> ## 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.

# [Public] Get payer detail

> Public payer detail. No API key required. IP-rate-limited.



## OpenAPI

````yaml /docs/openapi.client.json get /v1/directory/payers/{slug}
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/directory/payers/{slug}:
    get:
      tags:
        - payers-public
      summary: '[Public] Get payer detail'
      description: Public payer detail. No API key required. IP-rate-limited.
      operationId: get_payer_public_v1_directory_payers__slug__get
      parameters:
        - description: Normalized payer slug identifier.
          in: path
          name: slug
          required: true
          schema:
            title: Slug
            type: string
      responses:
        '200':
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/PayerDetail'
          description: Successful Response
        '422':
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/HTTPValidationError'
          description: Validation Error
components:
  schemas:
    PayerDetail:
      properties:
        aliases:
          items:
            type: string
          title: Aliases
          type: array
        appeal_rules:
          items:
            $ref: '#/components/schemas/AppealRuleResponse'
          title: Appeal Rules
          type: array
        billing_rules:
          items:
            $ref: '#/components/schemas/BillingRuleResponse'
          title: Billing Rules
          type: array
        contacts:
          items:
            $ref: '#/components/schemas/ContactResponse'
          title: Contacts
          type: array
        core_certification_status:
          anyOf:
            - type: string
            - type: 'null'
          title: Core Certification Status
        core_certified_rule_sets:
          items:
            type: string
          title: Core Certified Rule Sets
          type: array
        coverage_scope:
          title: Coverage Scope
          type: string
        coverage_types:
          items:
            type: string
          title: Coverage Types
          type: array
        data_quality_score:
          default: 0
          title: Data Quality Score
          type: number
        denial_patterns:
          items:
            $ref: '#/components/schemas/DenialPatternResponse'
          title: Denial Patterns
          type: array
        display_name:
          anyOf:
            - type: string
            - type: 'null'
          title: Display Name
        edi_payer_ids:
          additionalProperties: true
          title: Edi Payer Ids
          type: object
        filing_rules:
          items:
            $ref: '#/components/schemas/FilingRuleResponse'
          title: Filing Rules
          type: array
        is_active:
          default: true
          title: Is Active
          type: boolean
        is_core_certified:
          default: false
          title: Is Core Certified
          type: boolean
        logo_url:
          anyOf:
            - type: string
            - type: 'null'
          title: Logo Url
        name:
          title: Name
          type: string
        parent_org:
          anyOf:
            - type: string
            - type: 'null'
          title: Parent Org
        payer_type:
          title: Payer Type
          type: string
        plan_types:
          items:
            type: string
          title: Plan Types
          type: array
        prior_auth_rules:
          items:
            $ref: '#/components/schemas/PriorAuthRuleResponse'
          title: Prior Auth Rules
          type: array
        slug:
          title: Slug
          type: string
        states_covered:
          items:
            type: string
          title: States Covered
          type: array
        website_url:
          anyOf:
            - type: string
            - type: 'null'
          title: Website Url
      required:
        - slug
        - name
        - payer_type
        - coverage_scope
      title: PayerDetail
      type: object
    HTTPValidationError:
      properties:
        detail:
          items:
            $ref: '#/components/schemas/ValidationError'
          title: Detail
          type: array
      title: HTTPValidationError
      type: object
    AppealRuleResponse:
      properties:
        appeal_level:
          title: Appeal Level
          type: integer
        deadline_days:
          title: Deadline Days
          type: integer
        external_review_deadline_days:
          anyOf:
            - type: integer
            - type: 'null'
          title: External Review Deadline Days
        level_name:
          anyOf:
            - type: string
            - type: 'null'
          title: Level Name
        peer_to_peer_available:
          default: false
          title: Peer To Peer Available
          type: boolean
        required_documents:
          items:
            type: string
          title: Required Documents
          type: array
        state_specific_rules:
          additionalProperties: true
          title: State Specific Rules
          type: object
        submission_method:
          anyOf:
            - type: string
            - type: 'null'
          title: Submission Method
