Learn · Medicare · RADV · Horizon Aegis
The CMS RADV sample letter is too late.
When the envelope arrives, the charts are cold. Horizon Aegis scores documentation support on V22/V24 while the encounter is still open — so sample day is a handoff, not a chart-archaeology project.
Why the letter is the wrong start date
CMS RADV does not wait for your SIU to get organized. Eligible MA contracts face larger samples and a faster cadence. Teams that start evidence work after the sample letter are reconstructing a year of HCC support under a deadline. That is how flags become reserves and reserves become panic.
What to do instead
Horizon Aegis is continuous shadow RADV: SIU work-queue, documentation-support calibration, sample stress. Live scoring is V22/V24 — the models current CMS RADV audits use. V28 is coded and held ready, not active. Nothing holds a payment until a human decides.
What you hand counsel
Four profiles of one CREB template — CREB-RADV, AREB-RADV, PIEB-RADV, RREB-RADV — not a fifth engine. See the sample packages and the Horizon Aegis product.
FAQ
Does Horizon Aegis adjudicate claims?
No. Default mode is shadow. It ranks, calibrates, and packages. Humans decide.
Is V28 the current RADV model?
No. Current CMS RADV audits run V22/V24. V28 is ready, not active.