> ## Documentation Index > Fetch the complete documentation index at: https://docs.rcintell.com/llms.txt > Use this file to discover all available pages before exploring further. # Pre-submission claim validation > Validate a finalized claim before submission: NCCI conflicts, timely filing deadline, payment estimates, and go/no-go verdict. ## OpenAPI ````yaml /docs/openapi.client.json post /v1/encounter/claim-check openapi: 3.1.0 info: description: >- Client API for RCIntel. Admin ingest, catalog sync, and internal audit routes are omitted. See Guides → Which API to use. summary: Multi-tenant knowledge API for healthcare revenue cycle management. title: Healthcare Knowledge Layer version: 0.1.0 servers: [] security: [] tags: - description: >- Geographic payer policy lookup (national NCD vs MAC LCD vs state). Query payer, code, state, plan_type. Each row includes geo_scope and document_version. name: policies - description: >- Payer network directory — search payers, check prior auth requirements, view filing rules, denial patterns, and appeal levels. name: payers - description: >- Resolve healthcare billing knowledge across the L1-L6 layer stack. Includes payment calculation, billing guidance, and per-layer queries. name: knowledge - description: >- CMS Fee Schedule lookups — OPPS (Addendum B / APC), DMEPOS (state-level pricing), and Clinical Lab Fee Schedule (CLFS). name: fee-schedules - description: >- NCCI (National Correct Coding Initiative) — dedicated MUE limits, PTP bundling edits, add-on code edits, and code pair validation. name: ncci - description: >- Service code intelligence — CPT/HCPCS lookup, RVU data, NCCI edits, payment calculation, implant/GUDID search, and service group classification. name: codes - description: >- Submit asynchronous AI agent jobs for code research, medical necessity, and denial resolution. Poll for results and retrieve reasoning traces. name: agents - description: >- Register and manage healthcare facilities by CCN (Medicare Provider Number). Each facility is the root entity for knowledge resolution. name: facilities - description: >- NPI Registry — live search against CMS NPPES API for provider and organization National Provider Identifiers. name: npi - description: >- OpenFDA drug product lookup by NDC. Includes product-level fields with normalized ingredient and package detail. name: drugs - description: Health checks, service metadata, and Prometheus metrics. name: system paths: /v1/encounter/claim-check: post: tags: - encounter summary: Pre-submission claim validation description: |- Validate a finalized claim before submission: NCCI conflicts, timely filing deadline, payment estimates, and go/no-go verdict. operationId: check_claim_v1_encounter_claim_check_post requestBody: content: application/json: schema: $ref: '#/components/schemas/ClaimCheckRequest' required: true responses: '200': content: application/json: schema: $ref: '#/components/schemas/ClaimCheckResponse' description: Successful Response '422': content: application/json: schema: $ref: '#/components/schemas/HTTPValidationError' description: Validation Error security: - APIKeyHeader: [] components: schemas: ClaimCheckRequest: description: Pre-submission claim validation — lighter than encounter check. properties: claim_type: default: professional description: 'Claim type: professional, institutional, dental' title: Claim Type type: string cpt_codes: description: Finalized CPT/HCPCS codes on the claim items: type: string maxItems: 25 minItems: 1 title: Cpt Codes type: array date_of_service: description: Date of service (YYYY-MM-DD) title: Date Of Service type: string locality: anyOf: - type: string - type: 'null' description: GPCI locality code title: Locality payer_slug: description: Payer slug title: Payer Slug type: string plan_type: anyOf: - type: string - type: 'null' description: Plan type for filing rule overrides title: Plan Type state: anyOf: - type: string - type: 'null' description: State code for filing rule overrides title: State required: - payer_slug - cpt_codes - date_of_service title: ClaimCheckRequest type: object ClaimCheckResponse: description: Pre-submission claim validation result. properties: codes: items: type: string title: Codes type: array date_of_service: title: Date Of Service type: string filing_status: anyOf: - $ref: '#/components/schemas/ClaimFilingStatus' - type: 'null' ncci_clean: default: true title: Ncci Clean type: boolean ncci_conflicts: items: $ref: '#/components/schemas/NCCIBatchConflict' title: Ncci Conflicts type: array payer_name: anyOf: - type: string - type: 'null' title: Payer Name payer_slug: title: Payer Slug type: string payment_estimates: items: $ref: '#/components/schemas/EncounterPaymentEstimate' title: Payment Estimates type: array submit_ready: description: True when no blockers found (NCCI clean + filing valid) title: Submit Ready type: boolean total_estimated_payment: default: 0 title: Total Estimated Payment type: number warnings: items: $ref: '#/components/schemas/EncounterWarning' title: Warnings type: array required: - payer_slug - codes - date_of_service - submit_ready title: ClaimCheckResponse type: object HTTPValidationError: properties: detail: items: $ref: '#/components/schemas/ValidationError' title: Detail type: array title: HTTPValidationError type: object ClaimFilingStatus: description: Timely filing status for the claim. properties: claim_type: title: Claim Type type: string days_remaining: title: Days Remaining type: integer deadline_date: title: Deadline Date type: string effective_days: title: Effective Days type: integer is_expired: title: Is Expired type: boolean override_applied: anyOf: - type: string - type: 'null' title: Override Applied standard_days: title: Standard Days type: integer required: - claim_type - standard_days - effective_days - deadline_date - days_remaining - is_expired title: ClaimFilingStatus type: object NCCIBatchConflict: description: A single PTP conflict found within the batch. properties: claim_type: anyOf: - type: string - type: 'null' title: Claim Type code1: title: Code1 type: string code2: title: Code2 type: string col1_proc_cd: anyOf: - type: string - type: 'null' title: Col1 Proc Cd col2_proc_cd: anyOf: - type: string - type: 'null' title: Col2 Proc Cd effective_date: anyOf: - type: string - type: 'null' title: Effective Date is_bundled: default: true title: Is Bundled type: boolean modifier_allowed: anyOf: - type: boolean - type: 'null' title: Modifier Allowed modifier_indicator: anyOf: - type: string - type: 'null' title: Modifier Indicator ptp_rationale: anyOf: - type: string - type: 'null' title: Ptp Rationale required: - code1 - code2 title: NCCIBatchConflict type: object EncounterPaymentEstimate: description: Payment estimate for a single code. properties: code: title: Code type: string conversion_factor: title: Conversion Factor type: number estimated_payment: title: Estimated Payment type: number facility_rate: default: true title: Facility Rate type: boolean locality: default: '0000' title: Locality type: string mp_rvu_adjusted: title: Mp Rvu Adjusted type: number pe_rvu_adjusted: title: Pe Rvu Adjusted type: number work_rvu_adjusted: title: Work Rvu Adjusted type: number required: - code - estimated_payment - work_rvu_adjusted - pe_rvu_adjusted - mp_rvu_adjusted - conversion_factor title: EncounterPaymentEstimate type: object EncounterWarning: description: A warning or advisory generated during encounter analysis. properties: code: anyOf: - type: string - type: 'null' title: Code message: title: Message type: string severity: description: info, warning, or critical title: Severity type: string required: - severity - message title: EncounterWarning type: object ValidationError: properties: ctx: title: Context type: object input: title: Input loc: items: anyOf: - type: string - type: integer title: Location type: array msg: title: Message type: string type: title: Error Type type: string required: - loc - msg - type title: ValidationError type: object securitySchemes: APIKeyHeader: in: header name: X-API-Key type: apiKey ````