> ## Documentation Index
> Fetch the complete documentation index at: https://docs.refactorbilling.com/llms.txt
> Use this file to discover all available pages before exploring further.

# Get Denial Clarification

> Retrieve denial details and recommended actions for a visit.

## Authentication

All requests require an API key passed via the `x-api-key` header, along with a `tenant_id` query parameter.

<ParamField header="x-api-key" type="string" required>
  Your tenant API key.
</ParamField>

## Query Parameters

<ParamField query="tenant_id" type="integer" required>
  Your tenant ID.
</ParamField>

<ParamField query="visit_number" type="string" required>
  The visit number to look up denial details for.
</ParamField>

## Response

<ResponseField name="visit_number" type="string">
  The visit number that was queried.
</ResponseField>

<ResponseField name="status" type="string">
  Call status. One of `completed`, `in_progress`, or `failed`.
</ResponseField>

<ResponseField name="payer_name" type="string">
  Name of the payer that issued the denial.
</ResponseField>

<ResponseField name="patient_name" type="string">
  Patient name on the denied claim.
</ResponseField>

<ResponseField name="claim_status_code" type="string">
  Claim status code (e.g. `4` = denied).
</ResponseField>

<ResponseField name="denial_reason" type="string">
  Human-readable explanation of the denial reason.
</ResponseField>

<ResponseField name="denial_remark_codes" type="string[]">
  Remittance advice remark codes (RARC) associated with the denial, e.g. `["N381", "MA04"]`.
</ResponseField>

<ResponseField name="adjustment_codes" type="DenialAdjustment[]">
  Claim adjustment codes explaining the denial.

  <Expandable title="DenialAdjustment">
    <ResponseField name="group_code" type="string">
      Claim adjustment group code (e.g. `CO`, `PR`, `OA`).
    </ResponseField>

    <ResponseField name="reason_code" type="string">
      Claim adjustment reason code (e.g. `16`, `197`, `50`).
    </ResponseField>

    <ResponseField name="amount" type="number">
      Dollar amount of this adjustment.
    </ResponseField>

    <ResponseField name="description" type="string">
      Human-readable description of the adjustment reason code.
    </ResponseField>
  </Expandable>
</ResponseField>

<ResponseField name="recommended_action" type="string">
  Suggested next step to resolve the denial (e.g. "Submit appeal with medical records", "Resubmit with corrected modifier").
</ResponseField>

<RequestExample>
  ```bash cURL theme={null}
  curl -X GET "https://api.refactorbilling.com/denial-clarification?tenant_id=1&visit_number=V12345" \
    -H "x-api-key: your-api-key"
  ```
</RequestExample>

<ResponseExample>
  ```json 200 theme={null}
  {
    "visit_number": "V12345",
    "status": "completed",
    "payer_name": "Aetna",
    "patient_name": "John Doe",
    "claim_status_code": "4",
    "denial_reason": "Service not covered under the patient's current benefit plan.",
    "denial_remark_codes": ["N381", "MA04"],
    "adjustment_codes": [
      {
        "group_code": "CO",
        "reason_code": "50",
        "amount": 750.00,
        "description": "These are non-covered services because this is not deemed a medical necessity by the payer."
      }
    ],
    "recommended_action": "Submit appeal with supporting clinical documentation demonstrating medical necessity."
  }
  ```
</ResponseExample>