Glossary | SentinelGraph

Glossary

Plain-language definitions

Fraud-detection vocabulary used on the SentinelGraph platform, written for visitors who aren't domain experts. Categories follow the program areas we cover.

Healthcare Corporate Legal Financial Disaster Workforce General

Healthcare

5 terms

NPI (National Provider Identifier): 10-digit ID issued to every US healthcare provider by CMS.; Required to bill Medicare or Medicaid. NPIs are public via NPPES. SentinelGraph uses NPI as the primary key for resolving healthcare leads — when an excluded individual is still billing under their NPI, that's the strongest fraud signal class.
LEIE (List of Excluded Individuals/Entities): OIG-maintained list of providers banned from federal healthcare programs.; Published monthly by the HHS Office of Inspector General. Once on LEIE, the individual cannot bill federal healthcare programs directly. SentinelGraph's primary excluded-provider data source. The fraud pattern: excluded individuals continuing to control or bill through layered corporate structures.
MFCU (Medicaid Fraud Control Unit): State-level prosecutor's office for Medicaid fraud + patient abuse.; Every US state has an MFCU, typically housed in the AG's office. They prosecute Medicaid provider fraud, patient neglect in nursing homes, and related criminal cases. Major SentinelGraph customer segment — they need entity-resolution intelligence to build cases against multi-entity provider networks.
OIG (Office of Inspector General): Federal watchdog; maintains LEIE; investigates Medicare/Medicaid fraud.; HHS-OIG is the most prominent. Issues exclusion orders, investigates provider fraud, publishes enforcement actions and corporate integrity agreements. Other agency OIGs (DOL, SBA, USDA) play parallel roles for their programs.
NPPES (National Plan and Provider Enumeration System): CMS public registry of all NPI holders.; Free, bulk-downloadable. Includes provider name, NPI, taxonomy (specialty), address, and licensing data. SentinelGraph cross-references NPPES with LEIE + state Medicaid exclusions to find providers operating despite exclusions.

Corporate

4 terms

Registered agent: Designated point of contact for legal service-of-process on a corporate entity.; Every LLC, corp, and partnership must designate a registered agent in each state where it does business. Public record via state SOS filings. Major fraud signal: a single registered agent across 5-50+ entities can indicate a shell-network. Sentinel's registered_agent edge type is one of the highest-signal connections.
Shell company: Corporate entity that exists on paper but has no real operations.; Legal in many cases (holding companies, SPVs). Becomes a fraud indicator when used to obscure beneficial ownership, evade exclusion lists, or layer assets out of reach. SentinelGraph detects shell networks via clustering: shared address, shared registered agent, shared corporate officers, rapid formation/dissolution patterns.
Beneficial owner: The natural person who actually controls or benefits from a corporate entity.; Under FinCEN's Corporate Transparency Act (effective 2024), most entities must disclose beneficial owners. Distinct from listed officers, directors, or shareholders — the BO is whoever ultimately controls. Fraud schemes often layer corporate structures to obscure the BO. SentinelGraph's officer-overlap detection helps surface likely BOs across nominal owners.
SOS filings (Secretary of State filings): State-level corporate registration records — public, varies by state.; Every state's Secretary of State publishes corporate filings. Coverage and quality vary widely: FL Sunbiz is comprehensive (officers, addresses, registered agent fields, formation/dissolution dates); some states publish minimal data. SentinelGraph normalizes 50-state SOS filings into a unified entity view.

Legal

4 terms

Exclusion vs. Debarment: Both bans, different scopes.; Exclusion (OIG-LEIE) bans the person from federal healthcare program participation. Debarment (SAM.gov) bans them from federal contracting more broadly. A subject can be on one list, both, or neither. Cross-list overlap is a strong fraud signal — typically indicates substantive misconduct, not procedural error.
SAM.gov: System for Award Management — federal contractor + grant recipient registry, with debarment list.; Anyone receiving federal contracts or grants must register in SAM.gov. The Excluded Parties List (EPLS) within SAM.gov tracks debarred parties. SentinelGraph cross-references SAM with LEIE for healthcare-related debarments.
False Claims Act: Primary federal law against billing fraud against the government.; 31 USC §3729. Imposes treble damages + per-claim penalties. Most healthcare fraud civil cases are FCA cases. Whistleblower provisions (qui tam) let private plaintiffs sue on behalf of the government for a cut of recovery. SentinelGraph's enforcement-adjacency signal class draws heavily from FCA settlements + judgments.
Corporate Integrity Agreement (CIA): Multi-year compliance contract between OIG and a healthcare entity post-violation.; Typically follows a False Claims Act settlement. Imposes monitoring, reporting, and structural controls for 3-5 years. CIA-bound entities are flagged in SentinelGraph as elevated-risk regardless of current behavior — the underlying conduct that triggered the CIA is part of their permanent record.

