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GOLD-TMP-06

Temporal reasoning · gold-v0.1

Case inputs

As of
2026-06-15
Patient
33 years, FL
Request
Immunara for rheumatoid arthritis
Insurance
CivicCare, CivicCare Plus · CCP-224419
Policy
immunara-v0.1
Inputs
sha256:30ae01bc3421…

Documents 2

Fax cover

fax_cover
SYNTHETIC RECORD - Example Bayshore Family Medicine - Fax Cover Sheet - 2026-06-09
To: CivicCare Plus Pharmacy Benefits
Re: Prior authorization request for Immunara
Patient reference SYN-6006. Member ID: CCP-224419. Pages: 1 of 1.

Physician note

clinic_note
SYNTHETIC RECORD - Example Bayshore Family Medicine - Visit Note - 2026-06-08
Patient reference SYN-6006. This 33-year-old woman was diagnosed with seropositive rheumatoid arthritis in 2023 and has continued to have active synovitis of both hands despite treatment. She works as a hairstylist and reports that the repetitive hand motions required for her job have become increasingly painful.

She took oral methotrexate 20 mg weekly starting in February 2026 and stopped it in early June 2026 because her joint swelling had not improved. She denies fevers or weight loss and otherwise feels well.

Given the inadequate response to methotrexate, Immunara is now being requested for her.

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
0.980
Step therapy met
0.970
Documentation complete
0.950
Material contradiction
0.060
Missing evidence
NONE 0.850
others: TREATMENT_HISTORY 0.08 · DOSAGE 0.06 · LAB_RESULT 0.01
Gate path· 7 gates, in engine order
  1. providerpassed

    all five decisions present and well-formed

  2. agepassed

    patient.age=33, 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=0.850), request info at >= 0.7

  6. auto_processFIRED → AUTO_PROCESS

    min(required p_yes)=0.950, 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)