        success_rate:
          anyOf:
            - type: number
            - type: 'null'
          title: Success Rate
      required:
        - appeal_level
        - deadline_days
      title: AppealRuleResponse
      type: object
    BillingRuleResponse:
      properties:
        billing_notes:
          anyOf:
            - type: string
            - type: 'null'
          title: Billing Notes
        claim_form:
          anyOf:
            - type: string
            - type: 'null'
          title: Claim Form
        electronic_filing:
          default: true
          title: Electronic Filing
          type: boolean
        enrollment_required:
          default: false
          title: Enrollment Required
          type: boolean
        modifier_requirements:
          additionalProperties: true
          title: Modifier Requirements
          type: object
        payment_methodology:
          anyOf:
            - type: string
            - type: 'null'
          title: Payment Methodology
      title: BillingRuleResponse
      type: object
    ContactResponse:
      properties:
        department:
          anyOf:
            - type: string
            - type: 'null'
          title: Department
        email:
          anyOf:
            - type: string
            - type: 'null'
          title: Email
        fax:
          anyOf:
            - type: string
            - type: 'null'
          title: Fax
        hours_of_operation:
          anyOf:
            - type: string
            - type: 'null'
          title: Hours Of Operation
        phone:
          anyOf:
            - type: string
            - type: 'null'
          title: Phone
        portal_url:
          anyOf:
            - type: string
            - type: 'null'
          title: Portal Url
      title: ContactResponse
      type: object
    DenialPatternResponse:
      properties:
        auto_appealable:
          default: false
          title: Auto Appealable
          type: boolean
        avg_resolution_days:
          anyOf:
            - type: integer
            - type: 'null'
          title: Avg Resolution Days
        denial_category:
          anyOf:
            - type: string
            - type: 'null'
          title: Denial Category
        denial_code:
          anyOf:
            - type: string
            - type: 'null'
          title: Denial Code
        documentation_needed:
          items:
            type: string
          title: Documentation Needed
          type: array
        frequency_rank:
          anyOf:
            - type: integer
            - type: 'null'
          title: Frequency Rank
        remark_code:
          anyOf:
            - type: string
            - type: 'null'
          title: Remark Code
        resolution_steps:
          items:
            type: string
          title: Resolution Steps
          type: array
        root_cause:
          anyOf:
            - type: string
            - type: 'null'
          title: Root Cause
        success_rate:
          anyOf:
            - type: number
            - type: 'null'
          title: Success Rate
      title: DenialPatternResponse
      type: object
    FilingRuleResponse:
      properties:
        claim_type:
          anyOf:
            - type: string
            - type: 'null'
          title: Claim Type
        effective_date:
          anyOf:
            - format: date-time
              type: string
            - type: 'null'
          title: Effective Date
        expiration_date:
          anyOf:
            - format: date-time
              type: string
            - type: 'null'
          title: Expiration Date
        plan_override_days:
          additionalProperties:
            type: integer
          title: Plan Override Days
          type: object
        standard_days:
          title: Standard Days
          type: integer
        state_override_days:
          additionalProperties:
            type: integer
          title: State Override Days
          type: object
      required:
        - standard_days
      title: FilingRuleResponse
      type: object
    PriorAuthRuleResponse:
      properties:
        delegation_vendor:
          anyOf:
            - type: string
            - type: 'null'
          title: Delegation Vendor
        gold_card_eligible:
          default: false
          title: Gold Card Eligible
          type: boolean
        pa_required:
          default: true
          title: Pa Required
          type: boolean
        portal_url:
          anyOf:
            - type: string
            - type: 'null'
          title: Portal Url
        required_documents:
          items:
            type: string
          title: Required Documents
          type: array
        service_category:
          title: Service Category
          type: string
        turnaround_standard_days:
          anyOf:
            - type: integer
            - type: 'null'
          title: Turnaround Standard Days
        turnaround_urgent_hours:
          anyOf:
            - type: integer
            - type: 'null'
          title: Turnaround Urgent Hours
      required:
        - service_category
      title: PriorAuthRuleResponse
      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

````