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TEST-CLAIM-00042
Synthetic Aetna · Prior Authorization
Deadline MissedMissed
Denial
CO-197: Precertification/authorization/notification absent.
- Billed
- $2,985
- Denied
- $1,064
- Funnel stage
- Awaiting Review
- Service date
- Sep 3, 2025
- Denial date
- Oct 25, 2025
- Appeal deadline
- Apr 23, 2026
Procedure codes: CPT: 66626 · ICD: F32.32, M17.11
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% | $0.0010 | 1.8s |
| Evidence Extractor | Succeeded | claude-haiku-4-5 · v2 | 85% | $0.0022 | 3.9s |
| Policy Checker | Succeeded | claude-sonnet-4-6 · v2 | 85% | $0.0048 | 3.7s |
| Appeal Drafter | Succeeded | claude-sonnet-4-6 · v2 | 85% | $0.0240 | 25.2s |
| Quality Checker | Succeeded | claude-sonnet-4-6 · v1 | 88% | $0.0174 | 14.0s |