QuickRCM API Docs

Workflow guide

Use these conservative workflow families to find the right endpoint pages and platform rules. This page is an index and sequencing aid, not a substitute for endpoint contracts or release evidence.

Workflow pages are not production recipes

Each endpoint page carries the current route status, side-effect label, authentication note, tenant-context rule, and publication gate. If a linked endpoint is compatibility-limited or needs publication review, use it for planning only.

How to read workflow docs

1

Start with route status

Open each endpoint page first and read the route-status badge. Baseline-reference endpoints can inform integration planning; compatibility-limited endpoints or endpoints needing publication review must not be used as happy-path public examples.

2

Follow workflow IDs, not tenant selectors

Use the resource IDs returned by module endpoints, such as claimId, batchId, appealId, accountId, or jobId. Tenant context comes from the API key, not a request-body organizationId.

3

Treat side effects as endpoint-specific

A create, submit, queue, upload, payment, communication, or external-system verb does not prove live execution. Check the endpoint side-effect label and related platform rules before documenting retries or completion.

4

Keep examples synthetic and metadata-first

Do not include real PHI, credentials, tokens, raw EDI, transcripts, S3 keys, signed URLs, payer payloads, or EHR payloads. File and artifact flows should stay metadata-only until governance closes.

Workflow families

The endpoint links below are representative anchors from generated OpenAPI. They are intentionally not exhaustive and do not guarantee that every linked route is externally publishable.

Coverage
Check eligibility and discover coverage
Use eligibility, insurance discovery, OIG exclusion, and COB pages to understand intake and coverage-adjacent contracts. Keep COB as review-only until its endpoint pages show approved route status.

Conservative checkpoints

  • Create or inspect an eligibility or discovery record for the patient and payer context.
  • Use returned check, search, batch, or match IDs for polling and reconciliation where the endpoint page documents them.
  • Treat OIG and COB records as adjacent setup or coordination evidence, not as required calls for every patient workflow.

Do not describe payer coverage, secondary-claim generation, or exclusion screening as complete until the specific endpoint response and status semantics support that statement.

Claims
Prepare claims, remittances, and payment posting
Use claims, EOB-to-ERA, ERA, payment posting, and SFTP pages as separate contract anchors. Submission, remittance import, posting, and SFTP are side-effect-sensitive.

Conservative checkpoints

  • Draft or inspect claim records before any submit-like endpoint.
  • Reconcile claim status, EOB conversion, ERA, and remittance records by the IDs returned from each module.
  • Separate local staging or validation from clearinghouse, payer, payment, or SFTP execution.

Compatibility ERA routes and payment/SFTP flows are not quickstart material. Use endpoint badges to decide whether links are planning references only.

Clinical
Manage prior auth, ADR, appeals, scribe, and coding work
Use this family for clinical and documentation-heavy workflows that can feed authorization, ADR, appeal, scribe, and coding records. Medical coding and prior-auth pages need extra route-status review.

Conservative checkpoints

  • Create or inspect the workflow record before attaching documents, packets, notes, or coded output.
  • Use module-owned IDs for status checks, packet compilation, document references, and handoffs.
  • Treat queued processing and simulated document assembly as accepted work or validation, not final clinical or payer determination.

Do not publish payer-decision, clinical-attestation, packet-delivery, or coding-source-of-truth claims without endpoint-specific evidence.

Setup
Configure provider, payer, EHR, GFE, and file ownership
Use credentialing, payer enrollment, EHR integration, GFE, and SFTP endpoints as setup and ownership references. Credential and file behavior is especially constrained.

Conservative checkpoints

  • Create or inspect provider, payer, EHR, or estimate records before any submit, activate, deliver, or file endpoint.
  • Keep credentials, webhook secrets, payer portal details, EHR tokens, and storage keys out of examples and troubleshooting text.
  • Use configuration and status pages to determine whether a route is read-only, local, simulated, queued, or external.

Credential provisioning, signed URLs, EHR writeback, GFE delivery, and SFTP execution need product and security approval before they become external recipes.

Revenue
Run billing, risk, revenue, reports, and specialty workflows
Use billing, risk adjustment, revenue integrity, reports, and specialty billing endpoint pages to orient module ownership. Reporting and revenue semantics remain evidence-gated.

Conservative checkpoints

  • Anchor work in billing encounters, risk jobs, or module-specific review records before downstream validation or finalization.
  • Read each report or dashboard endpoint as a specific generated contract, not as a universal analytics model.
  • Keep rate, recovery, export, and specialty submission claims tied to endpoint-specific status and side-effect labels.

Do not imply metric freshness, export safety, recovery state machines, specialty submission behavior, or payment impact unless the endpoint page and release evidence say so.

Financial
Manage patient AR, collections, work queues, and support
Use patient AR, AR management, collections, and support pages to understand account, follow-up, placement, and ticket records. Payment and communication actions need tighter review.

Conservative checkpoints

  • Create or inspect account, queue, placement, or ticket records before changing financial, collection, or communication state.
  • Use returned record IDs for payment application, follow-up, dispute, activity, and response records.
  • Treat payment, collection, notice, and support-message flows as sensitive until side-effect and PHI policies are explicit.

Do not publish payment, refund, collection notice, debt placement, or support visibility claims before product and security decisions close.

Automation
Queue automation and review prevention signals
Use prevention pages for claim-scrub and risk-signal references. Use agent-builder pages as planning references until execution, credentials, templates, and latent side effects are approved for public use.

Conservative checkpoints

  • Review prevention findings, predictions, or alerts before taking corrective action.
  • Treat generated education, learned rules, and automation executions as queue or local-workflow events unless an endpoint page says otherwise.
  • Keep credentials, portal activity, browser automation, and webhook behavior out of public examples.

Do not document browser automation, credential use, external portal changes, or agent template publication as public behavior until the endpoint page no longer needs publication review.

Platform primitives to check for every workflow

Use these guide pages before turning any module sequence into onboarding material, SDK behavior, or production runbooks.

Route Status
Decide whether an endpoint is baseline-reference, compatibility-limited, or needs publication review.
Open guide
Side-Effect Modes
Check whether an endpoint is read-only, local, simulated, queued, file-like, payment, communication, or external.
Open guide
Async Jobs
Handle 202, queueing, polling, and terminal-state gaps as endpoint-specific behavior.
Open guide
Idempotency
Retry mutating endpoints only after checking current resource, job, batch, or status state.
Open guide
Files and Artifacts
Keep documents, PDFs, reports, transcripts, EDI, and signed URL examples metadata-first.
Open guide
Tenant Context
Use API-key organization context; do not add organizationId as a public tenant selector.
Open guide
PHI and Security
Keep PHI, credentials, tokens, raw vendor payloads, and storage keys out of examples and logs.
Open guide
Publication Readiness
Use release gates before expanding to external docs, SDKs, or production recipes.
Open guide

Endpoint-level details

Open generated reference