Policy twin. AVA continuous RADV readiness on the models CMS actually audits today (V22/V24). V28, MEAT, and vacated extrapolation stay ready, not active. Then CREB, AREB, PIEB, and RREB when the record must stand alone. Upstream of the claim. Ahead of the sample letter.
AVA and the policy twin are updated as CMS finalizes or proposes changes. Live scoring remains on the models CMS is actually using in current RADV audits (V22/V24). New 2027 - 2028 provisions - risk-adjustment model refreshes, unlinked chart-review exclusions, HHS-RADV refinements, prior-authorization API mandates, and IPPS/quality-program shifts - are modeled, staged, and held ready for activation the moment they become operative.
Legacy payment integrity waits for money to move, then fights to get it back. Next-gen JIL scores, simulates, and seals before capital leaves the building.
Everything in the hero expands here for teams that want the operating detail.
Run live claim streams through a digital twin of payment policy. Model CMS RADV rule changes and edit packs against MLR and revenue integrity before you deploy them.
Risk-score claims at intake. High audit-risk dollars can be held in a targeted review path before disbursement instead of recovered years later under pressure.
Continuous documentation support scoring for HCCs. Catch weak charts while the encounter is still actionable - using CMS record-validity standards, not coding folklore. MEAT is not cited as CMS law.
Live scoring is V22/V24 - the models current CMS RADV audits use. V28 is coded and held ready, not active. Stress tests project sample exposure; they are not a booked CMS liability and not nationwide extrapolation.
Provider AI scribes and coding bots flood payers with perfect-looking claims. JIL validates clinical logic against policy so algorithmic coding does not outrun proof.
Move beyond static ZIP packages. Hash-linked clinical, temporal, and review events form a tamper-evident chain that becomes CREB or AREB when the institution needs sealed proof.
Even with better detection, the moment a counterparty or auditor pushes back, you still need chain of custody, clinical spans, and a record that can stand alone.
That is why every serious path ends in a sealed package: CREB when something went wrong, AREB when you must prove it went right.
Detection is a commodity. Proof is the product.
We hand you the case already built.
Not another reason to open a file. The file.
AVA is the continuous shadow workbench: SIU queue, documentation-support calibration, sample stress. Live scoring is V22/V24 - the models CMS uses on current RADV audits. V28, MEAT, and B11 extrapolation stay ready, not active. RADV is a profile of CREB / AREB / PIEB / RREB, not a fifth engine.
AVA scores HCC support on V22/V24. Simulated sample exposure. Stress tests months ahead of selection.
Match enrollees to sealed CREB-RADV / AREB-RADV / PIEB-RADV / RREB-RADV packages. Fill only true gaps.
Confirmed findings structured for recovery. Outcomes calibrate the models. The ledger remembers.
Whether you stopped the dollar upstream or proved it downstream, the institution needs a sealed record it owns.
Unsupported HCCs. Improper payments. Integrity failures. Built for SIU, recovery, counsel, and litigation, with evidence spans and provenance inside the seal.
Proof that diagnoses and payments were supported. Defense-ready for CMS RADV, auditors, and regulators. Not merely "no finding was issued."
CREB-RADV recovers the weak. AREB-RADV defends the strong. PIEB-RADV and RREB-RADV (RRADV) complete the family. AVA runs them in shadow on V22/V24.
Shadow by default. Pre-adjudication where governance allows. Sealed proof when it must stand alone.
Bring a RADV exposure question or a pre-adjudication use case. Leave with a clear view of AVA (V22/V24 live; V28 ready, not active) and sealed CREB / AREB / PIEB / RREB, and whether a shadow pilot is worth 6 to 10 weeks.
