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TEST-CLAIM-00048

Synthetic UHC · Medical Necessity

Needs Clinical ReviewApproaching

Denial

CO-50: These services are not deemed a medical necessity by the payer.

Billed
$4,630
Denied
$1,615
Funnel stage
Awaiting Review
Service date
Jan 31, 2026
Denial date
Apr 20, 2026
Appeal deadline
Jul 19, 2026
Procedure codes: CPT: 54548, 76550 · ICD: M17.36, K21.75

Appeal

A draft appeal has been produced.

AI pipeline trace (6 runs)

StepStatusModel · promptConfidenceCostLatency
ClassifierFailedclaude-haiku-4-5 · v2$0.0000
ClassifierSucceededclaude-haiku-4-5 · v295%$0.00101.4s
Evidence ExtractorSucceededclaude-haiku-4-5 · v272%$0.00224.4s
Policy CheckerSucceededclaude-sonnet-4-6 · v282%$0.00564.9s
Appeal DrafterSucceededclaude-sonnet-4-6 · v282%$0.030132.1s
Quality CheckerSucceededclaude-sonnet-4-6 · v191%$0.00842.5s