Facing a RADV Audit? We Help You Mitigate Risks.
Tailored solutions to ensure compliance, safeguard financial performance, and
reduce audit complexities.
Our RADV Services
Comprehensive Services to address your RADV requirements:
Targeted Strategies
- Advanced analytics focus on high-impact encounters to improve compliance
in key areas. - Tailored solutions ensure your submissions align with regulatory
requirements.
Deep RADV Expertise
- Active in RADV audits since the 2006 pilot, offering unmatched insights.
- Expertise in managing complex CMS requirements to ensure compliance.
Precision in Coding
- 800+ AAPC-certified coders deliver accuracy and compliance.
- Confidence Rating System ensures strong, error-free HCC submissions.
Efficient Record Retrieval
- Multithreaded approach ensures timely data retrieval for HCC submissions.
- Over 3 million records retrieved for audits, payment integrity, and legal cases.
Mock Audits for Readiness
- Simulates CMS processes to identify compliance gaps and risks.
- Proactive readiness ensures smooth audits and secures financial outcomes.
Proprietary Confidence Rating System
- Categorizes documentation into confidence tiers for optimized submissions.
- Optimized processes minimize risks and maximize compliance with CMS
standards.
Get Ahead of RADV Challenges
Don’t wait for an audit to uncover issues — partner with Annova Solutions for
proactive and comprehensive RADV support.
Frequently Asked Questions
What is a RADV audit, and why is it important?
A Risk Adjustment Data Validation (RADV) audit is conducted by CMS to verify the
accuracy of risk adjustment data submitted by Medicare Advantage (MA)
organizations. These audits ensure that health plans receive payments aligned with
the health status of their members. An accurate RADV audit protects your
organization from penalties and ensures compliance with CMS guidelines.
What are the key challenges organizations face during RADV audits?
Organizations often face tight deadlines, complex documentation requirements, and
difficulties retrieving medical records. Ensuring the accuracy of submitted HCCs and preparing for unexpected audits can also be daunting without the right expertise and processes.
How can Annova Solutions help with RADV audits?
Annova offers end-to-end support, including:
- Multithreaded record retrieval to save time.
- Expert coding with a proprietary Confidence Rating system to focus on high-confidence HCCs.
- Mock RADV audits to proactively identify vulnerabilities.
- Retrospective reviews and Clinical Documentation Improvement (CDI)
programs to enhance documentation quality.
What is Annova’s Confidence Rating system, and how does it benefit RADV audits?
Our proprietary Confidence Rating system evaluates documentation at the diagnosis
level, categorizing it as Best-Support, Moderate, or Low Confidence. This ensures
that only the strongest records are submitted to CMS, minimizing the risk of
unsupported HCCs and maximizing compliance.
What is multithreaded record retrieval, and why is it important?
Multithreaded record retrieval means chasing multiple medical records
simultaneously instead of one at a time. This approach significantly reduces delays,
ensuring that your organization meets CMS deadlines efficiently without
compromising on accuracy.
How does Annova conduct Mock RADV Audits?
Our Mock RADV Audits replicate the CMS audit process. Starting with claims or
encounter data, we retrieve records, analyze documentation, and identify gaps in
HCC submissions. This proactive approach prepares your organization for real
audits while minimizing risks.
Why is Clinical Documentation Improvement (CDI) crucial for RADV readiness?
CDI ensures that provider documentation fully supports submitted HCCs and aligns
with CMS requirements. Annova’s CDI reviews include actionable guidance for
providers, improving accuracy and reducing the likelihood of unsupported codes.
What types of organizations can benefit from Annova’s RADV services?
Our RADV services are ideal for Medicare Advantage plans, payer organizations,
and healthcare providers looking to enhance compliance, protect revenue, and
streamline audit processes.
What experience does Annova have with RADV audits?
Annova’s leadership team has been involved in RADV audits since the first PY2006 pilot audits. Our experience spans thousands of records retrieved and coded,
ensuring we bring unmatched expertise to every client engagement.
Are Annova’s RADV services HIPAA-compliant?
Yes, all of Annova’s processes are fully HIPAA-compliant. We prioritize data security and ensure that medical records are handled with the highest levels of confidentiality and protection.
How does Annova ensure timely completion of RADV projects?
With our multithreaded processes, experienced team, and robust infrastructure, we meet tight RADV deadlines without compromising on accuracy or quality.
Can Annova customize its RADV services for my organization’s needs?
Absolutely. Annova tailors its services to match your unique requirements, including
mock audits, coding reviews, and educational programs for providers.
What is the cost of Annova’s RADV services?
The cost depends on the scope of work and specific needs of your organization.
Contact us for a customized quote tailored to your RADV requirements.
How do I get started with Annova’s RADV services?
Getting started is simple! Fill out our contact form to discuss your needs and create a customized solution.
Annova Solutions Pvt. Ltd.
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