Our Risk Adjustment team is reaching out to select provider offices via fax to request medical records for a Risk Adjustment Data Validation (RADV) audit and an Initial Validation Audit (IVA) for Medicare and commercial ACA members.
These audits are required by the Centers for Medicare and Medicaid Services (CMS) and the Department of Health and Human Services (HHS) and work to confirm the accuracy of the diagnoses we submit to CMS for our members for risk adjustment purposes.
What do you need to do?
If you’re contacted, please submit the requested documentation by the deadline provided in your communication.