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TEST-CLAIM-00062
Synthetic Humana · Medical Necessity
Needs Clinical ReviewOn Track
Denial
CO-50: These services are not deemed a medical necessity by the payer.
- Billed
- $948
- Denied
- $578
- Funnel stage
- Awaiting Review
- Service date
- Apr 18, 2026
- Denial date
- Jun 6, 2026
- Appeal deadline
- Aug 5, 2026
Procedure codes: CPT: 57537 · ICD: N39.69
Appeal
A draft appeal has been produced.
AI pipeline trace (6 runs)
| Step | Status | Model · prompt | Confidence | Cost | Latency |
|---|---|---|---|---|---|
| Classifier | Failed | claude-haiku-4-5 · v2 | — | $0.0000 | — |
| Classifier | Succeeded | claude-haiku-4-5 · v2 | 95% | $0.0010 | 1.6s |
| Evidence Extractor | Succeeded | claude-haiku-4-5 · v2 | 72% | $0.0021 | 3.6s |
| Policy Checker | Succeeded | claude-sonnet-4-6 · v2 | 85% | $0.0049 | 3.7s |
| Appeal Drafter | Succeeded | claude-sonnet-4-6 · v2 | 82% | $0.0287 | 33.3s |
| Quality Checker | Succeeded | claude-sonnet-4-6 · v1 | 91% | $0.0079 | 2.1s |