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Review Workflow Builder

Automate the handoffs. Keep the judgment human. BETA

Review Workflow Builder configures evidence checks, routing rules, exception queues, and deadlines around your case files, then stops at every judgment-shaped step for a named human approval. No automatic denial, coverage decision, compensability call, verdict, medical opinion, or certification leaves the workflow without someone accountable signing off on it.

Adams, T. · Case #IME-4812 Workflow
1 · Evidence check passed
2 · Routing auto
3 · Exception queue 1 open
4 · Approval gate requires: j.rivera
Nothing moves past step 4 without a named approval
BETA status
In active beta · refined hands-on with early customers, the approval gate is never optional.

Build the workflow your queue already runs — just faster.

Configure the evidence checks each file must pass, the rules that route it to the right reviewer, and the exception queues that catch what doesn't fit the standard path — all in one workflow, mapped to the process your team already runs.

Evidence checks, routing rules, and deadlines, configured once
Exceptions route to a queue, never silently dropped
Exception queue1 open
Case #IME-4812
Missing evidence check failed on p.140 (quarantined page) — routed for reviewer decision before the file can advance.
Deadline: configured, not guessed.
Approval gaterequired
Judgment-shaped step
Compensability recommendation drafted — awaiting named approval from j.rivera before it can move to the next stage.
This step cannot be configured to auto-advance.

The approval gate that can't be skipped.

Wherever a workflow reaches a denial, coverage call, compensability decision, medical opinion, or certification, the platform inserts a mandatory gate: a named person must approve before the file moves on. It's a step in the process design that no configuration can remove.

Judgment-shaped steps always require a named approver
No auto-advance option exists for these steps

Every transition explainable and logged.

Each routing decision, exception, and approval writes into the same append-only trail used by Audit Trail & Chain of Custody, so the workflow's own history is provable, not just the file's.

Every approval attributed to a named user
Exportable for a HIPAA audit or an admissibility question
Workflow logCase #IME-4812
10:41 Routed to exception queue · j.rivera
16:20 Approval granted · j.rivera, gate 4
The boundary

AI drafts the queue. A named human approves the call.

Review Workflow Builder cannot produce an automatic denial, coverage decision, compensability decision, verdict, medical opinion, or certification. Any judgment-shaped output always requires a named human approval step — that gate is not a configuration option, it's built into the workflow itself.

Every transition through the workflow is explainable and logged, so the process behind a decision is as reviewable as the decision itself.

No auto-denial, ever Named approval required, always

From configuration to a logged, human-approved outcome.

Three steps — you design the process once, the platform runs the handoffs.

Configure checks & routes

Set the evidence checks, routing rules, exception queues, and deadlines your process needs.

Files move through automatically

Cases flow through checks and exception queues without manual handoffs.

A named human approves the call

Every judgment-shaped step stops for a real person's sign-off before the file advances.

Who configures a review process on it.

Any team with a repeatable review process and a hard rule that a person signs off on the decision.

FAQ

Review Workflow Builder, answered.

It's a configuration layer for building your own review process on top of the platform: evidence checks, routing rules, exception queues, and deadlines, with mandatory human approval gates placed wherever a judgment-shaped step occurs. You design the workflow; a named person still signs off on the calls that matter.

No. Review Workflow Builder cannot produce an automatic denial, coverage decision, compensability decision, verdict, medical opinion, or certification. Any output shaped like a judgment always stops at a named human approval step before it moves forward — that gate cannot be configured away.

Anything that reads as a decision rather than a fact or a routing step: approving or denying coverage, determining compensability, issuing a rating or opinion, or certifying a finding. Evidence checks, routing, and reminders are automatable; the judgment step itself is not.

Yes, in beta. Review Workflow Builder is live and testable now; we're refining it hands-on with early customers, and if your review process is a good fit we'll help you configure it directly.

Every transition through the workflow — a routed file, an exception raised, an approval granted — is timestamped, attributed to a named user, and written into the same append-only trail used by Audit Trail & Chain of Custody, so the workflow itself stays explainable after the fact.

Related capabilities.

Automate the routing. Never the judgment.

Join the beta and we'll help you map your review process into a workflow, approval gates included. Handled under our BAA.