Platform
Structured intake. Authorization analysis. A decision-ready summary.
AVC takes the documents a case already produces and turns them into one structured, source-linked package: what is being requested, what the authorization on file describes, what evidence is present, and what a person still has to decide.
AVC prepares the decision. Humans make it. Nothing on this page describes a measured result. AVC is pre-validation, and every case, field and value shown below is synthetic and illustrative.
01. Structured intake
Documents in. Structured case data out.
A case arrives as a stack of files in different formats from different systems. Intake reads that stack and produces one structured record: the fields a reviewer would otherwise transcribe by hand, each one still pointing back at the document it came from.
What intake captures
- Referral identifier
- Authorization identifier
- Authorized specialty
- Authorized scope
- Authorization start date
- Authorization end date
- Proposed procedures
- Tooth
- Surface
- Quadrant
- Arch
- Quantity
- Clinical rationale
- Supporting evidence
Document types supported
- Referral documents
- Authorization documents
- Dental treatment plans
- Dental request forms
- Radiographs
- CBCT
- Periodontal charts
- Intraoral images
- Clinical narratives
Images and imaging studies are handled as evidence a clinician interprets. AVC records that they are present, where they came from and when they were taken.
Source traceability
Illustrative extraction
Synthetic example. Not a real case.
Requested Service
Implant placement, Tooth #19
Source
Treatment PlanPage 2Procedure Line 4
Authorized Specialty
Oral surgery
Source
Authorization DocumentPage 1Field: Authorized Specialty
Quantity
1
Source
Treatment PlanPage 2Procedure Line 4
Clinical Rationale
Narrative supporting restoration of the mandibular left quadrant
Source
Clinical NarrativePage 3Paragraph 2
AVC never overwrites the source document. Extraction writes a separate structured record. The original file stays intact and stays viewable beside every field, so a reviewer can confirm a value, correct it, or compare it against the page it was read from.
Identifier minimalism
AVC does not collect Social Security numbers. A field exists in the record only if the analysis needs it, and every sensitive field carries four things before it is allowed in.
Data minimization is easier to hold as a design rule than to retrofit as a policy, so it is enforced at the schema.
Purpose
The specific analytical question the field is needed for.
Source
The document and location the value is permitted to come from.
Access policy
Which roles can read it, recorded with the field itself.
Retention rule
How long it is kept, and what happens at the end of that period.
02. Authorization analysis
Every requested procedure, evaluated against the whole package.
Analysis does not look at a procedure on its own. For each requested service, AVC evaluates the full set of elements together and records which ones drove the result.
What is evaluated, for every requested procedure
- Authoritative eligibility context
- Referral
- Authorization
- Procedure
- Procedure code
- Anatomy
- Quantity
- Evidence
- Rule
No single element decides the result. A procedure code is one input among nine (see below). This site shows procedure descriptions rather than code values.
The line AVC will not cross
AVC does not state whether a Veteran is eligible.
Every classification answers one narrow question: how does this request compare against the authorization context supplied with it? That comparison is not a statutory benefits determination, and AVC never presents one.
This is deliberate design, not a gap waiting to be filled. A system that issued benefits determinations would need authority it does not have and cannot be given by software. A system that prepares them can be adopted without moving any authority at all, which is precisely why it is safe to put in front of a reviewer.
Permanently prohibited outputs
- “Eligible”
- “Not Eligible”
Neither string is a valid AVC output. The system has eight classifications and these are not among them.
The vocabulary
Eight classifications. No ninth.
Every requested procedure resolves to exactly one of these. The vocabulary is fixed: a reviewer who learns these eight has learned the entire output surface of the product, and a flag can be audited against the same eight next year.
- 01Within Current Authorization
Available evidence indicates the requested service is consistent with documented authorization.
- 02Likely Within Scope — Human Confirmation Suggested
System evidence suggests the request may be within scope, but human confirmation is appropriate.
- 03Additional Approval Likely Required
The requested service appears to exceed or modify documented authorization.
- 04Documentation Missing
A required evidence element appears absent.
- 05Authorization Review Required
The case contains an authorization question requiring human review.
- 06Policy Conflict
A documented rule appears inconsistent with the request.
