RADV Services

The team at RADV has been developing and perfecting our audit solutions for years and we are confident in our ability to help health plans successfully fulfill their RADV audits requirements. Some of the highlights of our RADV Audit Solution process include:

  • Careful analysis of CMS list of sample members in order to identify which medical records will provide the best results for each member.
  • Rapid retrieval of RADV data in order to ensure that as many records as possible are collected. It is imperative that RADV audit results are submitted on time and we guarantee that they will be.
  • All retrieved charts are examined by our experienced team of professional coders to ensure that all possible HCC codes are identified and to validate members' conditions.
  • Adjusted risk score calculations that are based off of the results and errors found by our team of coders.
  • Close interaction with the health plan throughout the process including joint review session before audit results are submitted.
  • Appeal support and documentation should there be a need for an appeal with the CMS.

RADV is prepared to assist health plans in every step of the complicated RADV audit process. We enable health plans to be confident in the results that they are submitting to the CMS and guarantee dedication and professionalism throughout the entire audit process. Contact us today to get the assistance your health plan needs in order to produce successful RADV audit results.

Accuracy Support Validation Simplified

Mock RADV Services

In addition to our ability to aid in RADV audits, we also offer our customers an extremely valuable Mock RADV service option. This service is designed to help health plans assess the effectiveness of their Risk Adjustment efforts and tests their preparedness for a RADV audit. The Mock RADV service assesses these key aspects by examining a plan's ability to collect and code medical records in a timely manner, determining how well submitted HCC codes match diagnosed conditions, and analyzing which diagnoses were over or under coded. After all of the analysis has been completed, a detailed report is provided to the health plan outlining the results. We then work with the help plan to help them identify their strengths and opportunities for improvement. The Mock RADV service is a great tool for helping health plans analyze their current RADV preparedness and enabling them to identify areas of concern. Contact us via web or telephone for additional information on this service.