On November 14, 2024, the Centers for Medicare & Medicaid Services (CMS) initiated Payment Year (PY) 2018 Risk Adjustment Data Validation (RADV) audits, notifying 60 Medicare Advantage (MA) contracts of their selection. These audits are essential for ensuring the accuracy of risk-adjusted payments by verifying that diagnoses submitted by MA organizations are supported by medical record documentation.
Navigating the complexities of RADV audits requires meticulous attention to detail and a thorough understanding of CMS guidelines. At Rebellis Group, we specialize in assisting health plans with comprehensive coding and chart review services tailored to meet all RADV requirements.
How Rebellis Group Can Support Your RADV Needs:
Expert Coding Services: Our team of certified coders ensures that all diagnoses are accurately captured and compliant with CMS standards, minimizing the risk of discrepancies during audits.
Comprehensive Chart Reviews: We conduct detailed reviews of medical records to confirm that all documented diagnoses are adequately supported, thereby reducing potential overpayments or underpayments.
Audit Preparation and Support: Rebellis provides end-to-end support throughout the RADV audit process, from initial preparation to post-audit analysis, ensuring your organization is well-prepared and compliant.
By partnering with Rebellis Group, health plans can confidently navigate the RADV audit process, ensuring compliance and financial accuracy.
Navigating an Uncertain Environment with Rebellis Group
In this shifting regulatory landscape, it’s more important than ever to have a strategic partner that understands the complexities of government program compliance, and plan performance. Whether you’re expanding operations, optimizing performance, launching a new service or investment, navigating compliance challenges, or exploring future market strategies, we provide the insight and expertise you need to succeed in MA, ACA, Medicaid, as a SNP, or a vendor. Our expertise ensures you not only stay ahead of changing policies but also seize growth opportunities while maintaining high standards of care and accountability.
We also offer a subscription service that analyzes HPMS and regulatory memos, ensuring your team stays up to date with the latest information to support your success.
By partnering with Rebellis Group, health plans can confidently navigate the RADV audit process, ensuring compliance and financial accuracy while staying ahead in today’s rapidly evolving healthcare landscape.