RADV Audit

Risk Adjustment Data Validation audit. CMS audit of Medicare Advantage plans verifying that submitted HCC diagnoses are supported by medical records. RADV findings can result in significant recoupment from MA plans, who in turn may recoup from delegated provider groups. Documentation must include the diagnosis, evaluation, and treatment plan in the same encounter note. Best practice: every HCC on the problem list gets MEAT (Monitored, Evaluated, Assessed, Treated) language in each annual visit note.