Payer system integration

Claim received (837P / 837I)
         │
    ┌────▼──────────────────────────────────┐
    │   Your Adjudication System            │
    │                                       │
    │   ┌───────────────────────────────┐   │
    │   │   RCI Knowledge Layer         │   │
    │   │                               │   │
    │   │   Validate facility type      │   │
    │   │   Validate coding             │   │
    │   │   Check medical necessity     │   │
    │   │   Calculate expected payment  │   │
    │   └───────────────────────────────┘   │
    │                                       │
    │   Clean → Auto-adjudicate             │
    │   Flagged → Queue for review          │
    │   Invalid → Deny with reason          │
    └───────────────────────────────────────┘

curl -X POST https://api-dev.rcintell.com/v1/knowledge/resolve \
  -H "X-API-Key: kp_test_..." \
  -H "Content-Type: application/json" \
  -d '{
    "ccn": "170001",
    "cpt": "99214",
    "payer": "Medicare",
    "care_setting": "outpatient"
  }'

curl -X POST https://api-dev.rcintell.com/v1/agents/medical-necessity \
  -H "X-API-Key: kp_test_..." \
  -H "Content-Type: application/json" \
  -d '{
    "query": "Does M17.11 support medical necessity for CPT 27447?",
    "cpt_code": "27447",
    "dx_codes": ["M17.11"],
    "clinical_notes": "Severe OA, failed conservative treatment 6 months."
  }'

curl -X POST https://api-dev.rcintell.com/v1/knowledge/payment-calc \
  -H "X-API-Key: kp_test_..." \
  -H "Content-Type: application/json" \
  -d '{"ccn": "170001", "cpt": "99214"}'