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TEST-CLAIM-00000
Synthetic BCBS-TX · Prior Authorization
Needs Clinical ReviewApproaching
Denial
CO-197: Precertification/authorization/notification absent.
- Billed
- $1,401
- Denied
- $752
- Funnel stage
- Awaiting Review
- Service date
- Feb 5, 2026
- Denial date
- Apr 17, 2026
- Appeal deadline
- Jul 16, 2026
Procedure codes: CPT: 82603, 40161, 87128 · ICD: M17.09
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 | 2.1s |
| Evidence Extractor | Succeeded | claude-haiku-4-5 · v2 | 85% | $0.0022 | 4.6s |
| Policy Checker | Succeeded | claude-sonnet-4-6 · v2 | 85% | $0.0046 | 4.0s |
| Appeal Drafter | Succeeded | claude-sonnet-4-6 · v2 | 85% | $0.0256 | 26.5s |
| Quality Checker | Succeeded | claude-sonnet-4-6 · v1 | 91% | $0.0144 | 11.4s |