Risk Adjustment Data Validation (RADV) Audit Services

Trusted RADV Audit Services for Clear Reporting and Compliant Risk Management

At MedCode we help health plans and providers stay audit-ready with complete, hands-on RADV audit services. Our experienced auditors review every chart and data point carefully to ensure coding accurately reflects patient complexity. This not only protects reimbursements but also reduces stress when CMS validation audits begin.

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Trusted by 1000+ Companies

Delivering Expert-Led RADV Audits

All the RADV audits we conduct combine real-world auditor expertise with smart technology that flags inconsistencies early. The result, practical, clear findings you can act on right away.

Each one of the reviews is conducted with precision, ensuring that organizations:

Maintaining accurate HCC reporting and risk adjustment data validation

Catching documentation gaps early, before CMS does

Reducing compliance and revenue risks before they escalate

We walk clients through every stage of the RADV audit services process, keeping it organized, transparent, and stress-free.

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Operational Pitfalls in RADV Audits

RADV audits can get tricky fast, especially when documentation or data isn’t consistent. Some common challenges include:

Variations in provider documentation that impact coding accuracy

Large volumes of patient charts during validation cycles

Misaligned data between clinical and administrative records

Pressure to stay audit-ready and meet CMS standards without tripping over compliance issues.

At MedCode, our RADV audits are built to make that process smoother, helping you catch errors early, protect reimbursements, and stay confident about compliance.

MedCode’s Specialized Services for Accurate RADV Outcomes

Audit preparation

Reviewing records and data to make sure everything is ready before the audit starts.

Data validation

Checking risk adjustment data for accuracy and transparency in coding.

Chart Review

Spotting incomplete or mismatched documentation so it can be fixed quickly.

Reporting & Feedback

Sharing clear reports with practical steps to improve audit outcomes.

Compliance Assurance

Ensuring workflows and processes meet CMS standards and RADV audit expectations

Why Leading Health Plans Partner with MedCode for RADV

Our RADV audit services stand out because of:

Certified auditors with direct RADV experience.

Scalable teams capable of handling high-volume audits efficiently.

Real-time issue identification to prevent discrepancies before submission.

Structured processes that strike an exemplary balance of accuracy with operational efficiency.

Complete alignment with CMS requirements for validated risk adjustment data.

Frequently Asked Questions

Why is Risk Adjustment Data Validation important?

It protects revenue, keeps you compliant, and helps avoid issues during CMS audits.

Is RADV only for large health plans?

No. Any organization in a CMS risk adjustment program can benefit, no matter the size.

How quickly can MedCode complete RADV audits?

The turnaround depends on chart volume, but our structured approach ensures prompt and reliable delivery.

What types of records are reviewed by MedCode during a RADV audit?

MedCode examines a wide range of clinical documentation, including medical charts, encounter data, and supporting records, to ensure valid and reliable risk scoring.

Improving the quality of documentation by addressing gaps and inconsistencies.

Accelerate Your Audit Process and Safeguard Risk Accuracy with MedCode

Choose MedCode for RADV audits that combine accuracy, compliance, and actionable insights. Ensure your organization is audit-ready, your risk adjustment data validation is precise, and your reporting reflects true patient complexity.