Predictika · Orthopedic bracing orders

An AI sales agent's knee brace order, checked before it goes out

An AI sales agent prepares an order for DonJoy osteoarthritis (OA) unloader knee braces: the brace, its size for the patient's thigh, the knee and indication, the billing code and the price. Before it goes out, the agent sends it to Predictika, which checks it against a declarative model of the sizing, indication and ordering rules and returns a verdict, every reason, a line-item quote and the figures it computed.

Scope: orders for DonJoy OA Adjuster 3, ROAM OA, OA GO, OA Nano, Clima-Flex OA and Defiance Pro (custom) unloader knee braces: size, indication, billing code, discount and total. See everything this validator covers

This validator models orders for these six DonJoy OA knee braces, not just the scenarios shown below. The product names are Enovis's; many of the rules and all of the prices are modeled from comparable bracing products and are not Enovis-published.

  • Size and fit — each stock size covers a range of thigh circumference (OA Adjuster 3: extra small 33–39 cm up to 3X large 75–81 cm, as published by a distributor); the ROAM OA comes in six sizes and no extra small (modeled); a custom Defiance Pro is made from patient measurements, not a stock size.
  • Indication — the braces offload one knee compartment, so they are not for both compartments; the OA Adjuster 3, OA GO and Clima-Flex OA are for mild to moderate osteoarthritis and the ROAM OA for moderate to severe, as Enovis describes them.
  • Billing and price — the billing code must fit the brace type (double-upright, single-upright or custom-fabricated) and a custom-fitted code needs a credentialed fitter; the quote is built from illustrative prices, a discount above 15 percent goes to sales management, above 30 percent is blocked, and the total the agent states is compared with the computed total.

Any order for these six braces that touches these rules is in scope — not only the scenarios pictured here. Not covered: other DonJoy and Enovis products (for example the Reaction Web, OA FullForce, TriZone), accessories, shipping, taxes, payer coverage and reimbursement rules, and the clinical decision itself. Prices, the discount limits, the ROAM OA sizes and the Nano indication are modeled assumptions.

The AI sales agentBuilds the brace order from the conversation and says it is ready.
Predictika validatorChecks every rule at once and returns the verdict, each finding, the line-item quote and the computed figures.

7 scenarios in 3 groups · each group runs from the agent’s first attempt to the outcome · click one to switch

What the agent proposes

The AI sales agent says

Illustrative agent statement. The validator receives the structured request below.

Proposing agent: AI sales agent (scripted)

Before sending, the agent must call Recorded run

Predictika validator


      

        
        
        
      

      
Waiting for the call.

      
    

  

  
  

    
Where rules-based CPQ gets it wrong
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Our assessment of what a typical rules-based CPQ (product rules, price rules and validation rules, as in Salesforce CPQ) does with the same cases. It is a judgment about effort and reliability, not a claim that nothing can be built.

    
What the validator caughtTypical rules-based CPQPredictika
Sizes that depend on a patient measurementOnly with care
A size table can be a lookup, but the patient thigh circumference sits on a different line from the size, so each size needs its own range rule that someone has to keep in step.		The measurement and the size are in one request and the range is checked on every call.
Indications that differ by braceOnly with care
A product rule per brace for mild, moderate and severe. It works, but each new brace is another set of rules to maintain.		The brace, the severity and the compartments are checked together.
Billing codes that depend on the brace type and on who fitted itOnly with workarounds
The allowed codes depend on the product on one line and the fitter on another, so it needs a cross-line rule that interacts with the others.		Brace, code and fitter are in one request and the pairing is checked with the rest.
Stated totals that must equal the discounted priceOnly with care
A stated figure is a free-entry field; a rule can compare it with a computed total, but the discount and the quantity have to be kept in step.		The stated total travels with the order and is compared with the computed total on every call.
Every problem returned in one answerOnly with workarounds
Rules tend to fire as the quote is saved or a step is completed, so a rep often fixes one error and meets the next.		All findings come back together, whatever order the choices arrived in.

  

  

    
What this validator catches: findings from its test cases
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Every rule is checked on every call, in any order the choices arrive; one problem never hides another. Blocking findings stop the order; approval findings need a person to sign off; everything else is computed.

