Written by: Dr. Richard Schamp, CEO

The Centers for Medicare and Medicaid Services (CMS) perform risk adjustment data validation audits on patients’ medical records. Risk adjustment data validation (RADV) is the process of verifying diagnosis codes submitted for payment are supported by medical record documentation. The purpose is to ensure risk adjusted payment integrity and accuracy.  CMS has announced its intention to increase auditing activity consistent with an emphasis to reduce payment errors.

Signs your plan may be at risk for…

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