# Claims-Denial Case — Mission 6 Evidence

Reveal this fictional source only after completing the Mission 5 design packet.
Mission 6 produces evaluation evidence for exact candidate `rec-0.4.2`; it cannot
make a release decision.

## Candidate behavior

- Normalizes denial codes using deterministic rules.
- Retrieves up to five passages from encounter notes and payer-policy documents.
- Uses a model call to propose a correction and cited explanation.
- Writes a recommendation to the workbench.
- Has no claim-submission capability.

## Evaluation lanes

| Lane | Result | Limitation or failure |
| --- | --- | --- |
| Schema and citation format | 48/50 pass | Two missing-note cases emitted an unsupported rationale |
| Expert correction review | 40/45 acceptable | One reviewer; five cases disputed and unadjudicated |
| Median latency | 7.8 seconds | Target is 10 seconds |
| Partial pre-pilot cost estimate | CAD 11.40 per case | Excludes support incidents, duplicate-entry time, and adoption burden |

The passing lanes cannot waive unsupported rationales, disputed labels, a missing
independent adjudicator, or unmeasured operating cost. Record the current
evaluation decision before opening the
[Mission 7 trusted-boundary evidence](https://www.lumyn.cc/resources/claims-denial-stage-7/).