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Your documents — parse and folder tree

POST /v1/policy/parse, /structure, and /retrieve turn a customer-owned PDF into cited chunks and a folder tree. Schema is in API Reference → Your documents. A kp_test_ key can call the same paths on sandbox so you can see a live response. That path never writes GET /v1/policies. Keys minted before this surface shipped need a remint. Guide: Your policy documents. Website: Payer Intelligence.

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Sandbox samples — Anthem, Aetna, extra CCNs

GET /v1/policies on sandbox now returns posted sample rows for payer=anthem (00100, A0427) and payer=aetna (93306, 81161). Playground scenarios and test mode use those codes. Empty still means the code is not in the mart. Test keys also seed IPPS CCNs 180017, 220071, 050625, and 330101.

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v0.1.1 — Payer policies API

GET /v1/policies and GET /v1/policies/changes are first-class client endpoints. Look them up in API Reference → Payer policies, or the Payer policies guide. Use payer=medicare_ffs, payer=uhc, payer=anthem, or payer=aetna. CARC/RARC is GET /v1/payers/denial-codes/{code}; UMLS is GET /v1/concepts/umls/search.

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v0.1.0 — Public Launch

March 2026 — RCI is now available for public use.

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Knowledge Resolution Engine

  • 6-layer knowledge graph — Resolve billing context from a single CCN: location (L1), facility type (L2), care setting (L3), payer rules (L4), service group (L5), and service-level payment (L6).
  • Billing guide generation — Get the correct billing form, type of bill, modifiers, and warnings for any facility/service combination.
  • Payment calculation — GPCI-adjusted Medicare MPFS payment estimates with full RVU breakdowns.

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AI Agents

  • Code research agent — CPT/HCPCS research with documentation requirements, coding guidelines, and modifier rules.
  • Medical necessity agent — ICD-10/CPT pairing validation with LCD/NCD policy analysis.
  • Denial resolution agent — CARC/RARC interpretation with appeal letter generation and supporting evidence.
  • SENTINEL audit — Every agent execution scored for quality and security with green/yellow/red tiers.

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NCCI Edits

  • MUE lookups — Medically Unlikely Edits for practitioner, hospital outpatient, and DME settings.
  • PTP edits — Procedure-to-procedure edits for practitioner and hospital settings.
  • Add-on code validation — Verify primary/add-on code pairings.
  • Provider lookup — Search the NPPES registry by name, NPI, taxonomy, or location.
  • Provider detail — Full provider profile with addresses, taxonomies, and identifiers.

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Platform

  • Multi-tenant architecture — Full data isolation with per-API-key rate limiting.
  • API key authentication — Scoped API keys with knowledge, agents, audit, and admin permissions.
  • Structured logging — Every request logged with request ID, tenant context, and response metrics.
  • OpenAPI documentation — Full interactive API reference at docs.rcintell.com/api-reference.
Have a feature request? Email support@rcintell.com.