Financial

1 term

UCC filing: Public lien filing on commercial assets.; Uniform Commercial Code Article 9 governs how creditors register security interests on debtor assets. Filed at state level. Indicates which entities have outstanding secured debt + against which collateral. SentinelGraph uses unresolved UCC filings as a financial-distress + ownership-complexity signal.

Disaster

2 terms

FEMA disaster declaration: Federal disaster authorization unlocking individual/public assistance funding.; Triggers eligibility for individual assistance, public assistance, hazard mitigation grants, etc. Disaster fraud sector at SentinelGraph tracks contractors and individual claimants exploiting these programs — duplicate claims, ghost contractors, post-disaster shell formation.
PPP / EIDL fraud: Pandemic-era SBA-loan program fraud.; Paycheck Protection Program + Economic Injury Disaster Loan. Issued ~$1T+ across 2020-2021 with minimal upfront verification. Massive fraud surface: ghost businesses, inflated payroll, ineligible recipients. SentinelGraph's SBA fraud sector cross-references PPP/EIDL recipient lists with NPPES, state exclusions, and corporate filing dates to surface synthetic-business patterns.

Workforce

3 terms

Workers' comp premium fraud: Misclassifying workers/payroll to underpay workers' comp insurance.; Distinct from claimant fraud (which is patient-side). Premium fraud is employer-side: classifying high-risk workers as low-risk, hiding payroll, ghost subcontractors. State workers' comp boards run enforcement programs. SentinelGraph's workers_comp sector tracks both employer-side (premium fraud) and provider-side (mill operations).
DOL WHD (Wage and Hour Division): DOL's wage-theft enforcement arm.; Investigates minimum wage, overtime, child labor, FMLA, and H-2 program violations. Issues back-wage assessments + civil money penalties. SentinelGraph cross-references high-dollar WHD actions ($2M+ recoveries) against ownership data to surface multi-entity wage-theft networks.
SNAP / EBT: Supplemental Nutrition Assistance Program / Electronic Benefit Transfer.; USDA-FNS administered. EBT cards function like debit cards at authorized retailers. Major fraud surfaces: trafficking (retailer pays cash for cards at discount), ghost-store fronts, recipient-side asset anomalies. SentinelGraph's SNAP sector tracks FNS retailer disqualifications + state-OIG SNAP cases.

General

3 terms

Score / Tier (SentinelGraph internal): Lead-confidence scoring system.; Numerical 0-100 score determined by signal weights + corroboration count + entity-resolution confidence. Bucketed into tiers: Platinum (≥80), Gold (60-79), Silver (50-59), Bronze (45-49), Iron (<45, suppressed from customer view). See `/methodology` page for the full breakdown.
Resolved entity: Multiple data-source records merged into a single canonical entity record.; When a person appears in LEIE under one name and in a state corporate filing under a slight variant, entity resolution merges them. Done via NPI/EIN identifier match (high confidence), full-name + DOB or address match (medium-high), or attribute-only match (medium). Each resolved entity carries a confidence score. Misresolution is the #1 source of false positives.
Watermarked dossier: Per-lead PDF that's traceable to the subscriber who downloaded it.; Every lead detail download from SentinelGraph gets a unique watermark embedded with the subscriber's identity, the report ID, and a download timestamp. If a dossier leaks, we can identify the source within minutes. SentinelGraph does not offer bulk export at any tier — this is by design.

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Important disclaimer: SentinelGraph provides structured intelligence based on publicly available data. It does not provide legal advice, conduct investigations, or make determinations of fraud, liability, or regulatory violation. All findings are preliminary, evidence-traceable observations intended to support — not replace — qualified legal, investigative, or compliance review. Use of this service does not create an attorney-client relationship or any professional engagement unless separately agreed in writing.