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Simulation · not operational100% synthetic data · the demos’ human decisions were simulated in batch
planlang
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Demo A · run suscripcion-planlang-a-002-200-v1.5 · one real trace

One case, end to end

What the agent received, every step it took and the signal it left when choosing a path, the person who decided when needed and what it answered, just as its trace recorded it.

This run’s human decisions were simulated. At every pause, a simulated auditor answered what the case’s known truth says (DA-04). Cases, members and the benefits plan are synthetic.

The case at a glance

Read as

Reading as leader. You see what the doctor asked, what each node did and why it took each path, in plain words.

Reading as expert. Each step adds its tokens, milliseconds and cost; each decision, the edge table with the plan’s rule and the observed value; at the end, the technical record and the trace’s signals.

A-130missing: 1 clarification

Approvedno personmatches the known truth
What should happen

One detail is missing: one clarification completes it and it is approved.

What happened

Final decision: approve, without a person.

Takes in

  • The doctor’s text
    Dear authorisations team: 66-year-old woman. Previous tests were reviewed. Request: Tonsillectomy. Estimated cost: 900 synthetic units. Sincerely, treating doctor.
  • The attached orderSYN-P-023 · care hospitalaria · No remarks.
  • Member: woman, 66 years oldname, ID, medical record, phone and email are masked before the model (decision D1)

Does

8 steps
enrutadorextractoraclaracionextractorverificador_coberturadecisionredactorguardia_salida

The doctor requested “Tonsillectomy” for a 66-year-old woman. The note did not state the diagnosis: the extractor caught it and the agent asked the doctor. After one answer from the doctor, the data were complete (0.85 confidence). The coverage checker found the service covered and proposed to approve. No escalation rule held and the agent decided to approve on its own. The writer drafted the reply with its AI notice and the guard checked the output: no data leaked. It took 17.1 s.

Delivers

  • The reply to the member, with its AI notice
  • The trace, with its fingerprint426050e66288…
17.1 send to end
8steps
4model calls
11,803tokens
0.0441nominal US$, not billed

Expert

The trace’s technical record

Trace
planlang-trace/v1 · 426050e66288b037d80d79d02bfbca0700161d28098f3d977a45a027f789011c
Run
suscripcion-planlang-a-002-200-v1.5 · variant multiagente · result completo
Errors
provider: none · schema on handoff: no
Known truth
decision aprobar · must escalate no · cycles needed 1
Case
faltante · faltante_un_ciclo · seed planlang-a-002

The path, step by step

real · steps and edge decisions

Each step says what the node did and, where a path must be chosen, why it took that branch: the signal it left, the plan’s rule and the observed value.

  1. 1
    enrutadorno model

    Classified the care type: inpatient.

    type enrutador · in 0 · out 0 tokens · 0 ms · US$ 0.000000 · schema retries 0

    neither an emergency nor an exempt service: on to the extractor

    1Signaltipo_atencionRule= urgenciaObservedhospitalariaHolds?noBranch—
    2Signalservicio_exentoRule= trueObservednoHolds?noBranchextractor
  2. 2
    extractor3.6 s · 4,303 tokens

    Read the doctor’s text and turned it into fields, with a stated confidence.

    type modelo · in 4032 · out 271 tokens · 3611 ms · US$ 0.015047 · schema retries 0

    data are missing: it asks the doctor

    1Signalproveedor_no_disponibleRule= trueObservednoHolds?noBranch—
    2Signalcampos_faltantes_countRule> 0Observed1Holds?yesBranchaclaracion
  3. 3
    aclaracion3.3 s · 1,288 tokens

    Asked the doctor (cycle 1).

    Question«Para continuar con la solicitud de amigdalectomía, por favor indique el diagnóstico clínico que justifica el procedimiento (con su código CIE-10, si lo tiene).»

    Answer«Aclaración del médico. Diagnóstico: Amigdalitis recurrente.»

    In the original Spanish: the model asks in the case’s language.

    type modelo · in 1173 · out 115 tokens · 3314 ms · US$ 0.004985 · schema retries 0

    back to the extractor with the answer

    1Signalproveedor_no_disponibleRule= trueObservednoHolds?noBranch—
    2Signalciclos_aclaracionRule≥ U3 = 2Observed0Holds?noBranchextractor
  4. 4
    extractor5.3 s · 4,479 tokens

    Read the case again with the doctor’s answer.

    type modelo · in 4065 · out 414 tokens · 5260 ms · US$ 0.016634 · schema retries 0

    nothing missing: on to the coverage checker

    1Signalproveedor_no_disponibleRule= trueObservednoHolds?noBranch—
    2Signalcampos_faltantes_countRule> 0Observed0Holds?noBranchverificador_cobertura
  5. 5
    verificador_coberturano model

    Applied the benefits plan rules: service covered; proposal: approve.

    type regla · in 0 · out 0 tokens · 0 ms · US$ 0.000000 · schema retries 0

  6. 6
    decisionno model

    Checked the plan’s 6 escalation rules, in order.

    type enrutador · in 0 · out 0 tokens · 1 ms · US$ 0.000000 · schema retries 0

    no escalation rule holds: on to the writer alone

    1Signalcarga_detectadaRule= trueObservednoHolds?noBranch—
    2Signalsenal_confianzaRule< U1 = 0.75Observed0.85Holds?noBranch—
    3Signalcosto_estimadoRule> U2 = 1000Observed900Holds?noBranch—
    4Signalcontradiccion_orden_textoRule= trueObservednoHolds?noBranch—
    5SignalpropuestaRule= negarObservedaprobarHolds?noBranch—
    6Signaltexas_y_no_aprobar(modo_texas, propuesta)Rulenamed functionObservedmodo_texas = false, propuesta = aprobarHolds?noBranchredactor
  7. 7
    redactor4.9 s · 1,733 tokens

    Wrote the reply to the member, with the AI notice.

    type modelo · in 1337 · out 396 tokens · 4909 ms · US$ 0.007466 · schema retries 0

  8. 8
    guardia_salidano model

    Checked the output: 0 findings, severity 0.

    type regla · in 0 · out 0 tokens · 0 ms · US$ 0.000000 · schema retries 0

The reply and the guard

real · salida_final and guardia_salida
What the member receives

Your request for a tonsillectomy (SYN-P-023) has been approved. This procedure is authorized as requested. If you have questions about the next steps, you can contact your health plan.

Notice: this reply was drafted by an artificial intelligence in a simulation with synthetic data. No denial is issued without review by a person.

Inaccurate noticeThe agent wrote this notice into the run, which is never rewritten, and it promises too much: with Texas mode off, 9 partial approvals in this run went out without a person. It holds for a full denial: from plan v1.5.1 on the agent writes it that way, and this run is from v1.5.

Output guard: fixed rules, no model

Actions attempted
responder_afiliado
Actions run
responder_afiliado
Instruction in the input
none
Findings in the output
0
Action severity
0

The 18 signals the trace leaves

Expert

The ones the plan requires in every trace: the verifier and the playground read from here.

campos_faltantes_count
0
carga_detectada
no
ciclos_aclaracion
1
contradiccion_orden_texto
no
costo_estimado
900
decision_final
aprobar
error_proveedor
—
latencia_total_s
17.09
modo_texas
no
nodos_visitados
enrutador → extractor → aclaracion → extractor → verificador_cobertura → decision → redactor → guardia_salida
pausa_humana
no
propuesta
aprobar
proveedor_no_disponible
no
senal_confianza
0.85
servicio_exento
no
severidad_accion
0
tipo_atencion
hospitalaria
tokens
11803