RADV Defense as Ongoing Posture, not Crisis Response
Plutus Health combines PE Full Review AI in RADV mode with certified risk adjustment coders to validate diagnosis coding, strengthen medical record documentation, prepare audit-ready evidence, and reduce payment risk across Medicare Advantage and Risk Adjustment Data Validation programs.
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We review diagnosis coding, documentation quality, and supporting medical records before CMS or payer audits begin.
Every submitted diagnosis is validated against physician documentation, encounter notes, laboratory results, imaging, and supporting clinical evidence.
Our certified coders confirm that every reported HCC meets CMS documentation requirements and is fully audit-defensible.
We identify ICD-10-CM coding errors, unsupported diagnoses, documentation gaps, and submission risks before they become payment recoupments.
We prepare evidence packets, chart retrieval workflows, audit reports, and documentation packages for Medicare Advantage organizations and health plans.
OlympusAI measures audit readiness, documentation quality, provider variation, and HCC defensibility across your population.
AI & Analytics, Working Underneath
PE Full Review AI (RADV Mode)
OlympusAI reviews every submitted diagnosis, validates supporting documentation, generates evidence indexes, and scores audit defensibility before submission.
- → Documentation validation
- → Evidence indexing
- → Defensibility scoring
- → ICD-10 verification
RADV Intelligence Engine
Analytics identify unsupported diagnoses, recurring documentation weaknesses, provider trends, and future audit exposure across your Medicare Advantage population.
- → Risk scoring
- → Provider analytics
- → Documentation trends
- → Audit forecasting
CMS Compliance Engine
Every chart is reviewed against CMS RADV guidelines, ICD-10-CM requirements, HCC validation rules, and Risk Adjustment documentation standards.
- → CMS validation
- → RADV compliance
- → HCC verification
- → Audit monitoring
How the Operating Model Actually Runs
Every submitted diagnosis is matched against physician documentation to confirm complete clinical support, accurate coding, and CMS compliance.
OlympusAI organizes supporting documentation, indexes medical records, links evidence of diagnoses, and builds complete, audit-ready files before they're requested.
Certified risk adjustment coders review flagged cases, validate audit findings, and finalize every RADV package before submission to CMS or Medicare Advantage plans.
FAQs
Be audit-ready before the audit arrives
Our 30-day RADV readiness assessment evaluates documentation quality, HCC validation, coding accuracy, audit defensibility, and CMS compliance to identify payment risk before your next Risk Adjustment Data Validation audit.