    
1A thigh circumference of 39 cm does not fit the selected size, which covers 33 cm up to 39 cm.
2The ROAM OA comes in six sizes, from small to triple extra large; extra small is not offered.
3An unloader brace offloads one knee compartment; it is not suitable when both compartments are involved.
4The selected brace is for mild to moderate osteoarthritis and the patient has severe osteoarthritis.
5The ROAM OA is for moderate to severe osteoarthritis and the patient has mild osteoarthritis.
6A custom brace is made from patient measurements and none have been submitted.
7Stock sizes apply to off-the-shelf braces and a custom brace uses the Custom size; the size and the brace do not match.
8The billing code does not match the brace type (double-upright braces use L1845 or L1852, custom-fabricated braces L1844 or L1846, other single-upright braces L1843 or L1851).
9A custom-fitted billing code needs a credentialed fitter to fit the brace and the quote shows none.
10A discount of 20 percent is above 15 percent and needs sales management approval.
11A discount of 31 percent is above the 30 percent maximum.
12An order of 25 braces is priced by sales management and needs approval.
13The quote states an order total of $1,979.00; the modeled prices give $1,980.00.
14The order has 0 braces; at least 1 is needed.

  

  

    
Scenarios and results
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The recorded result of the validator for each scenario on this page: the request the AI agent sent, the verdict, and every finding, in the order they appear above.

    
1. Indication and size: Severe osteoarthritis on a mild-to-moderate brace, a size that does not fit and a total missing the quantity

    
The agent's request. Please quote 6 x DonJoy OA Adjuster 3 for a right knee, medial compartment osteoarthritis (severe), size large, patient thigh circumference 50 cm, billing code L1852. The quote states an order total of $495.00. It is ready to send.

    
Verdict: Blocked.

    
    
      
  • Thigh size does not fit the brace size. A thigh circumference of 50 cm does not fit the selected size, which covers 53 cm up to 60 cm.
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  • Severe osteoarthritis on a mild-to-moderate brace. The selected brace is for mild to moderate osteoarthritis and the patient has severe osteoarthritis.
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  • Stated total does not match. The quote states an order total of $495.00; the modeled prices give $2,970.00.
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2. Indication and size: The agent resubmits after fixing the errors

    
The agent's request. Please quote 6 x DonJoy ROAM OA for a right knee, medial compartment osteoarthritis (severe), size large, patient thigh circumference 56 cm, billing code L1851. The quote states an order total of $4,770.00. It is ready to send.

    
Verdict: Allowed.

    
    
      
  • Order summary. 6 braces at $795 each, order total of $4,770.00 at the illustrative prices.
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3. Billing code, total and discount: A billing code that does not fit the brace, a total that leaves out the discount and a 20 percent discount

    
The agent's request. Please quote 12 x DonJoy OA Adjuster 3 for a left knee, lateral compartment osteoarthritis (moderate), size medium, patient thigh circumference 49 cm, billing code L1843, with a 20 percent discount, fitted by a credentialed fitter. The quote states an order total of $5,940.00. It is ready to send.

    
Verdict: Blocked.

    
    
      
  • Billing code does not match the brace type. The billing code does not match the brace type (double-upright braces use L1845 or L1852, custom-fabricated braces L1844 or L1846, other single-upright braces L1843 or L1851).
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  • Stated total does not match. The quote states an order total of $5,940.00; the modeled prices give $4,752.00.
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  • Discount needs approval. A discount of 20 percent is above 15 percent and needs sales management approval.
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4. Billing code, total and discount: The agent resubmits after fixing the errors

    
The agent's request. Please quote 12 x DonJoy OA Adjuster 3 for a left knee, lateral compartment osteoarthritis (moderate), size medium, patient thigh circumference 49 cm, billing code L1845, with a 20 percent discount, fitted by a credentialed fitter. The quote states an order total of $4,752.00. It is ready to send.

    
Verdict: Needs approval.

