UNBUNDLE // Autonomous Medical Sentinel Console

UNBUNDLE BEDROCK SENTINEL v2.1

Eleanor Rigby

UHC Insured (Active)

DTCC NETTING METRIC

$3,620 / $4,280

+84.5% NET

STATUTORY WINDOW

30 DAYS

29 CFR § 2560

Elapsed: Day 0 Federal Limit: Day 30

LEAST-PRIVILEGE GATE

AWS Cedar & WebAuthn
Session Protection

PULL UP // DISCREPANCY INTERCEPTED CMS NCCI INDICATOR 0 VIOLATION

$190.00 Unbundled Charge on Claim #CLM-2026-NY-8912

Memorial Regional Health billed Basic Metabolic Panel (CPT 80048) alongside mutually inclusive Comprehensive Metabolic Panel (CPT 80053).

Excised by Sentinel

$190.00

Revised Lawful: $0.00

Cedar Policy: forbid dispatch unless token_valid

EXPLICIT DENY: Awaiting Patient Key

Adjudicated EOB Line Items

Parsed from unvarnished Memorial Regional Health text export

Verified via SQLite NCCI

#	CPT	Description	Billed	Patient Resp	Sentinel Finding

ERISA § 503 Dossier

View formal court appeal brief & citations

→

Silence Ledger

2 routine claims audited with 0 pings

→

Safety Gate & Bug Story

2 ambiguous charges quarantined safely

→

Statutory ERISA § 503 Formal Dispute Dossier

Self-contained legal dispute packet compliant with 29 U.S.C. § 1133 and 29 C.F.R. § 2560.503-1.

Open Print Dossier (PDF) → Download .txt

Dispute Brief & Statutory Citations

29 U.S.C. § 1133

Awaiting 1-tap human authorization to attach cryptographic signature and emit legal dossier. Click "1-Tap Approve" on the Cockpit tab to seal.

Judge Sandbox Controls

1-Click Scenarios

MEMBER SIGNATURE AFFIDAVIT

Formally executed under penalty of perjury pursuant to member session key authority. Includes immutable CMS NCCI indicator proof table.

SIGNER: Eleanor Rigby

ALGORITHM: WebAuthn FIDO2 / ECDSA P-256

CEDAR STATUS: Sealed

The Silence Ledger (Zero-Fatigue Defense Standard)

"The best alert is 0 alerts." An autonomous medical defense agent must defend quietly. Routine, lawful healthcare claims pass silently through CMS NCCI tables without waking up the patient.

2 ROUTINE VISITS SILENTLY VERIFIED

SILENT ARCHIVAL

2 / 2 Claims

100% Deterministic CMS Match

PATIENT INTERRUPTIONS

0 Pings Sent

Zero False-Alarm Notifications

TOTAL ROUTINE BILLED

$445.00

Lawful Copay: $0.00 (Preventative)

Audited Clean Records (0 Pings Emitted)

Archived to Silence Ledger

Why the Silence Principle Matters (Aviation Annunciator Standard):

If an AI agent notifies the user about every routine copay, preventative checkup, or standard lab draw, user fatigue causes a 95% notification bounce rate. UNBUNDLE operates on aviation annunciator principles: the cockpit remains dark and silent during normal operations, waking up only when an unlawful unbundling or modifier violation occurs.

AWS Cedar Least-Privilege Policy Gate

Enforces least-privilege session keys. Prevents the autonomous agent from forging member signatures.

POLICY: FORBID DISPATCH UNLESS TOKEN_VALID

policies.cedar

AWS Cedar v3.0 Spec

// AWS Cedar Policy: Least-Privilege Member Gate
forbid (
    principal,
    action == Action::"dispatch_dispute",
    resource
)
unless {
    context.has_valid_human_token == true &&
    context.token_scope == "dispute_approval" &&
    context.device_bound == true
};

PRINCIPAL: Patient::"eleanor_rigby"

ACTION: Action::"dispatch_dispute"

RESOURCE: Claim::"CLM-2026-NY-8912"

Negative-Space Attack Testing

Least-Privilege Security Boundary

Test the two paths: verify that an autonomous dispatch without a valid patient token results in an immediate HTTP 403 EXPLICIT_DENY, while 1-tap member signing passes the gate.

Status: Awaiting test interaction. Click an action above to evaluate live Cedar policy engine.

Radical Honesty: Dual Cryptographic Token Paths

WebAuthn biometric path and ECDSA fallback path both produce a real cryptographic token. The biometric binding is stronger; the fallback is device-scoped. Both satisfy the Cedar gate. Neither is a fake approval.

