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  • How to Ensure Accurate Data Validation for Medicare Risk Adjustment
    Health Care

    How to Ensure Accurate Data Validation for Medicare Risk Adjustment

    March 28, 2023 /

    Regarding Medicare risk adjustment (RADV), health plans must verify diagnoses are reflected accurately in medical records. This requires a strong, enduring partnership between payers, providers, and members. Verify the Source Data Whether it’s a Medicare Advantage plan, a Medicaid managed care plan, or a public health insurance exchange, and the risk adjustment process is essential to ensure that payers are compensated appropriately for their healthcare costs. It also levels the playing field to encourage providers and payers to offer members more preventive and appropriate care. Accurate risk adjustment begins with collecting statistics and evaluating patients’ health conditions, medical history, and professional encounter data. This data is then used to calculate…

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    James Eaton Comments Off on How to Ensure Accurate Data Validation for Medicare Risk Adjustment

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