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GOLD-STR-04

Straightforward · gold-v0.1

Case inputs

As of
2026-09-01
Patient
52 years, WA
Request
Immunara for rheumatoid arthritis
Insurance
ExampleHealth, ExampleHealth Gold · EXH-771230
Policy
immunara-v0.1
Inputs
sha256:5b19e0b46f3f…

Documents 2

Physician note

clinic_note
SYNTHETIC RECORD - Example Meridian Telehealth - Virtual Visit Note - 2026-08-28
Patient reference SYN-3390. Telehealth follow-up was requested because his rheumatoid arthritis symptoms have not settled. He was diagnosed in 2020 by his rheumatologist, who documented symmetric small-joint swelling and positive serology at that time. He is 52 years old.

He started oral methotrexate in January 2026 and continued it through July 2026, when it was stopped because his hands and feet remained swollen and painful despite the medication. He mentions his commute has gotten harder because of stiffness in his feet, and he has recently taken up swimming to help with mobility. He denies any new rashes or fevers. He is otherwise healthy aside from mild seasonal allergies.

Discussed transitioning to Immunara given the inadequate response to methotrexate. He would like to proceed and has no questions at this time.

Insurance card

insurance_card
SYNTHETIC RECORD - ExampleHealth Gold - Member Insurance Card - Issued 2026-01-01
Payer: ExampleHealth
Plan: ExampleHealth Gold
Member ID: EXH-771230
Group Number: EXHG-88214
Member Services: 555-0142

Decisions by provider

AUTO_PROCESScorrect

Decided by: auto_process gate · auto_process 0.89

Judgments

p_yes for yes/no questions; ticks are the thresholds a gate compares each one with.

Diagnosis supported
0.910
Step therapy met
0.960
Documentation complete
0.950
Material contradiction
0.060
Missing evidence
NONE 0.830
others: DOSAGE 0.09 · TREATMENT_HISTORY 0.06 · DIAGNOSIS 0.01
Gate path· 7 gates, in engine order
  1. providerpassed

    all five decisions present and well-formed

  2. agepassed

    patient.age=52, policy min_age=18

  3. contradictionpassed

    p_yes(material_contradiction)=0.060, review at >= 0.8

  4. documentationpassed

    p_yes(documentation_complete)=0.950, request info below 0.6

  5. missing_evidencepassed

    missing_evidence=NONE (p=0.830), request info at >= 0.7

  6. auto_processFIRED → AUTO_PROCESS

    min(required p_yes)=0.910, auto at >= 0.89; p_yes(material_contradiction)=0.060, blocks at >= 0.2

  7. default_reviewnot reached

passed = the gate checked and did not fire; not reached = an earlier gate decided.

  • all required judgments are at or above 0.89 and contradiction risk is below 0.2
Run details· q-v0.2

run_20260925T170857Z_b95be9 · q-v0.2 · immunara-v0.1 (v0.1)

auto_process 0.89, chosen on gen-v0.2-dev.

questions: q-v0.2 →

Show expected answer (evaluation only)