> ## 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.

# Knowledge Network

> Searchable directory of payer rules, filing deadlines, appeal processes, and billing requirements — updated as rules change

> Browse the knowledge that drives healthcare billing. Free. Open. Updated continuously.

The Knowledge Network is RCI's public directory of healthcare billing rules. Like a phone book for payer requirements — searchable by payer, state, facility type, or rule category.

**Browse it at [rcintell.com/network](https://rcintell.com/network)**

## What's in the Knowledge Network

### Payer Rules Directory

Every payer has different rules. The Knowledge Network makes them searchable.

| Payer            | Timely Filing   | Appeal Level 1  | Appeal Deadline | Prior Auth             | COB Rules           |
| ---------------- | --------------- | --------------- | --------------- | ---------------------- | ------------------- |
| Medicare         | 12 months       | Redetermination | 120 days        | Rarely                 | MSP rules           |
| Medicaid (KS)    | Varies by state | State review    | 60 days         | Required for some      | Crossover claims    |
| Cigna            | 90-180 days     | Internal appeal | 180 days        | Required for surgical  | Standard COB        |
| Aetna            | 90 days         | Internal appeal | 180 days        | Required for imaging   | Standard COB        |
| UnitedHealthcare | 90-365 days     | Internal appeal | 180 days        | Required for many      | Standard COB        |
| BCBS (varies)    | 90-365 days     | Internal appeal | Varies by plan  | Plan-dependent         | Standard COB        |
| TRICARE          | 12 months       | Reconsideration | 90 days         | Required for referrals | Federal rules       |
| Self-Pay         | N/A             | N/A             | N/A             | N/A                    | Good Faith Estimate |

**Filter by:**

* Payer name or alias (Cigna, UHC, BCBS, etc.)
* State (payer rules vary by state, especially Medicaid)
* Rule category (timely filing, prior auth, appeals, COB)
* Coverage type (medical, dental, behavioral health)

### Facility Type Catalog

Every facility type has different billing requirements:

| CCN Range | Facility Type            | Payment System | Billing Form     | EDI         | Primary TOB |
| --------- | ------------------------ | -------------- | ---------------- | ----------- | ----------- |
| 0001-0879 | Short-term Hospital      | OPPS/IPPS/MPFS | CMS-1500 / UB-04 | 837P / 837I | 111, 131    |
| 1300-1399 | Critical Access Hospital | Cost-based     | UB-04            | 837I        | 111, 131    |
| 3000-3299 | Home Health Agency       | HH PPS         | UB-04            | 837I        | 321, 322    |
| 4000-4499 | Skilled Nursing Facility | SNF PPS        | UB-04            | 837I        | 211, 212    |
| 5000-6499 | Rehabilitation           | IRF PPS        | UB-04            | 837I        | 111         |

### GPCI Values by Area

Geographic Practice Cost Indices change how much Medicare pays. Searchable by state, city, or CBSA.

| Area              | Work GPCI | PE GPCI | MP GPCI | Impact vs National Average |
| ----------------- | --------- | ------- | ------- | -------------------------- |
| Manhattan, NY     | 1.058     | 1.281   | 1.554   | +34%                       |
| San Francisco, CA | 1.045     | 1.318   | 0.773   | +24%                       |
| Kansas            | 1.000     | 0.891   | 0.407   | -14%                       |
| Rural Mississippi | 1.000     | 0.799   | 0.382   | -19%                       |
| National Average  | 1.000     | 1.000   | 1.000   | Baseline                   |

### MAC Jurisdictions

Which Medicare Administrative Contractor processes claims for each state.

### Appeal Processes

Side-by-side comparison of appeal levels, deadlines, and required documentation across payers.

## Rule Change Feed

Payer rules change constantly. The Knowledge Network tracks and surfaces these changes:

* **CMS fee schedule updates** — annual conversion factor, RVU changes
* **Payer policy changes** — timely filing limit changes, new prior auth requirements
* **State Medicaid updates** — program changes, rate updates
* **Coding updates** — new CPT/HCPCS codes, deleted codes, revised descriptions
* **NCCI edit changes** — new bundling rules, MUE updates

Subscribe to the feed by polling, RSS, or email. There is no webhook registry.

```bash theme={null}
curl "https://api-dev.rcintell.com/v1/data/changes?since=2026-01-01" \
  -H "X-API-Key: kp_test_..."
```

## API access

Everything in the Knowledge Network is available via API:

```bash theme={null}
# Search payer rules
curl https://api-dev.rcintell.com/v1/knowledge/layers/170001/l4?payer=Cigna \
  -H "X-API-Key: kp_test_..."

# Get GPCI values for a facility
curl https://api-dev.rcintell.com/v1/knowledge/layers/170001/l1 \
  -H "X-API-Key: kp_test_..."

# Full L1-L6 resolution
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": "99213", "payer": "Medicare"}'
```

## Free to browse

The Knowledge Network is free and publicly accessible at [rcintell.com/network](https://rcintell.com/network). No account required to browse. API access requires a free API key.