Lead Management
Receive leads from intake, Detect alerts, referrals, external sources, or manual entry. Score, triage, assign, and convert leads to cases with full context preserved.
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AEGIS ISD Core
Lead management, case management, and medical review in one workspace.
Core is the operational home for program integrity teams. It connects lead intake, case investigation, medical review, evidence, recovery, SVRS sampling, reporting, AI assistance, and Drive documents into one audit-ready workflow.
Capabilities
Every operational step from signal to outcome.
Case Management
Full lifecycle management with configurable stages, activities, allegations, subjects, outcomes, communications, corrective actions, and immutable audit timelines.
Medical Review
Structured clinical review with peer verification, medical necessity decisions, claim context, documentation requests, QA analyst workflows, and auto-sync with case stages.
SVRS Sampling
RAT-STATS aligned statistically valid random sampling. Cochran's formula for sample sizing, Fisher-Yates selection, Mean Per Unit extrapolation, and methodology PDF generation.
Recovery Tracking
Track financial actions, referrals, and corrective actions from identification through resolution. Recovery amounts, payment status, and outcome reporting in one timeline.
Reports & Analytics
Configurable dashboards with role-aware widgets. Per-widget XLSX export, dashboard PDF export, preset-driven date filtering, tenant-scoped caching, and audit logging.
Who it's for
Built for the teams that investigate and resolve.
- Special Investigations Units (SIU)
- Medical Review Teams
- Program Integrity Departments
- Recovery and Corrective Action Teams
- Compliance Officers and Supervisors
- Intake Analysts and Lead Triage Teams
What the demo covers
- Lead triage, scoring, and conversion to case
- Case activity timeline and evidence management
- Medical review workflow with QA verification
- Recovery tracking and financial action outcomes
- AI-assisted investigation with active case context
- Dashboard configuration and XLSX/PDF export
FAQ
Common questions about AEGIS ISD Core.
What investigation types does Core support?
Core supports fraud, waste, and abuse investigations across Medicaid, Medicare, and commercial health plans. Workflows, stages, queues, and evidence requirements are fully configurable by program without code changes.
How does lead conversion work?
Leads can arrive from Detect alerts, external referrals, manual entry, or batch import. After scoring and triage, an analyst converts a lead to a case with one action. All lead context, documents, and history transfer to the case record.
Does Core include AI and Drive?
Yes. AI assistance and Drive document management are included as shared capabilities within Core. Investigators access AI summaries, evidence-linked recommendations, and Drive documents directly from the case workspace.
How does medical review integrate with case stages?
Medical review status auto-syncs with case audit status through forward-only progression. When a medical review QA stage completes, the linked case audit status advances automatically. The MR QA analyst role has narrow permissions for stage completion and MR closure.
Can Core operate without Detect or DataBridge?
Yes. Core is a standalone product. It receives leads from any source including manual entry, external referrals, and batch imports. If Detect is also deployed, qualified alerts flow into Core leads automatically with evidence and context attached.