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TEST-CLAIM-00085
Synthetic Cigna · Medical Necessity
Needs Clinical ReviewOn Track
Denial
CO-55: Procedure/treatment is deemed experimental/investigational by the payer.
- Billed
- $1,272
- Denied
- $971
- Funnel stage
- Awaiting Review
- Service date
- Jan 6, 2026
- Denial date
- Apr 4, 2026
- Appeal deadline
- Aug 2, 2026
Procedure codes: CPT: 87993 · ICD: K21.71
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 | 85% | $0.0012 | 2.0s |
| Evidence Extractor | Succeeded | claude-haiku-4-5 · v2 | 75% | $0.0022 | 3.5s |
| Policy Checker | Succeeded | claude-sonnet-4-6 · v2 | 82% | $0.0051 | 4.6s |
| Appeal Drafter | Succeeded | claude-sonnet-4-6 · v2 | 82% | $0.0309 | 33.4s |
| Quality Checker | Succeeded | claude-sonnet-4-6 · v1 | 91% | $0.0208 | 18.4s |