Work queue
Sorted by SLA — the case closest to breaching the CMS decision window is worked first. You are acting as nurse.
Your nurse queue
4| Case | Plan | Service | Urgency | Status | Routing | SLA remaining |
|---|---|---|---|---|---|---|
| CASE-1002 | Meridian Commercial PPO | MRI lumbar spine without contrast (CPT 72148) | standard | Nurse review | Likely deny | … |
| CASE-1006 | Meridian Medicare Advantage | MRI lumbar spine without contrast (CPT 72148) | standard | Nurse review | Engine error → manual | … |
| CASE-1004 | Meridian Commercial PPO | MRI lumbar spine without contrast (CPT 72148) | standard | Nurse review | Likely deny | … |
| CASE-1005 | Meridian Medicaid MCO | MRI lumbar spine without contrast (CPT 72148) | standard | Nurse review | Needs review | … |
Resolved
2 engine auto-decisions + closed reviews| Case | Plan | Service | Status | Routing | Confidence | |
|---|---|---|---|---|---|---|
| CASE-1003 | Meridian Commercial PPO | MRI lumbar spine without contrast (CPT 72148) | Auto-approved | Expedited — red flag | high | Response → |
| CASE-1001 | Meridian Commercial PPO | MRI lumbar spine without contrast (CPT 72148) | Auto-approved | Clean auto-approve | high | Response → |
🔒 Synthetic data only — not for clinical use. The engine never auto-denies; only a Medical Director may deny.