Mock Risk Adjustment Data Valuation (RADV) Audit

CMS annually selects Medicare Advantage and PACE organizations for Risk Adjustment Data Valuation (RADV) audits.  These audits measure organization-level payment error rates related to risk adjustment data for payment recovery. If your program does not have an understanding of your audit risk, now is the time to prepare for a potential audit. CMS and the Office of the Inspector General (OIG) are ramping up auditing as part of the recovery audit activities. In addition, beginning in 2015, the OIG will be doing their own Risk Adjustment Data Validation Audits (RADV), which may look just like a CMS RADV, but may be more targeted.

We can help your organization become compliant and ready.

At Capstone Performance Systems, we take  a client-centered approach to Mock RADV Audit services. We offer plan-specific audit analysis reporting, calculations of potential payment error, and recommendations for trouble areas identified during the mock audit.

Capstone works with your organization to collect the data needed for your Mock RADV Audit.  We mirror CMS’s RADV audit process, giving your program a true audit experience and reliable results.

After receiving a Mock RADV Audit from Capstone, your organization will:
•     Know and understand potential risk.
•     Develop a plan to mitigate the potential risk.
•      Realize the financial impact of uncorrected errors.
•      Satisfy internal auditing and monitoring requirements for compliance.
•      Receive guidance to correct any trouble areas.


Besides our Mock RADV Audit, Capstone offers other audit services, including:

1.        Targeted Audit: A targeted audit reviews pre-identified medical records and submitted
diagnosis codes with a complete report.
2.       Full Chart Audit: A full chart audit reviews all of your charts using RADV methodology.
3.       Clinical Audit: A clinical audit identifies potential diagnoses that were not captured.
4.       Custom Audit: A custom audit is created for your organization based on your needs.


Contact us today to learn more.





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