- 07Human Review Required
System confidence or case complexity prevents deterministic resolution.
- 08Unable to Determine
Available information is insufficient for a meaningful classification.
Color and the icon are reinforcement only. Every badge carries its full text label, in the product and on this page, so meaning never depends on a color a reader may not be able to distinguish.
Documentation
Four documentation states.
Separate from the classification, every case carries a documentation state describing the condition of the record itself.
Every element required for the requested procedure is present in the submission and located.
A required element is absent, and the missing item is named. INCOMPLETE without a named item is not an acceptable output.
Two or more source elements disagree. AVC reports the disagreement and both sources; it does not pick a winner.
The documentation question cannot be resolved from the record and is routed to a person.
Illustrative conflict
Synthetic example. Not a real case.
Source A
Clinical Narrative · Page 3 · Paragraph 2
Narrative references Tooth #19.
Source B
Treatment Plan · Page 2 · Procedure Line 4
Procedure table references Tooth #30.
Anatomical reference disagreement between two source elements.
AVC does not decide which source is correct. It names the disagreement, shows both origins, and routes the case to a person.
Scope
Scope analysis compares proposed treatment against the authorization on file.
- Existing authorization
- What the authorization on file actually grants.
- Authorized specialty
- Whether the proposed treatment sits inside the specialty that was authorized.
- Authorization dates
- Whether the proposed date of service falls inside the authorized window.
- Authorized anatomical area
- Tooth, surface, quadrant and arch, compared against the area described in the authorization.
- Quantity
- Units requested against units authorized.
- Visit limits
- Visits already recorded in the case against any limit the authorization states.
- Referral intent
- What the referring clinician described as the reason for referral.
- Applicable rules
- The documented rule that governs the comparison, captured with its version.
Why this matters
A code is an input. It is not an authorization.
Most automation in this space collapses the authorization question into a list membership test. AVC does not, because the test is wrong in both directions.
Code present
does not establish authorization
A code appearing on a list says nothing about whether this referral, this specialty, this anatomical area, these dates and this quantity are covered by the authorization actually on file.
Code absent
does not establish non-authorization
An absent code may mean the service is described differently, or that the list is not the authoritative context for this case. It is not evidence of anything on its own.
AVC never implements code absent from list = denied. Authorization is a contextual question, and a contextual question requires contextual analysis, with each element named, sourced and versioned.
Scope note. The MVP does not independently diagnose findings from imaging. Radiographs, CBCT and intraoral images are treated as evidence a clinician interprets: AVC records their presence, source and date and surfaces them for review.
03. Explainability
Every material flag shows its work.
A flag a reviewer cannot interrogate is a flag a reviewer will eventually ignore. Every material flag AVC raises carries the same seven-part record, and that record is what a reviewer accepts, corrects or overrides.
- Input used
- The specific value the flag was computed from.
- Source
- Document, page and location where that value was found.
- Rule
- The documented rule identifier that produced the flag.
- Rule version
- Which version of that rule was in force.
- Reason
- A plain statement of why the flag was raised.
- Confidence
- Recorded where applicable, and named as not applicable where the comparison is deterministic.
- Human disposition
- What a person did with the flag: accepted, overridden, returned, or still pending.
Illustrative flag record
Synthetic example. Not a real case.
- Requested Service
- Implant placement, Tooth #19
- Classification
- Additional Approval Likely Required
- Reason
- Requested procedure appears beyond documented authorization scope.
- Input used
- Authorized scope: surgical extraction and related evaluation · Proposed procedure: implant placement
- Sources
- Authorization Document, Page 1Treatment Plan, Page 2
- Rule
- AUTH-SCOPE-014Rule version 2026.07
- Confidence
- Not applicable: deterministic scope comparison.
- Human Disposition
- Pending
Nothing in this record is asserted without a stated source. A reviewer can accept it, override it, or send the case back, and the disposition is written to the record either way.
04. Authorization summary
One package for the person who decides.
The summary is the artifact that leaves AVC. It states the case, the authorization context it was measured against, what is ready, what is not, and what is still open, in a fixed order, so a reviewer reads the same structure on every case.
