Are You RADV Audit Ready? Three Strategies to Get You There

Posted in GeBBS Healthcare Solutions, Inc.

The Centers for Medicare and Medicaid Services (CMS) recently announced plans to ramp up its risk adjustment data validation (RADV) audit program in 2020 based on a recent study by the Office of Inspector General (OIG), which found potential issues related to Medicare Advantage Organizations (MAOs) using chart reviews to inappropriately increase risk adjusted payments. …

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It’s Working – CMS Report Concludes the Effectiveness of Risk Adjustment

Posted in GeBBS Healthcare Solutions, Inc.

In late June, the Centers for Medicare & Medicaid Services released data demonstrating that its Risk Adjustment Program – developed as part of the Affordable Care Act just five years ago – is working just as planned. What was the plan? To prevent payers from developing plans intended to attract healthier patients and to incentivize …

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