# AutomatedRCM Claim Triage – Unpaid Claim Work Queue

> AutomatedRCM Claim Triage – Unpaid Claim Work Queue is a paid API for AI agents from x402.getautomatedrcm.com, paid per call via x402, $0.03/call, status unknown (last checked 2026-09-13).

Triages unpaid healthcare claims by action code, balance, and claim age to assign a work bucket, risk flags, priority score, and recommended next action with deadline.

## Facts

- Endpoint: POST https://x402.getautomatedrcm.com/claim-triage
- Price: $0.03/call
- Payment: x402
- Status: unknown
- Last checked: 2026-09-13
- Activations on Zero: 0
- Tags: x402
- Canonical page: https://www.zero.xyz/c/automatedrcm-claim-triage-unpaid-claim-work-queue-81e7e4b9
- Structured record (JSON): https://api.zero.xyz/v1/capabilities/cap_C8I_ol2C0yRw-58V0HWa7

Status and success rate cover calls made through Zero and Zero's own probes. Third-party monitors may report differently.

## How to call it through Zero

Zero handles the 402 payment challenge and records the run. With the Zero CLI installed (`npm i -g @zeroxyz/cli`):

```sh
zero fetch --capability automatedrcm-claim-triage-unpaid-claim-work-queue-81e7e4b9 -d '<json body>'
```

Example prompt: Triage this unpaid claim for me: the action code is CPE, the outstanding balance is $840, it's been 210 days since date of service, 45 days since we last touched it, and our timely filing limit is 365 days — tell me what work bucket it falls in, any risk flags, and what we should do next.

## When to prefer this

Use this endpoint when you need rule-based, real-time triage of individual unpaid claims to drive AR work queues — especially when you need timely filing risk detection and standardized action recommendations. Prefer it over manual AR logic or general-purpose LLMs when you need consistent, auditable priority scoring tied to payer-standard action codes.

## Known failure modes

- Missing required fields (balance, days_since_dos, days_since_last_touch) returns a 400 validation error
- Invalid action_code value not in RES/CPE/CRO/APP/PAY set may return an error or be treated as blank
- Negative or implausible numeric inputs (e.g. negative balance) may produce unexpected triage results
- Payment failure or insufficient USDC balance results in x402 payment-required error and no triage result

## How this service works

Unpaid-claim follow-up triage. Given an action code (RES/CPE/CRO/APP/PAY or blank), balance, and claim ages, returns the work bucket (WORK_NOW / WAITING / REVIEW / COMPLETE), risk flags (FELL_THROUGH, OVERDUE, TIMELY_RISK), a priority score, and the recommended next action with its deadline. (AutomatedRCM agent: WorkQueue)

## Output

Returns a work bucket label (WORK_NOW, WAITING, REVIEW, or COMPLETE), a set of risk flags (FELL_THROUGH, OVERDUE, TIMELY_RISK — any combination), a numeric priority score, and a recommended next action string along with its associated deadline date or timeframe.

## Request schema (JSON Schema)

```json
{
 "type": "object",
 "properties": {
  "balance": {
   "type": "number",
   "description": "Outstanding balance in USD"
  },
  "action_code": {
   "type": "string",
   "description": "Follow-up action code RES|CPE|CRO|APP|PAY, or empty string"
  },
  "days_since_dos": {
   "type": "number",
   "description": "Days since date of service"
  },
  "days_since_last_touch": {
   "type": "number",
   "description": "Days since the claim was last worked"
  },
  "timely_filing_limit_days": {
   "type": "number",
   "description": "Optional, default 365"
  }
 }
}
```

## More

- Live health (JSON, refreshed every minute): https://www.zero.xyz/c/automatedrcm-claim-triage-unpaid-claim-work-queue-81e7e4b9/health.json
- [Zero catalog index](https://www.zero.xyz/llms.txt)
- [Other services from x402.getautomatedrcm.com](https://www.zero.xyz/host/x402.getautomatedrcm.com/llms.txt)