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TEST-CLAIM-00022
Synthetic Humana · Prior Authorization
Deadline MissedMissed
Denial
CO-197: Precertification/authorization/notification absent.
- Billed
- $9,218
- Denied
- $8,554
- Funnel stage
- Awaiting Review
- Service date
- Dec 11, 2025
- Denial date
- Feb 17, 2026
- Appeal deadline
- Apr 18, 2026
Procedure codes: CPT: 72216, 68991, 43972 · ICD: K21.98
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 | 95% | $0.0011 | 2.6s |
| Evidence Extractor | Succeeded | claude-haiku-4-5 · v2 | 82% | $0.0024 | 4.2s |
| Policy Checker | Succeeded | claude-sonnet-4-6 · v2 | 82% | $0.0048 | 3.8s |
| Appeal Drafter | Succeeded | claude-sonnet-4-6 · v2 | 82% | $0.0271 | 28.0s |
| Quality Checker | Succeeded | claude-sonnet-4-6 · v1 | 91% | $0.0078 | 2.6s |