Find the same conclusion in the operations view
Read the automated and human-review distribution and connect one claim decision to team-wide operations.
Question for this chapter
How does a decision found in one claim connect to the team's complete processing picture?
Why this matters now
One ESCALATED decision determines the next action for one reviewer. The operations team must also see
how automated handling and human review divide across all claims and which reasons repeat.
Try it in the dashboard
Open claims_processing (alias: Claims Processing Dashboard) and focus on three questions:
- Does Claims Received show 10 claims?
- Does Decision Distribution show 4
APPROVED, 1REJECTED, and 5ESCALATED? - Can you find
confidence 0.52 below threshold 0.6in Escalations by Reason?
Deep dive — all eight widgets
- Claims Received (statistic) — 10 received claims
- Decisions Made (statistic) — 10 claims with decisions
- Avg Extraction Confidence (statistic) — raw average
0.845 - SLA Met Rate (statistic) — 100% of
sla_metvalues are true - Decision Distribution (donut) — 4 approved, 1 rejected, 5 escalated
- Escalations by Reason (bar) — count by decision reason
- Claims by Channel (bar) —
email4,portal4,fax2 - Recent Claims (data table) — up to 100 most recently received claims
Success looks like this
ESCALATED, the route requiring human review, is the largest group in Decision Distribution. In
Escalations by Reason, you can recover the low-confidence reason for CLM-2025-006.
Interpret the result
The dashboard does not make a new decision. It regroups the results left in extracted_fields and
decision_log for operations questions. It shows where one claim's route sits in the team's workload.
Deep dive — limits of the demonstration widgets
Despite its name, the current Escalations by Reason query groups every decision reason rather than
filtering only ESCALATED. To show escalation reasons only, it needs a
WHERE decision = 'ESCALATED' condition.
claim_adjudicator also records sla_met = true for every row. SLA Met Rate at 100% is not a
calculation from processing duration and does not establish a causal link with the escalation rate.
Next decision
You have placed one claim within the full operations picture. Next, check field provenance and the automation boundary in four questions, then return to the opening problem for the final explanation.