# Claims-Denial Case — Mission 2 Evidence

Reveal this fictional source only after completing the Mission 1 field map. It
adds normative policy and exact-build behavior. Neither source grants disposition
authority or establishes behavior outside its stated scope.

## Available sources

| Source ID | Source and revision | Evidence class | Scope | Limitation |
| --- | --- | --- | --- | --- |
| S4 | Claims security policy, revision 8, effective 1 Jul | Authoritative policy | Corrected-claim approval and submission | Policy owner must confirm applicability to the pilot service account |
| S5 | Adapter test report, build `nl-adapter-2026.08.03`, 6 Aug | Exact-build test | NorthLake adapter build only | Does not prove Summit behavior or production configuration |

## S4 — Claims security policy revision 8

> Only an authenticated billing specialist assigned to the applicable facility
> may approve and submit a corrected claim. Approval is scoped to the claim,
> correction revision, actor, facility, and policy revision. Recommendation tools
> may not reuse the specialist credential or infer approval from prior cases.

> A submission is complete only after the claims system of record returns a status
> for the same claim and correction revision. A timeout after a possible submission
> must be reconciled before retry.

Policy owner: Director of Product Security. No pilot exception is recorded.

## S5 — NorthLake adapter exact-build test

Tested build: `nl-adapter-2026.08.03`, test fixture revision `mod25-r2`.

| Test | Expected | Observed |
| --- | --- | --- |
| Same-day evaluation documented | Preserve modifier 25 | Modifier 25 removed |
| No separate evaluation documented | Remove modifier 25 | Modifier 25 removed |
| Duplicate correction request | One recommendation record | Two recommendation records |

The report does not cover Summit, production deployment identity, specialist
approval, submission, or claims-system readback.

Complete Mission 2 before opening the
[Mission 3 evidence](https://www.lumyn.cc/resources/claims-denial-stage-3/).