> ## 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. # CRD-style PA determination > CRD-style PA determination with facility-aware, 5-tier resolution + rationale chain. ## OpenAPI ````yaml /docs/openapi.client.json get /v1/prior-auth/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/prior-auth/check: get: tags: - prior-auth summary: CRD-style PA determination description: >- CRD-style PA determination with facility-aware, 5-tier resolution + rationale chain. operationId: check_pa_v1_prior_auth_check_get parameters: - description: Payer slug or alias in: query name: payer_slug required: true schema: description: Payer slug or alias title: Payer Slug type: string - description: CPT/HCPCS code in: query name: code required: false schema: anyOf: - type: string - type: 'null' description: CPT/HCPCS code title: Code - description: Service category in: query name: service_category required: false schema: anyOf: - type: string - type: 'null' description: Service category title: Service Category - description: Plan type filter in: query name: plan_type required: false schema: anyOf: - type: string - type: 'null' description: Plan type filter title: Plan Type - description: State abbreviation in: query name: state required: false schema: anyOf: - type: string - type: 'null' description: State abbreviation title: State - description: Place of service code in: query name: place_of_service required: false schema: anyOf: - type: string - type: 'null' description: Place of service code title: Place Of Service - description: Current visit count in: query name: visit_count required: false schema: anyOf: - type: integer - type: 'null' description: Current visit count title: Visit Count - description: >- Facility CCN. When supplied, the engine auto-fills state/place-of-service from the facility profile and applies any facility-specific overrides (Tier 0) ahead of the shared payer rules. in: query name: ccn required: false schema: anyOf: - type: string - type: 'null' description: >- Facility CCN. When supplied, the engine auto-fills state/place-of-service from the facility profile and applies any facility-specific overrides (Tier 0) ahead of the shared payer rules. title: Ccn responses: '200': content: application/json: schema: $ref: '#/components/schemas/PACheckResponse' description: Successful Response '422': content: application/json: schema: $ref: '#/components/schemas/HTTPValidationError' description: Validation Error security: - APIKeyHeader: [] components: schemas: PACheckResponse: description: CRD-style PA determination with rationale chain. properties: auth_type: anyOf: - type: string - type: 'null' title: Auth Type code: anyOf: - type: string - type: 'null' title: Code confidence: title: Confidence type: number delegation_vendor: anyOf: - type: string - type: 'null' title: Delegation Vendor delegation_vendor_phone: anyOf: - type: string - type: 'null' title: Delegation Vendor Phone delegation_vendor_portal: anyOf: - type: string - type: 'null' title: Delegation Vendor Portal determination: title: Determination type: string determination_id: anyOf: - type: string - type: 'null' description: Persisted determination ID for audit trail title: Determination Id pa_required: title: Pa Required type: boolean pa_threshold: anyOf: - type: integer - type: 'null' description: Threshold at which PA becomes required (if applicable) title: Pa Threshold payer_name: title: Payer Name type: string payer_slug: title: Payer Slug type: string plan_type: anyOf: - type: string - type: 'null' description: Plan type used for resolution (commercial, medicaid, etc.) title: Plan Type rationale_chain: items: $ref: '#/components/schemas/RationaleStep' title: Rationale Chain type: array required_documents: items: type: string title: Required Documents type: array resolution_tier: title: Resolution Tier type: string service_category: anyOf: - type: string - type: 'null' title: Service Category standard_turnaround_days: anyOf: - type: integer - type: 'null' title: Standard Turnaround Days submission_info: $ref: '#/components/schemas/SubmissionInfo' threshold_remaining: anyOf: - type: integer - type: 'null' description: Remaining visits before PA threshold is reached title: Threshold Remaining urgent_turnaround_hours: anyOf: - type: integer - type: 'null' title: Urgent Turnaround Hours visit_count: anyOf: - type: integer - type: 'null' description: Visit count supplied in the request title: Visit Count required: - payer_slug - payer_name - determination - resolution_tier - confidence - pa_required title: PACheckResponse type: object HTTPValidationError: properties: detail: items: $ref: '#/components/schemas/ValidationError' title: Detail type: array title: HTTPValidationError type: object RationaleStep: description: One step in the CRD-style resolution rationale chain. properties: detail: title: Detail type: string matched: title: Matched type: boolean tier: title: Tier type: integer tier_name: title: Tier Name type: string required: - tier - tier_name - matched - detail title: RationaleStep type: object SubmissionInfo: description: Contact and portal information for PA submission. properties: email: anyOf: - type: string - type: 'null' title: Email fax: anyOf: - type: string - type: 'null' title: Fax mailing_address: anyOf: - type: string - type: 'null' title: Mailing Address phone: anyOf: - type: string - type: 'null' title: Phone portal_url: anyOf: - type: string - type: 'null' title: Portal Url title: SubmissionInfo 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 ````