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Risk Adjustment Data Validation (RADV) Audit Services

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Plutus Health Is A One-stop Personalized solution For All ASC Billing, Coding, And RCM Needs

AAPC-Certified

AAPC certified ASC coders

Denial and AR Management Services

Specialized denial and A/R management services

One Click support

One-click support 24/7* 365 days

Stop compromising your ASC’s revenue performance. Speak to our ASC medical billing and coding specialist today.

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Adopt the right strategy to best use the risk adjustment process

Plutus Health identifies errors that impact the risk scores. We analyze enrollment and demographic information to collate it with the source system. Our team reviews the HCCs and performs risk adjustment calculations to detect changes

Code verification

Verify the submitted diagnosis codes using medical record documentation to ensure accuracy and integrity

RADV audit preparation

Identify ICD-10 coding errors and confirm reported diagnoses. We review medical records to provide necessary suggestions

Comprehensive documentation

Compile detailed records supporting your claims and ensuring compliance with audit requirements

Accounts Receivables (AR) and Denial Management

Transparent and open communication with a dedicated point of contact to address any questions or concerns promptly

Experts in Risk Adjustment Data Validation (RADV) Audit Support

Plutus Health follows the CMS audit model and offers reliable results. The process includes:

  • Avoid improper payments with the best medical documentation
  • Discover specific medical records based on the high-risk factor
  • Review coding documents to confirm reported diagnoses
  • Detect incorrect ICD-10-CM codes, unreported data, and other coding errors
  • Validate if medical records are according to RADV documentation requirements
  • Proactive CDI improvement services along with physician education

Plutus Health’s RADV audit services help you meet the requirements of each (Medicare Advantage) MA plan.
Need support on RADV audit

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RADV audit services provided by Plutus Health

MA (Medicare Advantage) plans undergo RADV audits from CMS. Plutus Health uses the right strategy to help physicians and payers utilize risk adjustment submissions and help them to reach their maximum potential. We provide RADV audit services for the payers to check if the submitted DX codes can be validated with submitted documents. Plutus Health’s RADV audit support includes:

  • Documentation vs coding gap analysis
  • Determine the right records for CMS submissions
  • Education program based on RADV audit needs
  • Use of simulation methods for RADV audits
  • Give audit analysis depending on the specific plan
  • Examine and retrieve charts to detect all HCC codes

Plutus Health’s RADV audit service includes data retrieval & reporting, preparing documents, and medical record review

  • HIPPA-compliant
  • Effective workflow process
  • Consistent reports and data
  • 15+ years of experience
  • Certified coders
  • 24*7*365 days assistance
  • Customizable and flexible solutions
  • Save 40-45% on costs
  • 100% support on risk adjustment discrepancy

Schedule a call with an
RADV expert

Experience the transformative power of RADV audit excellence with Plutus Health’s Audit Solutions

Plutus Health’s comprehensive RADV audit services

Plutus Health aids payers to submit accurate Dx (Diagnosis) codes. We perform both retrospective and prospective audits. Our RADV auditors follow all the (Centers for Medicare & Medicaid Services) CMS risk adjustment data validation guidelines. Plutus Health’s RADV audit services include the following

Evaluate the existing data

Conduct simulated RADV Audits

Perform MRA/HCC coding with RADV validation

Review medical records to ensure compliance

Validate RADV documentation requirements

Generate plan-specific audit analysis reports

Identify areas of concern & propose corresponding solutions

Conduct simulated RADV Audits

Review medical records to ensure compliance

Generate plan-specific audit analysis reports

Evaluate the existing data

Perform MRA/HCC coding with RADV validation

Validate RADV documentation requirements

Identify areas of concern & propose corresponding solutions

Our happy clients

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