Horizon Aegis · Medicare Advantage · continuous RADV

Before the sample letter.On the sample day. On one ledger.

Horizon Aegis is the continuous shadow RADV workbench: SIU queue, documentation-support calibration, sample stress. Live scoring is V22/V24 — the models CMS uses on current RADV audits. V28 is coded and held ready, not active. Packages are profiles of the four bundles: CREB-RADV, AREB-RADV, PIEB-RADV, and RREB-RADV (RRADV). Not a fifth engine. The institution owns the seal.

Schedule a briefing Redacted demo walkthrough All four RADV samples SIU workbench

Horizon Aegis V22 / V24 live V28 ready, not active Shadow default

Operating model

Shadow → Package → Seal → Act

Same intelligence cycle as the rest of JIL. Intervention never auto-onboards.

Before the letter

Horizon Aegis scores HCC support on V22/V24. Simulated sample exposure. Stress tests months ahead of selection. Not adjudication.

When the sample lands

Match enrollees to sealed packages. Fill only true gaps. Respond from proof already in hand.

After the fight

Confirmed findings structured for recovery. Outcomes calibrate the models. The ledger remembers.

Audit model honesty

V22/V24 live. V28 ready, not active.

A RADV briefing can be thorough on current CMS audits without selling a payment-year transition as live law.

V22 / V24 · live

The HCC models CMS uses on current RADV audits. Horizon Aegis scores documentation support against these. Samples use V24.

V28 · ready, not active

Coded for the payment-year transition. Flag defaults off. Not the model of a current RADV audit.

MEAT / B11 · ready, not active

MEAT is AAPC/CDI, not CMS RADV law. B11 is a self-ID / reserve scenario. Nationwide extrapolation was vacated in Humana v. Becerra.

One ledger. Four covers.

RADV is a profile, not a fifth engine

CREB-RADV, AREB-RADV, PIEB-RADV, and RREB-RADV (RRADV) are covers of the same CREB template. Horizon Aegis drafts them in shadow. You own the sealed packages.

Unsupported · SIU / counsel

CREB-RADV

Unsupported HCCs and integrity failures—built for SIU, recovery, and counsel with evidence spans inside the seal.

Supported · audit defense

AREB-RADV

Proof diagnoses were supported—defense-ready for CMS RADV, auditors, and regulators.

Plan-side provider integrity

PIEB-RADV

Provider-integrity packaging on a plan engagement. A PIEB-RADV route on a provider-side engagement is still 403.

Recovery-ready · non-legal

RREB-RADV · RRADV

Collections / AP cover. Sample-only exposure — not a booked CMS liability and not nationwide extrapolation.

Full packages: /docs/samples/radv/ · JSON: CREB · AREB · PIEB · RREB · Walkthrough

Stop the dollar upstream. Seal the proof either way.

Bring a RADV exposure question. Leave with a clear view of Horizon Aegis on V22/V24, what stays ready-not-active (V28 / MEAT / B11), and the four RADV packages.

Schedule a briefing View walkthrough