{"txn_id":"HL-UR-0889","assessment_id":"ra_6ca67413cc4a4308","occurred_at":"2026-10-20T20:05:45+00:00","state":"NY","line_of_business":"health","stage":"utilization_review","program_area":"Utilization Management/Utilization Review/Prior Authorization/Level of Care Determination","ai_system":{"system_id":"ur-auto","model_version":"2.0","vendor":"third_party","vendor_name":"ClinPath AI (fictional)","high_risk_class":"utilization_review"},"inputs":{"feature_classes":["clinical_criteria","medical_records"],"protected_factors_used":[],"ecdis_present":false,"consumer_report_used":false,"credit_used":false,"data_source_refs":["ehr://harborline/clinical-record"],"consumer_token":"tok_367ea5e661"},"output":{"decision":"approve","score":0.374,"reason_codes":[],"premium_delta_pct":null},"human_involvement":{"reviewed":true,"reviewer_role":"nurse","overridden":false},"adverse_action":{"is_adverse":false,"notice_sent_at":null,"reasons_provided":false,"specific_reasons":false,"ecdis_disclosed":false,"appeal_channel":null},"carrier_note":null,"assessment":{"disposition":"PASS","summary":"PASS: 0 finding(s) under rules 2026.10+dbe5ddf6, corpus 2026-10-30-5f07c521. No regulatory finding; the case file is recorded.","narrative":"On 2026-10-20, ur-auto v2.0 (a third-party system from ClinPath AI (fictional)) produced 'approve' in a NY health utilization review transaction. Inputs included clinical criteria, medical records. A human reviewed the output by a nurse. The outcome was not adverse to the consumer. RegBench applied 1 rule(s) in force on 2026-10-20 and recorded no findings.","findings":[],"point_in_time":{"as_of":"2026-10-20","rules_version":"2026.10+dbe5ddf6","corpus_snapshot":"2026-10-30-5f07c521","engine_version":"regbench-engine/0.4.0","model_version":"deterministic-1"},"evaluated_at":"2026-10-30T11:23:24.833145+00:00","fingerprint":"5814b9a84b9c8ba5c643e85e"},"review":null,"ledger":{"seq":889,"hash":"08bff08aa92d235facd1726583e8c26224f3e0aab172c8ffc4f78adfd69690c3","prev_hash":"377819c8f06b14687f1859f9eb2c95a38c42c1da1ee69bdcd002fd544ada463f","recorded_at":"2026-10-20T20:08:44+00:00"}}