← Triage Tracker
TEST-CLAIM-00060
Synthetic Humana · Medical Necessity
Needs Clinical ReviewApproaching
Denial
CO-50: These services are not deemed a medical necessity by the payer.
- Billed
- $4,404
- Denied
- $3,482
- Funnel stage
- Awaiting Review
- Service date
- Apr 16, 2026
- Denial date
- May 8, 2026
- Appeal deadline
- Jul 7, 2026
Procedure codes: CPT: 63516, 25292, 28320 · ICD: M17.38
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% | $0.0012 | 2.5s |
| Evidence Extractor | Succeeded | claude-haiku-4-5 · v2 | 72% | $0.0023 | 3.8s |
| Policy Checker | Succeeded | claude-sonnet-4-6 · v2 | 82% | $0.0056 | 8.0s |
| Appeal Drafter | Succeeded | claude-sonnet-4-6 · v2 | 82% | $0.0272 | 30.9s |
| Quality Checker | Succeeded | claude-sonnet-4-6 · v1 | 91% | $0.0181 | 17.9s |