For Medicaid Fraud Control & Program Integrity Units

Follow the money.
Map the network. Build the case.

Medicaid fraud hides in the gaps between systems, claims in one place, provider enrollment in another, ownership and licensing somewhere else. Aria pulls it all into one connected map and uses AI to expose the shell-company rings, shared addresses, and synthetic identities behind coordinated schemes.

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See It Work

From scattered records to a flagged ring in 60 seconds

A guided run-through of exactly what your team would see: data flowing in, the network forming, and the AI zeroing in on the identity behind the scheme.

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Daniel R. Schmidt SYNTHETIC IDENTITY
94
  • Controls 4 shell entities
  • All share 1820 Industrial Way, Bend OR
  • No verifiable license or NPI history
  • 3 entities re-enrolled after exclusion
0Records ingested
0Entities resolved
0Links analyzed
0Rings flagged
0:00 / 0:25

Connect your sources — live SOS API, Excel, or XML upload.

Why Investigators Use It

The case is already in your data, just spread across different systems

One location for everything

Bring registry filings, provider enrollment, claims extracts, licensing boards, and exclusion lists into a single connected graph, no more switching between portals and spreadsheets.

See the ring, not just the provider

Aria's AI surfaces the shared addresses, common owners, and billing patterns that link one flagged provider to the wider scheme operating around them.

Defensible findings, ready to hand off

Every flag carries the data behind it, and a full audit trail records every action, so findings hold up in a case file, a referral, or court.

What Aria Surfaces

The Medicaid fraud patterns you already recognize

Aria is tuned for the schemes program-integrity teams see most, and the connections that are nearly impossible to spot by hand.

Shell & phantom providersMultiple entities at one address, formed in rapid succession, billing with little real activity.
Common-ownership ringsOne person quietly controlling many billing entities or NPIs through layered ownership.
Excluded-party re-entryA provider on an exclusion list reappearing under a new entity, owner, or identity.
Synthetic identitiesFabricated owners and providers with no verifiable license, credential, or history.
Credential mismatchesBilling under a license that is lapsed, disciplined, or belongs to someone else entirely.
Coordinated timingClusters of linked entities filing, enrolling, or changing status within days of one another.
How It Fits

Built to strengthen a layered program-integrity approach

Leading Medicaid programs don't rely on any single safeguard, they layer provider screening, claims analytics, audits, exclusion monitoring, and cross-agency enforcement across health, human-services, and law-enforcement teams. Aria is designed to reinforce that kind of layered model: it pulls data from across those systems into one connected map and uses AI to surface the networks behind coordinated fraud, so every layer is working from the same picture.

Program-integrity layer
How Aria supports it
Provider screening & credentialing
Resolves each applicant against businesses, owners, addresses, and prior entities, surfacing hidden ties to previously sanctioned or terminated providers before enrollment.
Risk-based review & site visits
Risk scoring ranks which providers warrant deeper review, focusing limited field and audit resources on the highest-risk networks.
Continuous claims monitoring & analytics
Continuously maps billing entities, NPIs, owners, and addresses, flagging coordinated patterns across the whole network, not one provider at a time.
Payment suspensions on credible allegations
When a flag surfaces, shows every connected entity, so action can reach the whole ring rather than one billing ID that simply re-emerges under a new name.
Exclusion-database monitoring
Continuously matches entities against exclusion lists (OIG-LEIE, SAM, state exclusion lists) and flags excluded parties re-entering under new entities, owners, or identities.
Multi-state data-matching
Resolves the same people, businesses, and addresses across fragmented, multi-source records into one identity, exposing actors operating across state lines.
Built for Sensitive Data

Your data never leaves your control

Full audit trailEvery change is recorded — who did what, to which entity, and when, supporting case integrity and oversight.
Role-based accessAnalysts, viewers, and administrators see exactly what their role allows, with all activity logged.

All names, business and license numbers, addresses, and other details shown in Aria and in this demonstration are fictitious and for illustrative purposes only; any resemblance or connection to a real person, business, or record is purely coincidental. Aria is investigative software that supports your team's work; it does not provide legal conclusions, and it is not affiliated with or endorsed by CMS, HHS-OIG, or any state agency.

See Aria run on the kinds of cases your unit works

We'll tailor a walkthrough to your data sources and the schemes you're chasing.

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