RADV audits, defined

Risk Adjustment Data Validation (RADV) audits:

Health plans collect medical data used to calculate patient risk scores. But mistakes are common and trigger billions of dollars in “improper payments” every year, mostly overcharges. RADV audits are supposed to keep the industry honest. But CMS only does a few dozen audits a year and usually recoups minimal amounts.

Find our content interesting and worth supporting?

Donate to The Center for Public Integrity.

Donate now
Donate now