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Simulation · not operational100% synthetic data · the demos’ human decisions were simulated in batch
planlang
ESEN

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-154normal, approvable

Approvedwith a persondoes not match the known truth
What should happen

Covered service, complete information and cost below the threshold: approved with no human pause.

What happened

Final decision: approve, with a person.

Takes in

  • The doctor’s text
    Referral note. 29-year-old man. Diagnosis: Arrhythmia under evaluation. Previous tests were reviewed. Request: 24-hour Holter monitoring. Estimated cost: 220 synthetic units. Thank you.
  • The attached orderSYN-P-007 · care ambulatoria · No remarks.
  • Member: man, 29 years oldname, ID, medical record, phone and email are masked before the model (decision D1)

Does

7 steps
enrutadorextractorverificador_coberturadecisionpausa_humanaredactorguardia_salida

The doctor requested “24-hour Holter monitoring” for a 29-year-old man. The extractor read the data with 0.95 confidence and nothing was missing. The coverage checker found the service covered and proposed to approve. The attached order and the doctor’s text ask for different procedures: the case went to an auditor, who decided to approve. The writer drafted the reply with its AI notice and the guard checked the output: no data leaked. It took 6.8 s.

Delivers

  • The reply to the member, with its AI notice
  • The trace, with its fingerprintf9f6a84063a0…
6.8 send to end
7steps
2model calls
5,890tokens
0.0209nominal US$, not billed

Expert

The trace’s technical record

Trace
planlang-trace/v1 · f9f6a84063a09745867e6a0f03ee5a478a7235a4cf4d5f16f4efbd715128832d
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 0
Case
normal · normal_aprobable · 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: outpatient.

    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= urgenciaObservedambulatoriaHolds?noBranch—
    2Signalservicio_exentoRule= trueObservednoHolds?noBranchextractor
  2. 2
    extractor3.1 s · 4,211 tokens

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

    type modelo · in 4044 · out 167 tokens · 3114 ms · US$ 0.014060 · schema retries 0

    nothing missing: on to the coverage checker

    1Signalproveedor_no_disponibleRule= trueObservednoHolds?noBranch—
    2Signalcampos_faltantes_countRule> 0Observed0Holds?noBranchverificador_cobertura
  3. 3
    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

  4. 4
    decisionno model

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

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

    order and text do not match: on to a person

    1Signalcarga_detectadaRule= trueObservednoHolds?noBranch—
    2Signalsenal_confianzaRule< U1 = 0.75Observed0.95Holds?noBranch—
    3Signalcosto_estimadoRule> U2 = 1000Observed220Holds?noBranch—
    4Signalcontradiccion_orden_textoRule= trueObservedyesHolds?yesBranchpausa_humana
    5SignalpropuestaRule= negarObservedaprobarHolds?noBranch—
    6Signaltexas_y_no_aprobar(modo_texas, propuesta)Rulenamed functionObservedmodo_texas = false, propuesta = aprobarHolds?noBranch—
  5. 5
    pausa_humanano model

    An auditor saw the full case and decided: approve.

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

  6. 6
    redactor3.7 s · 1,679 tokens

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

    type modelo · in 1345 · out 334 tokens · 3685 ms · US$ 0.006889 · schema retries 0

  7. 7
    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 human pause: what the auditor saw

real · interrupt payload

No full denial goes out without a person. The agent stops and hands the auditor the full case: why it stopped, what it read, the original text, the evidence and the counter-evidence.

Why it stopped

The attached order and the doctor’s text ask for different procedures.

payload.motivo: Edge 4 of decision: contradiccion_orden_texto (true) equal to true (true).

signal contradiccion_orden_texto · declared threshold true · applied true · node pausa_humana · step 5 · role auditor

Evidence

  • The order asks for SYN-P-007 and the note describes SYN-P-006.

Counter-evidence

  • Doubt about what a service covers is resolved in the member's favour (Law 1751, art. 8).
  • The benefit plan covers SYN-P-006.
  • Diagnosis SYN-D-09 is consistent with SYN-P-006.

What the extractor read

costo_estimado 220 · diagnostico SYN-D-09 · procedimiento SYN-P-006 · urgencia no · confidence 0.95

The rest of the case it received

  • Order: SYN-P-007 · care ambulatoria · No remarks.
  • Coverage: requires authorization · rules RB-05
  • Clarifications: none
What the auditor answered

aprobar

Simulated auditor: in this batch run it follows the case’s known truth (policy sigue_verdad_conocida). In production a person decides with this same payload.

The reply and the guard

real · salida_final and guardia_salida
What the member receives

Your request for a transthoracic echocardiogram (SYN-P-006) has been approved. A person reviewed your case before making this decision. You can coordinate the study with your health care provider.

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
0
contradiccion_orden_texto
yes
costo_estimado
220
decision_final
aprobar
error_proveedor
—
latencia_total_s
6.80
modo_texas
no
nodos_visitados
enrutador → extractor → verificador_cobertura → decision → pausa_humana → redactor → guardia_salida
pausa_humana
yes
propuesta
aprobar
proveedor_no_disponible
no
senal_confianza
0.95
servicio_exento
no
severidad_accion
0
tipo_atencion
ambulatoria
tokens
5890