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TEST-CLAIM-00011
Synthetic Cigna · Medical Necessity
Needs Clinical ReviewOn Track
Denial
CO-55: Procedure/treatment is deemed experimental/investigational by the payer.
- Billed
- $1,599
- Denied
- $825
- Funnel stage
- Awaiting Review
- Service date
- Mar 15, 2026
- Denial date
- Jun 7, 2026
- Appeal deadline
- Oct 5, 2026
Procedure codes: CPT: 56898 · ICD: J45.85
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 | 1.9s |
| Evidence Extractor | Succeeded | claude-haiku-4-5 · v2 | 72% | $0.0022 | 3.6s |
| Policy Checker | Succeeded | claude-sonnet-4-6 · v2 | 82% | $0.0049 | 3.7s |
| Appeal Drafter | Succeeded | claude-sonnet-4-6 · v2 | 82% | $0.0262 | 27.5s |
| Quality Checker | Succeeded | claude-sonnet-4-6 · v1 | 85% | $0.0172 | 15.1s |