CMS-HCC v28 & RADV Readiness for Medicare Advantage Plans

The rules have changed – and so have your revenue and audit risk.

Expanded RADV audits, V28 RAF compression, and increased risk of clawbacks are pushing Medicare Advantage plans to strengthen their end-to-end RA workflows by closing common gaps:

Volume Over Defensibility

Volume-focused coding that prioritizes capturing net new HCCs and increasing RAFs over ensuring that documentation passes RADV scrutiny.

Disconnected Vendors

Disconnected retrieval, coding, and audit workstreams that limit accountability across vendors.

Blind Review Strategy

Review strategies that lack CDI feedback loops and offer little insight into where risk is defensible vs. exposed.

At Annova Solutions, we don’t just look for codes, we help our clients safeguard revenue throughout the entire risk adjustment journey.

Comprehensive Support

We specialize in end-to-end RA support that goes beyond code capture. We blend chart retrieval, precision HCC coding reviews, and CDI expertise to help you manage documentation wholistically.

Analysts First

We train our coders to be risk adjustment analysts who apply clinical reasoning & compliance judgment when making coding decisions. This improves accuracy, reduces false positives, and strengthens audit defensibility.

Smarter AI

We identify high-risk HCCs before CMS does. Our AI-driven “human-in-the-loop” approach uses logic derived from CMS, AHA, OIG, and RADV guidelines to help prevent coding errors.

Capture More

With nationwide retrieval capabilities, we reach the providers and charts your current vendors miss, giving you every opportunity to capture audit-ready documentation.

Want to learn more about how Annova partners with health plans?

Share a few details about your MA book of business and current risk adjustment setup.

We’ll follow up to schedule a no-obligation 30- minute working session focused on where your retrieval, coding, and documentation are most exposed — and what you can realistically fix before the next audit cycle.