Virgo Governed Analytics Demo
A guided, governed analytics control plane for healthcare revenue-cycle teams.
Guided Revenue-Cycle Walkthrough
Follow Sarah, a senior practice manager, as she uses Virgo to monitor Aetna Clean Claim Rate and safely investigate CO-50 denials.
Meet Sarah
Sarah is a senior practice manager at a healthcare group.
Her goal is to protect the practice's revenue by monitoring Aetna's Clean Claim Rate (CCR) so the group does not fall into lower-tier reimbursement schedules.
Sarah also needs to know which providers are causing the most Medical Necessity denials — Code CO-50.
The old way
Sarah used to spend 45 minutes:
- Logging into payer portals
- Reading 15-page Clinical Policy Bulletins
- Exporting claims data
- Cross-referencing member IDs in Excel
- Trying not to expose PHI while doing it manually
The Virgo promise
Sarah opens the governed dashboard and asks:
What is the CCR for each of our providers, and which ones have the most CO-50 denials?
Before the AI answers, Virgo walks her through what the system knows and what it is allowed to do.
Click Step 1 — View Database to begin.
View Database
This layer shows the governed database view: business entities, raw tables, column meanings, PHI constraints, and approved join paths.
Catalog Summary
- Entities: members, claims, providers
- Approved joins: claims → members, claims → providers
- Blocked PHI columns: SSN, first name, DOB
- Direct members → providers joins: not approved The model does not get a raw database dump. It gets a governed semantic catalog.
View Policies
Governance policies become hard enforcement rules during SQL validation.
Active Governance Rules
Hard Policy: no_phi_in_output
Blocks analytical output containing:
members.ssnmembers.first_namemembers.dob
Hard Policy: unapproved_join_violation
Blocks direct relationship paths that bypass clinical claim lineage.
Example blocked path: members → providers
Create New Metric Registry
Click a metric to walk through how it becomes governed.
Available Metric Templates
Start with a high-value healthcare revenue cycle metric.
Other future templates:
- Denial volume by code
- Total member responsibility
- Authorization mismatch rate
Metric Walkthrough
Click Configure Clean Claim Rate to begin.
Registry Tables
Virgo Playground
Click benchmark queries to see whether Virgo approves or blocks them. Benchmark Query → Mechanistic Triage → SQL Generation → Layer 4 Gatekeeper → Audit Result
Run a benchmark query to see the gatekeeper decision.
Aetna Audit Dashboard
Manager view for traceability, compliance review, and governance performance. This dashboard answers:
- Who asked what question?
- What policy was triggered?
- Was the query approved or blocked?
- Did the system catch every governance violation?
Governance Summary
The system successfully caught:
100%
of governance violations in the benchmark run. This includes PHI/PII exposure attempts, SSN retrieval, email export attempts, direct member-provider joins, and clinical lineage bypass attempts.