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Simulation · not operational100% synthetic data · the demos’ human decisions were simulated in batch
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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-170missing: 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: 57-year-old woman. No relevant history. Request: Electromyography. Estimated cost: 240 synthetic units. Thank you.
  • The attached orderSYN-P-021 · care ambulatoria · No remarks.
  • Member: woman, 57 years oldname, ID, medical record, phone and email are masked before the model (decision D1)

Does

8 steps
enrutadorextractoraclaracionextractorverificador_coberturadecisionredactorguardia_salida

The doctor requested “Electromyography” for a 57-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 14.9 s.

Delivers

  • The reply to the member, with its AI notice
  • The trace, with its fingerprintafc984246c85…
14.9 send to end
8steps
4model calls
11,675tokens
0.0404nominal US$, not billed

Expert

The trace’s technical record

Trace
planlang-trace/v1 · afc984246c8566bc1b18365878184a87ca120893c0fd48531528c2c6c5d59faa
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: 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
    extractor3.8 s · 4,280 tokens

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

    type modelo · in 4022 · out 258 tokens · 3781 ms · US$ 0.012318 · schema retries 0

    data are missing: it asks the doctor

    1Signalproveedor_no_disponibleRule= trueObservednoHolds?noBranch—
    2Signalcampos_faltantes_countRule> 0Observed1Holds?yesBranchaclaracion
  3. 3
    aclaracion3.2 s · 1,277 tokens

    Asked the doctor (cycle 1).

    Question«Para continuar con la solicitud de electromiografía, por favor indique el diagnóstico clínico que justifica el estudio (código CIE-10 o descripción diagnóstica).»

    Answer«Aclaración del médico. Diagnóstico: Síndrome del túnel carpiano.»

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

    type modelo · in 1164 · out 113 tokens · 3208 ms · US$ 0.004901 · schema retries 0

    back to the extractor with the answer

    1Signalproveedor_no_disponibleRule= trueObservednoHolds?noBranch—
    2Signalciclos_aclaracionRule≥ U3 = 2Observed0Holds?noBranchextractor
  4. 4
    extractor4.5 s · 4,544 tokens

    Read the case again with the doctor’s answer.

    type modelo · in 4055 · out 489 tokens · 4546 ms · US$ 0.017332 · 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 · 0 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 = 1000Observed240Holds?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
    redactor3.3 s · 1,574 tokens

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

    type modelo · in 1337 · out 237 tokens · 3327 ms · US$ 0.005864 · 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 the electromyography (SYN-P-021) has been approved. You can proceed with the procedure as indicated by your healthcare provider. This decision was not reviewed by a person.

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
240
decision_final
aprobar
error_proveedor
—
latencia_total_s
14.86
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
ambulatoria
tokens
11675