Returns the payer-policy graph explanation for a claim. Foresight evaluates the claim against the connected payer’s policy graph and returns the matching corrective recommendations (modifier requirements, place-of-service rules, replacement codes, prior-auth flags, and related policy citations) along with the compiled submission rules that were considered.
Use this endpoint to inspect why a claim received specific scrub findings, surface the underlying payer policies and source citations to billers, or build review UI before calling POST /v1/claims/{id}/apply-fixes.
Behavior
retrievalMode: "policy_graph" when the claim’s payer has indexed policies and at least one rule was evaluated.retrievalMode: "policy_graph_empty" with an empty recommendations array when the claim has no payer attached or no policies match.status of eligible_auto_apply, manual_review, shadow, or blocked_by_gate, plus a confidenceLevel (1–3), safetyClass, and releaseStatus so you can decide which fixes to apply automatically vs. send to manual review.Scopes: claims:read.
Documentation Index
Fetch the complete documentation index at: https://docs.have-foresight.app/llms.txt
Use this file to discover all available pages before exploring further.