{"txn_id":"HL-UR-0926","assessment_id":"ra_ed7f0f5ad2144b0a","occurred_at":"2026-10-17T20:18:26+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_4c7da07d7a"},"output":{"decision":"approve","score":0.243,"reason_codes":[],"premium_delta_pct":null},"human_involvement":{"reviewed":false,"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 2026-10-17, 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. No human reviewed the output before it took effect. The outcome was not adverse to the consumer. RegBench applied 5 rule(s) in force on 2026-10-17 and recorded no findings.","findings":[],"point_in_time":{"as_of":"2026-10-17","rules_version":"2026.10+dbe5ddf6","corpus_snapshot":"2026-10-30-5f07c521","engine_version":"regbench-engine/0.4.0","model_version":"deterministic-1"},"evaluated_at":"2026-10-30T11:23:24.925709+00:00","fingerprint":"753ef04d1dedb2e60f2249d1"},"review":null,"ledger":{"seq":926,"hash":"b3637c2244f103abbce6d6fe7a4548efa92eb344e0618dc47257855d40473330","prev_hash":"e19b9637fa24b1b6ffe9f4489ee450d9962203915ec93e2065bf5973e44e3a4d","recorded_at":"2026-10-17T20:20:34+00:00"}}