Staged case evidence
Claims-Denial Case — Mission 6 Evidence
Claims-Denial Case — Mission 6 Evidence: a bounded synthetic evidence reveal for the Lumyn FDE School claims-denial practice case.
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.