ERISA § 503 Statutory Clock & State DOI Escalation

Statutory countdown under 29 C.F.R. § 2560.503-1. Auto-escalates to State Department of Insurance upon adverse denial.

30-DAY STATUTORY TIMELINE

Automated Dispute Lifecycle Flow

✓

Stage 1: Ingestion & Deterministic NCCI Intercept

COMPLETED

Memorial Regional Health text export parsed. Unlawful $190.00 CPT 80048 unbundling excised.

Stage 2: Least-Privilege Cryptographic Dispatch

PENDING SIGN

Member signs with WebAuthn/ECDSA key. AWS Cedar permits dispatch to UnitedHealthcare clearinghouse.

Stage 3: 30-Day Payor Response Window

AWAITING STAGE 2

Federal clock running (29 CFR § 2560.503-1). If payor ignores after 30 days, claim is deemed exhausted.

Stage 4: Overturn or State DOI Docket Escalation

STANDBY

Adverse denial automatically triggers official complaint to State Department of Insurance Commissioner.

Payor Adjudication Simulator

ERISA § 503

Simulate payor clearinghouse reactions to observe deterministic escalation:

Clinical Safety Gate & Deltr Bug Story (Radical Honesty)

When hospital billing systems emit non-standard unstructured strings, LLMs hallucinate plausible CPT codes. Sentinel enforces an algorithmic confidence threshold (≥ 0.90). If confidence is below, the line is quarantined rather than invented.

2 AMBIGUOUS LINES QUARANTINED

Quarantined Charges (Refused to Hallucinate)

Confidence < 0.90

MISC SURGICAL SUPPLIES TRAY 3 $450.00

Confidence: 0.25 (Below 0.90 safety gate)
Non-standard hospital line item without CPT code. Sentinel quarantined this item for manual clinical coder review instead of hallucinating a CPT code.

GLOBAL FACILITY OVERHEAD CHG $800.00

Confidence: 0.25 (Below 0.90 safety gate)
Unbundled overhead facility charge without supporting documentation. Quarantined safely.

Raw Hospital Text Export

real_unstructured_eob.txt

MEMORIAL REGIONAL HEALTH SYSTEM
EXPLANATION OF BENEFITS / STATEMENT OF CHARGES
PATIENT: ELEANOR RIGBY
CLAIM ID: CLM-2026-NY-8912
SERVICE DATE: 2026-01-14

LINE 01: 80053 COMPREHENSIVE METABOLIC PANEL     BILLED: $1,420.00  COPAY: $0.00
LINE 02: 80048 BASIC METABOLIC PANEL             BILLED: $190.00    PATIENT RESP: $190.00
LINE 03: 71046 CHEST X-RAY 2 VIEWS               BILLED: $380.00    COPAY: $25.00
LINE 04: 99285 EMERGENCY DEPT VISIT HIGH SEV     BILLED: $1,040.00  COPAY: $100.00
LINE 05: MISC SURGICAL SUPPLIES TRAY 3           BILLED: $450.00    [NO CPT CODE FOUND]
LINE 06: GLOBAL FACILITY OVERHEAD CHG            BILLED: $800.00    [NO CPT CODE FOUND]

TOTAL CHARGES BILLED: $4,280.00
TOTAL PATIENT RESPONSIBILITY: $315.00

Multilateral Netting & Claims Analytics

DTCC clearinghouse comparison: gross provider billed charges vs. net lawful liability after deterministic NCCI excision.

Gross Provider Billed

$4,280.00

Raw presented hospital claim volume

Unlawful Charges Excised 84.6% REDUCTION

$3,620.00

Excised via NCCI unbundling & safety gates

Net Lawful Liability

$660.00

True lawful patient financial responsibility

Bilateral Clearinghouse Netting Flow

Daily gross claim inflow vs. adjudicated lawful settlement amount

Gross Billed ($4,280) Lawful Net ($660) 84.6% Excised Netting Ratio

DTCC Clearinghouse Netting Mechanics

Netting Compression: 6.48 : 1

Rather than settling raw gross medical claims individually ($4,280.00), Bedrock Sentinel executes automated bilateral netting against the CMS NCCI edit tables before clearinghouse dispatch. Mutually exclusive, bundled, and unsubstantiated lines are compressed out prior to payment settlement.

Gross Claim Total

$4,280.00

100% Presented Volume

NCCI Intercept

-$190.00

CPT 80048 unbundled

Clinical Safety Quarantine

-$1,250.00

Overhead & Tray held

Cleared Lawful Balance