「adjudication」の検索結果

Adjudicates whether a hit generated by sanctions, PEP, or adverse-media screening is a true positive, false positive, or requires human escalation. Use whenever a user presents a screening alert, a name match against a watchlist (OFAC SDN, EU consolidated list, UK OFSI, UN list, PEP list, adverse media hit, etc.), or asks to clear a screening hit / reduce false positives / determine whether a flagged name is actually the listed party. Use even when the user describes the task casually — "is this person actually on the sanctions list", "did we get a real match", "clear this alert", "I have a hit on X" — these are all screening-adjudication tasks. Produces a deterministic determination with full audit trail (structured JSON + human-readable narrative). Designed for use by compliance analysts and screening systems.

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Generate Claim, ClaimResponse, and ExplanationOfBenefit (EOB) resources for healthcare billing including professional, institutional, pharmacy (Rx), dental, and vision claims. Use when user mentions claims, EOB, explanation of benefit, billing, reimbursement, adjudication, pharmacy claims, Rx claims, denied claims, copay, deductible, or allowed amount.

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Build human adjudication / hand-labeling sheets from LLM-pipeline data without evidence truncation. Use when: (1) preparing a CSV/Excel sheet for a human to rule on cases an LLM classifier or rater panel judged, (2) a labeler reports "there is no information to label from" or cells look empty in Excel, (3) excerpt columns cluster at one exact length (e.g. all 1,500 chars — a hard truncation cap). Covers: full rating-basis recovery, Excel 32,767-char cell cap, multi-line CSV mangling, ruling dropdowns, companion text files.

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Use when a BizOps lead, COO, or process-improvement owner needs to document an end-to-end business process (procurement, employee onboarding, incident handoff, customer-onboarding, claims adjudication) in BPMN-style notation, measure cycle times by stage, surface where work spends most of its time waiting vs. being worked, and quantify the gap between processing time and total elapsed time. Pairs Lean / Six Sigma / Theory-of-Constraints canon with deterministic stdlib-only Python tools to produce a process map, a ranked bottleneck list (with severity + root-cause hypothesis), and a cycle-time analysis (P50, P90, value-add ratio, Little's-Law throughput). Distinct from sales-pipeline, system-reliability (SLO), and strategic-OKR work — this is tactical process documentation for internal operations.

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Use when the user asks to "plan how our narrative lands on every surface", "write per-surface message-match specs", or "brief each creative builder from the canon"; maps the narrative-registry canon onto every flagship surface (homepage, pricing, store listing, sales deck, social bio, docs, email) as a per-surface message-match spec — what claim, pillar, proof, and objection reframe each surface must carry — and cuts a handoff brief to each discipline's creative builder (content-writer, ad-creative-builder, email-creative-builder, social-creative-builder, message-house-builder), so the same story lands consistently everywhere. Not for writing the finished surface copy — use each discipline creative builder; not for the tier-scoped launch asset manifest — use launch-asset-packager; not for scoring cross-surface consistency — use narrative-quality-auditor; not for claim adjudication — use offer-claims-registry. 叙事落地/逐面消息一致/创意交接简报/画布传导

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Use when the user asks to "build our pitch deck narrative", "write a fundraising story", or "structure the sales pitch narrative"; derives from the narrative canon a company pitch/deck narrative — problem → the undeniable shift → product-as-hero → proof → the ask — as a slide-beat outline (one narrative beat per slide, with the claim ID each proof beat rests on), for both a sales pitch and a fundraising deck. Every proof beat is labeled Measured / User-provided / '[needs source]' and unverified ones route to the claims candidates. Not for the launch-window battle cards and talk track — use sales-enablement-kit; not for the durable message hierarchy or the arc itself — use message-system-architect / strategic-narrative-designer; not for finished deck visual design — out of scope; not for claim adjudication — use offer-claims-registry. 路演叙事/融资故事/销售 pitch/幻灯节拍

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Use when the user asks to "map the category narrative", "tear down how competitors tell their story", or "find the language conventions in our market"; produces a category narrative map — the dominant stories and points of view in the category, its language conventions and framing clichés, and a per-competitor narrative teardown (arc, claimed onlyness, proof pattern) plus how each rival's messaging has shifted over time (scraped copy vs archived copy). Not for the positioning canvas itself — use positioning-mapper; not for the beachhead's beliefs and objections — use audience-belief-mapper; not for SERP keyword targeting — use keyword-research; not for claim adjudication — use offer-claims-registry. 品类叙事/竞争叙事拆解/语言惯例/叙事演变

