{"txn_id":"HL-UR-0962","assessment_id":"ra_d1084893f4384b30","occurred_at":"2026-10-14T12:57:58+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_c38ed6f321"},"output":{"decision":"approve","score":0.331,"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 2026-10-14, 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 2026-10-14 and recorded no findings.","findings":[],"point_in_time":{"as_of":"2026-10-14","rules_version":"2026.10+dbe5ddf6","corpus_snapshot":"2026-10-30-5f07c521","engine_version":"regbench-engine/0.4.0","model_version":"deterministic-1"},"evaluated_at":"2026-10-30T11:23:25.015443+00:00","fingerprint":"646ba12d9add1fb6397cdc75"},"review":null,"ledger":{"seq":962,"hash":"8101a855f6e4d8d230241885617fd8f7e608c723fe77e147d5c0f1a1b1abdba0","prev_hash":"d2fda5df80237cddc7ae32e8e3d4530fb6db8c10e458bcb651998575ae1bb1b6","recorded_at":"2026-10-14T13:00:03+00:00"}}