Authorization Summary
Illustrative and synthetic. Not a real case, provider, or person.
Case header
- Referral
- REF-2026-0148
- Authorization
- AUTH-2026-0293
- Provider
- Example Dental Group, PC
- Facility
- Example Dental, Location 2
- Authorization dates
- 2026-04-02 to 2026-10-02
- Prepared
- 2026-07-14
Authorization context
- Authorized specialty
- Oral surgery
- Authorized scope
- Surgical extraction and related evaluation
- Authorized anatomical area
- Mandibular arch, quadrants 3 and 4
- Visit limit
- 3 visits
- Visits recorded
- 1
- Context source
- Authorization Document, Page 1
Readiness
Documentation status
INCOMPLETEPeriodontal charting not located in the submission.Scope status
One requested procedure appears outside the documented authorization scope.Additional approval
Likely required for one requested procedure. Not requested by AVC; routed to the reviewing organization.Conflicts
CONFLICTClinical narrative references Tooth #19; procedure table references Tooth #30.Human review required
HUMAN REVIEWTwo items routed: the anatomical conflict, and one procedure with insufficient supporting evidence.
Requested procedures
| Procedure | Anatomy | Qty | Classification |
|---|---|---|---|
| Extraction, Tooth #30 | Tooth #30 | 1 | Within Current Authorization |
| Implant placement, Tooth #19 | Tooth #19 | 1 | Additional Approval Likely Required |
| Periodontal evaluation, Quadrant 2 | Quadrant 2 | 1 | Documentation Missing |
| Bone graft, Tooth #19 site | Tooth #19 | 1 | Human Review Required |
Relevant clinical evidence
| Item | Value | Source | Date | Age |
|---|---|---|---|---|
| HbA1c | 8.2% | Clinical Narrative, Page 3 | 2026-05-18 | 57 days |
| Panoramic radiograph | Present | Imaging upload | 2026-06-02 | 42 days |
| Periodontal charting | Not located | — | — | — |
AVC surfaces these items for reviewer attention with their value, source, date and age. It does not translate a clinical value into a treatment prohibition. A laboratory result is context for a clinician, not a rule the software applies.
Human recommendation
Awaiting reviewer entry. This field is authored by a person and is never populated by AVC.
Outstanding issues
- 01Periodontal charting for Quadrant 2 has not been located in the submission.
- 02Anatomical reference disagreement between the clinical narrative and the procedure table.
- 03Implant placement, Tooth #19 appears outside the documented authorization scope and needs a decision from the reviewing organization.
The recommendation field is written by a person. AVC assembles everything above it and leaves it blank.
The case journey
Ten steps, in a fixed order.
Half of them are human steps. That ratio is the product.
- 01
Create case
Open a case record for one referral.
- 02
Add authorization context
Attach the authoritative authorization context the analysis will be measured against.
- 03
Upload documents
Referral, authorization, treatment plan, charts, images, narrative.
- 04
Extract
Documents become structured fields, each linked to its origin.
- 05
Review extraction
Human stepA person confirms or corrects each extracted field beside the original document.
- 06
Run analysis
Each requested procedure is evaluated and classified.
- 07
Resolve missing information
Human stepNamed gaps are worked until the record is complete or the gap is documented.
- 08
Human review
Human stepFlags routed for review receive a recorded disposition.
- 09
Generate summary
Human stepThe case is assembled into one decision-ready package, including a human recommendation.
- 10
Downstream workflow
Human stepThe package leaves AVC and enters the reviewing organization’s own process.
Human authority
AVC prepares the decision. Humans make it.
Everything on this page is built around one constraint: the product must be able to say what it did and where the answer came from, and it must stop at the point where judgment begins. When the record does not support a conclusion, AVC classifies it as unresolved and routes it. It does not close the gap by guessing.
A technical failure never becomes an authorization conclusion.
AVC does not
- Determine Veteran eligibility
- Diagnose dental disease
- Approve or deny treatment
- Replace a licensed clinician
- Submit a request without a human
Bring us a case that breaks it.
The fastest way to find out whether this holds up is to walk a real workflow with the people who run it, including the parts of the model that are wrong. We are recruiting pilot organizations now.