Risk Adjustment Data Validation (RADV) Audit Support

  • Simulated RADV Audits
  • Gap Analysis (documentation vs. coding)
  • Provider education for clinical documentation improvement
  • Methodology for RADV audit that helps in determining the best records for CMS submission
  • Coder education based on RADV Audit requirements
Case Studies
Risk Score Optimization through CDI
Scope: A major university-based health system wanted a thorough review of their documentation to see if it was supporting the level of care they are providing to the risk adjusted patient population.
Provider Data Management - Process Innovation and Technology Result in Cost Savings
The Challenge: A cost intensive update process required checking data on all provider information update forms, rather than the ones which were actually changed (typically only 40%).