Executive dashboard Platform architecture Governance & evidence

Prediction detail

Elevated fraud, waste & abuse risk

Weighted inputs crossed the advisory band; rationale and drivers align to your published profile.

fwa_prediction_profilevprofile-1.4

Profile fwa_prediction_profile · Model profile-1.4

Open entity record

HIGH

76%

Calibrated risk

Confidence & defensibility

74%

Calibrated confidence

MEDIUM

Level from profile rules

Weighted inputs crossed the advisory band; rationale and drivers align to your published profile.

Confidence

74%

MEDIUM

Raw → calibrated

71% → 76%

Index vs scaled score

Completeness

90%

Feature coverage

Reason codes

Traceable drivers

Recommendations

From profile templates

Audit entries

Pipeline + governance

Evidence chain

Raw event through outcome

Completeness: 3 / 3 stages present

ingest
Inputs normalized
Domain adapter aligned source events to canonical signals.
score
Profile-driven score
Shared engine applied thresholds, calibration, and reason mapping.
recommend
Recommendation issued
Playbook mapping produced a prioritized action with evidence linkage.

Top contributing signals

Weighted drivers

procedure_intensity_vs_peers

Weight 20% · normalized 70%

31%

billing_cadence_anomaly

Weight 25% · normalized 70%

27%

Thresholds

Risk bands crossed

advisory

Floor 65%

Met

Reason codes

Structured explanations

PATTERN_DIVERGENCE

Signals depart from peer or baseline expectations per active policy.

Recommended actions

Pre-payment clinical & billing review

Structured review of high-variance procedures with documentation checks.

Chronological audit

Immutable milestone trail

5/1/26, 1:00:00 PM
SCORE COMPUTED
prediction: pred_demo_fwa_001
5/1/26, 1:00:00 PM
RECOMMENDATION CHAIN
prediction: pred_demo_fwa_001

Processing trace

Core engine checkpoints

decision:pred demo fwa 001governance:reviewed

Feature evidence

primary_signal_index

adapter