{"txn_id":"HL-UR-0905","assessment_id":"ra_fc94b53377194ddc","occurred_at":"2026-10-15T23:21:48+00:00","state":"TX","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_acf3c387ae"},"output":{"decision":"approve","score":0.266,"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 2026-10-15, ur-auto v2.0 (a third-party system from ClinPath AI (fictional)) produced 'approve' in a TX 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 5 rule(s) in force on 2026-10-15 and recorded no findings.","findings":[],"point_in_time":{"as_of":"2026-10-15","rules_version":"2026.10+dbe5ddf6","corpus_snapshot":"2026-10-30-5f07c521","engine_version":"regbench-engine/0.4.0","model_version":"deterministic-1"},"evaluated_at":"2026-10-30T11:23:24.877882+00:00","fingerprint":"944b7816cb4e90fe816bf10b"},"review":null,"ledger":{"seq":905,"hash":"a08cd0b085730be1f2e5d080d600a3dcc17c960ba5dc09964ef19eb3672ca530","prev_hash":"7b03be2959511d54c01be0c38abc778a6277106abfb59202d8e90f39f3bcd713","recorded_at":"2026-10-15T23:24:58+00:00"}}