RADV mastery: HCCs, documentation, and the path to RADV audit success
Read time: 10 min
Summary
RADV audits are no longer an occasional hurdle. They’re an annual requirement for eligible Medicare Advantage plans. And with CMS expanding audit volume, shortening timelines, and raising financial stakes through extrapolated findings, organizations can’t afford to push off preparation.
Success will depend on precise documentation – particularly for Hierarchical Condition Category (HCC) coding – and strong collaboration between payers and providers. This insight brief breaks down the new RADV reality, the risks of falling behind, and the practical steps you can take to protect revenue and reputation.
Key learnings
Annual RADV audits bring higher stakes, with more records reviewed, tighter deadlines, and greater financial exposure
A clear audit trail built on accurate HCC coding and M.E.A.T.-based documentation is critical to defending patients’ risk scores
A step-by-step checklist on page 4 offers practical guidance to help organizations get, and stay, audit-ready
Featured speaker(s)
April Curtis
Marketing Director
IMO
Thomas Magnum
Marketing Manager
IMO
B.A. Baracus
Data Analyst
IMO
B.A. Baracus
Data Analyst
IMO
Who It's For
Download the Insight brief
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