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Use when the user asks to "build a message house", "write a PR-FAQ for our launch", or "define the launch narrative and value pillars"; derives from the positioning canvas a message house — tagline, one-liner, three value pillars, per-persona proof points (each labeled Measured / User-provided / [needs source]) — plus a working-backwards PR-FAQ narrative spine (launch-day tense, empty-chair test, five external + five internal FAQs) and per-channel message angle packs (angles, not finished copy). Not for the positioning canvas itself — use positioning-mapper; not for finished blog posts or pages — use content-writer; not for ad or email units — use each discipline creative builder; not for claim adjudication — use offer-claims-registry. 消息屋/PR-FAQ/价值支柱/发布叙事

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Use when the user asks to "author our durable brand message hierarchy", "build the brand message house that seeds the canon", or "define the main narrative, three pillars, and tagline for the whole brand"; produces the DURABLE brand message system — main narrative, three value pillars, per-persona proof points (each labeled Measured / User-provided / '[needs source]'), and the tagline/one-liner — that seeds the narrative-registry canon and from which every per-launch house derives. Not for a single launch's message house or PR-FAQ — use message-house-builder; not for claim adjudication — use offer-claims-registry; not for the change-narrative arc itself — use strategic-narrative-designer. 品牌消息屋/主叙事/三支柱/标语/持久叙事 canon

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Use when the user asks to "codify our brand voice", "define naming rules for our products and tiers", or "write the tone-of-voice guide with banned phrases"; produces the brand-level voice canon (register, tone spectrum, banned-phrase list, few-shot examples drawn only from the brand's own published material) and the naming tax (product / feature / tier naming rules plus approved and banned terms) that seeds the narrative-registry canon and that every channel's voice adaptation points up to. Not for per-platform voice adaptation — use channel-registry's voice-dossier; not for finished copy or blog posts — use content-writer; not for the message hierarchy itself — use message-system-architect; not for claim adjudication — use offer-claims-registry. 品牌语气/词汇表/命名税/禁用词/品牌语言规范

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Use when the user asks to "read back" a paid campaign change, "did this ad change work", or "compare ROAS/CPA before and after"; reads ROAS/CPA against a control over a fixed readback window and returns a Promote / Keep-testing / Rollback / Unproven readback decision with the math delegated to roi-calculator. Not for RQS scoring or veto adjudication — use ad-account-auditor; not for the ROI ratio math — use roi-calculator; not for cross-channel rollups — use performance-analyzer. 付费广告复盘/ROAS回看/投放效果归因

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Adjudicates authorized exercise outcomes against independently held ground truth, redacted evidence, and explicit status boundaries. Use when comparing observations, resolving discrepancies, or preparing evidence-led security-review handoffs.

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Use when designing a study that benchmarks AI systems against a human-expert panel, before data collection. Plans the arms, decoupled rubrics with anchors, planted calibration probes, reviewer panel, inter-rater reliability targets and LLM-as-judge versus human adjudication.

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HealthSim generates realistic synthetic healthcare data for testing EMR systems, claims processing, pharmacy benefits, and analytics. Use for ANY request involving: (1) synthetic patients, clinical data, or medical records, (2) healthcare claims, billing, or adjudication, (3) pharmacy prescriptions, formularies, or drug utilization, (4) HL7v2, FHIR, X12, or NCPDP formatted output, (5) healthcare testing scenarios or sample data generation.

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HealthSim generates realistic synthetic healthcare data for testing EMR systems, claims processing, pharmacy benefits, and analytics. Use for ANY request involving: (1) synthetic patients, clinical data, or medical records, (2) healthcare claims, billing, or adjudication, (3) pharmacy prescriptions, formularies, or drug utilization, (4) HL7v2, FHIR, X12, or NCPDP formatted output, (5) healthcare testing scenarios or sample data generation.

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RxMemberSim generates realistic synthetic pharmacy data for testing PBM systems, claims adjudication, and drug utilization review. Use when user requests: (1) pharmacy claims or prescription data, (2) DUR alerts or drug interactions, (3) formulary or tier cohorts, (4) pharmacy prior authorization, (5) NCPDP formatted output.

