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TEST-CLAIM-00006
Synthetic Aetna · Medical Necessity
Needs Clinical ReviewCritical
Denial
CO-55: Procedure/treatment is deemed experimental/investigational by the payer.
- Billed
- $7,608
- Denied
- $7,297
- Funnel stage
- Awaiting Review
- Service date
- Nov 18, 2025
- Denial date
- Dec 25, 2025
- Appeal deadline
- Jun 23, 2026
Procedure codes: CPT: 42271, 85880, 87924 · ICD: F32.10
Appeal
A draft appeal has been produced.
AI pipeline trace (5 runs)
| Step | Status | Model · prompt | Confidence | Cost | Latency |
|---|---|---|---|---|---|
| Classifier | Succeeded | claude-haiku-4-5 · v2 | 90% | $0.0011 | 2.1s |
| Evidence Extractor | Succeeded | claude-haiku-4-5 · v2 | 75% | $0.0024 | 3.7s |
| Policy Checker | Succeeded | claude-sonnet-4-6 · v2 | 82% | $0.0053 | 4.2s |
| Appeal Drafter | Succeeded | claude-sonnet-4-6 · v2 | 78% | $0.0277 | 28.6s |
| Quality Checker | Succeeded | claude-sonnet-4-6 · v1 | 82% | $0.0192 | 17.6s |