Our synthetic Medicare Advantage denial was 98.5% confident. Individual clinical factors carried just 22% of attribution. That fell below the 35% review floor we set in CertaRoute. The case moved to a physician-review route instead of becoming a final denial. This is a demonstration with synthetic cases and a demo review-queue state, not a clinical decision or a staffed health-plan workflow. For prior authorization teams: which signals currently pull a confident denial into physician review? #MedicareAdvantage #PriorAuthorization #UtilizationManagement #AIGovernance