日本語の概要は準備中です。原文の説明を表示しています。

HealthSim generates realistic synthetic healthcare data for testing EMR systems, claims processing, pharmacy benefits, and analytics. Use for ANY request involving: (1) synthetic patients, clinical data, or medical records, (2) healthcare claims, billing, or adjudication, (3) pharmacy prescriptions, formularies, or drug utilization, (4) HL7v2, FHIR, X12, or NCPDP formatted output, (5) healthcare testing scenarios or sample data generation.

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Analyze insurance claims workflow systems for intake optimization, adjudication rules, subrogation, litigation management, and settlement analytics. Use when: 'audit claims process', 'review FNOL workflow', 'evaluate claims automation', 'check subrogation recovery', 'assess claims fraud detection', 'optimize claims cycle time', 'review Guidewire ClaimCenter setup'.

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Use for 1-7 independent read-only sessions investigating one bounded Anabasis failure, diff, or design question before a fix. Defines non-leading prompts, evidence packets, symmetric fault hypotheses, self-falsification, source adjudication, and concise synthesis. Do not use for whole-run coverage at any session count; use whole-run-investigation instead.

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This skill should be used to spawn specialized OpenAI Codex CLI subagents for code review, debugging, architecture analysis, security audits, refactoring, documentation, comparative evidence adjudication, and autonomous /goal runs. It adds each persona through process-local developer instructions while preserving the project's AGENTS.md chain, including during parallel launches. Supports GPT-6-Astra across low, medium, high, xhigh, max, and ultra reasoning with default or priority service tiers, plus GPT-5.6 and GPT-5.5 models. Triggers on 'delegate to Codex', 'Codex Astra', 'Astra subagent', 'Codex subagent', 'code review agent', 'security audit', 'refactor with Codex', 'goal run', 'autonomous goal', 'have Codex weigh this'.

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Before designing, training, or auditing ANY model that replicates human-annotated labels, audit the annotation protocol's INPUT — the exact document/evidence the human labelers consulted — and give the model that same input. Use when: (1) designing a classifier/LLM extractor whose target is a hand-coded label set, (2) a label-replication model shows low recall concentrated in a label subset and the diagnosis on offer is "the label's information is not in the features", (3) reviewers propose construct splits (e.g. "designation vs record-evident"), adjudication sittings, or per-domain stop rules to explain residual disagreement with gold, (4) validating an extraction pipeline against labels transcribed from a source document. Symptom of the underlying failure: elaborate theory accumulates to explain why gold is "partially unpredictable" when the model was simply never shown the document the annotators read.

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Analyze insurance claims workflow systems for intake optimization, adjudication rules, subrogation, litigation management, and settlement analytics. Triggers: 'audit claims process', 'review FNOL workflow', 'evaluate claims automation', 'check subrogation recovery'.

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Foundational ethics, authority hierarchy, and structural principles for the Predicate agent. Always-on law (composable system-prompt core): Truth>Harmony, Evidence>Authority, Halt>Assumption, Outcomes>Process — four ordered principles that govern every walk. Reference (by-moment): conflict resolution, ethics adjudication, novel situations, precedence walkthrough, entropy diagnostics, principled resistance. Trigger (reference depth): resolving rule conflicts, ethics calls, novel situations. Prompt contains: constitution, principles, precedence, truth over harmony, outcomes over process, evidence over authority, principled resistance.

日本語の概要は準備中です。原文の説明を表示しています。

Use when the user asks to "build our pitch deck narrative", "write a fundraising story", or "structure the sales pitch narrative"; derives from the narrative canon a company pitch/deck narrative — problem → the undeniable shift → product-as-hero → proof → the ask — as a slide-beat outline (one narrative beat per slide, with the claim ID each proof beat rests on), for both a sales pitch and a fundraising deck. Every proof beat is labeled Measured / User-provided / '[needs source]' and unverified ones route to the claims candidates. Not for the launch-window battle cards and talk track — use sales-enablement-kit; not for the durable message hierarchy or the arc itself — use message-system-architect / strategic-narrative-designer; not for finished deck visual design — out of scope; not for claim adjudication — use offer-claims-registry. 路演叙事/融资故事/销售 pitch/幻灯节拍

日本語の概要は準備中です。原文の説明を表示しています。