Compliance is becoming an increasingly difficult challenge for Medicare Advantage plans, especially when it comes to their risk adjustment programs. When CMS selects plans for a risk adjustment data validation (RADV) audit, they need to have a high degree of certainty that their diagnoses submitted for reimbursement are valid. So, what’s the solution? We look at the benefits of coding claim validation with Lesley Brown, Cotiviti vice president of Risk Adjustment.

Episode 10 - How risk adjustment coding validation gives health plans more certainty

Overheard at AcademyHealth: Health Policy, Social Determinants, and Data

Jordan Bazinsky, executive vice president and administrative officer for Cotiviti, breaks down various factors impacting innovation, including market trends that he believes are both headwinds and tailwinds to innovation, as well as shares a framework based on what’s happening in the current health care landscape.

For more content, visit populationhealthnet.com

Regulatory, Structural Trends Impacting Innovation for Payers

Addressing the Complexities of Value-Based Payment Models

From the Trenches is a healthcare analytics podcast from Cotiviti (formerly Verscend Technologies), a leading solutions and analytics company that is reshaping the economics of healthcare. On the show, we explore the latest trends in healthcare quality and performance analytics, risk adjustment, payment integrity, and data management. Tweet your suggestions and comments for the podcast to @cotiviti or email jeffrey.robinson@cotiviti.com.

Episode 10 - How risk adjustment coding validation gives health plans more certainty

Cotiviti

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