RADV Services
Our RADV Audit Solution is a comprehensive, turnkey service tailored to help health plans successfully navigate the entire CMS RADV audit process. We manage every detail—from identifying the right sample members to supporting your appeals—ensuring your plan remains compliant, efficient, and audit-ready.
Targeted Sample Selection
Careful identification of sample members from CMS-provided listings to ensure relevance and compliance.
Rapid Medical Record Retrieval
Guaranteed and timely collection of required medical records through our secure retrieval process.
Accurate Coding & Validation
Thorough HCC reviews by certified coders to identify supported conditions and eliminate errors.
Risk Score Adjustment
Precise recalculations of risk scores using verified clinical data for accurate audit outcomes.
Collaborative Audit Review
In-depth pre-submission audit evaluations to ensure data integrity and maximize success.
CMS Appeals Support
Expert assistance with appeal documentation and strategy to defend and justify audit findings.