    
    
      
  • Discount needs approval. A discount of 20 percent is above 15 percent and needs sales management approval.
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  • Order summary. 12 braces at $495 each, order total of $4,752.00 at the illustrative prices.
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5. Billing code, total and discount: The agent resubmits after fixing the errors

    
The agent's request. Please quote 12 x DonJoy OA Adjuster 3 for a left knee, lateral compartment osteoarthritis (moderate), size medium, patient thigh circumference 49 cm, billing code L1845, with a 15 percent discount, fitted by a credentialed fitter. The quote states an order total of $5,049.00. It is ready to send.

    
Verdict: Allowed.

    
    
      
  • Order summary. 12 braces at $495 each, order total of $5,049.00 at the illustrative prices.
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6. Custom brace: A custom brace ordered without measurements, with a stock size and an off-the-shelf code

    
The agent's request. Please quote 2 x DonJoy Defiance Pro (custom) for a left knee, medial compartment osteoarthritis (moderate), size medium, patient thigh circumference 52 cm, billing code L1851. The quote states an order total of $2,990.00. It is ready to send.

    
Verdict: Blocked.

    
    
      
  • Custom brace without measurements. A custom brace is made from patient measurements and none have been submitted.
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  • Stock size and custom brace mixed up. Stock sizes apply to off-the-shelf braces and a custom brace uses the Custom size; the size and the brace do not match.
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  • Billing code does not match the brace type. The billing code does not match the brace type (double-upright braces use L1845 or L1852, custom-fabricated braces L1844 or L1846, other single-upright braces L1843 or L1851).
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7. Custom brace: The agent resubmits after fixing the errors

    
The agent's request. Please quote 2 x DonJoy Defiance Pro (custom) for a left knee, medial compartment osteoarthritis (moderate), size custom, patient thigh circumference 52 cm, billing code L1846, with the patient measurements submitted. The quote states an order total of $2,990.00. It is ready to send.

    
Verdict: Allowed.

    
    
      
  • Order summary. 2 braces at $1,495 each, order total of $2,990.00 at the illustrative prices.
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Narration transcript
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The text of the narrated walkthrough, step by step.

    
    
      
  1. Welcome to a demo of Predictika's Validator. An AI sales agent prepares an order for DonJoy osteoarthritis (OA) unloader knee braces: the brace, its size for the patient's thigh, the knee and indication, and more. Before it goes out, the agent sends it to Predictika, which checks it against a declarative model of the sizing, indication and ordering rules and returns a verdict, every reason, a line-item quote and the figures it computed.
    2. 
      
  2. I will start with the first request by the agent.
    3. 
      
  3. The agent says. Please quote 6 x DonJoy OA Adjuster 3 for a right knee, medial compartment osteoarthritis (severe), size large, patient thigh circumference 50 cm, billing code L1852. The quote states an order total of $495.00. The rest of the request is on screen.
    4. 
      
  4. Before it goes out, the agent calls the validator.
    5. 
      
  5. Blocked, with three findings, all in one answer. A thigh circumference of 50 cm does not fit the selected size, which covers 53 cm up to 60 cm. The selected brace is for mild to moderate osteoarthritis and the patient has severe osteoarthritis. The quote states an order total of $495.00; the modeled prices give $2,970.00.
    6. 
      
  6. The validator returned three blocking findings in one answer. A check that reads one field at a time would pass most of this; it shows only when the choices in the quote are checked against each other and against the stated total.
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  7. What this shows: for stated totals that must equal the discounted price, a rules-based CPQ is error-prone for this.
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  8. Now the agent resubmits.
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  9. The corrected request. It changes the brace to DonJoy ROAM OA, the patient thigh circumference to 56 cm, the billing code to L1851 and the stated order total to $4,770.00.
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  10. It calls the validator again.
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  11. This time the validator clears it.
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  12. The validator also returns the line-item quote, on screen.
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  13. All three earlier findings are cleared, and the validator's total, $4,770.00, matches the quote.
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  14. Three problems caught in one call, fixed in one pass, and a clean $4,770.00 quote. That is the value of Predictika's validator: catching mistakes before they reach the customer. Now you can try the other scenarios yourself.
    15.