provider filing window in whole days; the schema permits 0 through 3650.Minimum value: 0. Maximum value: 3650.
expeditedFilingHoursbodyNointegerOptional nullable expedited filing window in hours; the schema permits 0 through 8760.Minimum value: 0. Maximum value: 8760. File, artifact, or raw-payload adjacent; keep examples metadata-only.
payerResponseDaysbodyYesintegerRequired payer response window in whole days; the schema permits 0 through 3650.Minimum value: 0. Maximum value: 3650.
expeditedResponseHoursbodyNointegerOptional nullable expedited payer response window in hours; the schema permits 0 through 8760.Minimum value: 0. Maximum value: 8760. File, artifact, or raw-payload adjacent; keep examples metadata-only.
regulatoryReferencebodyYesstringRequired reference text for the policy, contract, or regulation supporting the rule; max length is 500.Minimum length: 1. Maximum length: 500.
descriptionbodyNostringOptional nullable rule description; max length is 2000. This is operational documentation, not legal advice.Minimum length: 1. Maximum length: 2000. File, artifact, or raw-payload adjacent; keep examples metadata-only.
penaltyForViolationbodyNostringOptional nullable description of consequence or policy for violating the rule; max length is 2000.Minimum length: 1. Maximum length: 2000.
isActivebodyNobooleanOptional boolean controlling whether the rule is active.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.

{
  "payerType": "example-payertype",
  "appealLevel": "LEVEL_1_RECONSIDERATION",
  "providerFilingDays": 1,
  "payerResponseDays": 1,
  "regulatoryReference": "example-regulatoryreference",
  "jurisdictionState": "example-jurisdictionstate",
  "expeditedFilingHours": 1,
  "expeditedResponseHours": 1,
  "description": "Example upsert_appeal_compliance_rule_by_id note",
  "penaltyForViolation": "example-penaltyforviolation",
  "isActive": 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.

200
Compliance rule updated
Generated from the OpenAPI response schema.
{
  "success": true,
  "data": {
    "complianceRule": {
      "id": "00000000-0000-4000-8000-000000000001",
      "organizationId": "00000000-0000-4000-8000-000000000001",
      "payerType": "example-payertype",
      "jurisdictionState": "example-jurisdictionstate",
      "appealLevel": "LEVEL_1_RECONSIDERATION",
      "providerFilingDays": 1,
      "expeditedFilingHours": 1,
      "payerResponseDays": 1,
      "expeditedResponseHours": 1,
      "regulatoryReference": "example-regulatoryreference",
      "description": "Example upsert_appeal_compliance_rule_by_id note",
      "penaltyForViolation": "example-penaltyforviolation",
      "isActive": true,
      "createdAt": "2026-06-08T10:15:30Z",
      "updatedAt": "2026-06-08T10:15:30Z"
    }
  }
}

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
Handle this response as normal integration control flow.
{
  "error": "Request validation failed",
  "statusCode": 400
}
401
Authentication required
Handle this response as normal integration control flow.
{
  "error": "Authentication required",
  "statusCode": 401
}
403
Organization access denied
Handle this response as normal integration control flow.
{
  "error": "Forbidden",
  "statusCode": 403
}
404
Compliance rule not found
Handle this response as normal integration control flow.
{
  "error": "Resource not found",
  "statusCode": 404
}

Adjacent endpoints

Nearby generated endpoints in the same OpenAPI tag. Route class and side-effect labels still apply per endpoint.