Tag Archives | RADV Audits

CMS Publishes RADV Medical Reviewer Guidance

In the Medicare Advantage (MA) context, “risk adjustment” is the process by which the Centers for Medicare & Medicaid Services (CMS) reimburses Medicare Advantage Organizations (MAOs) based on demographic factors and the health status of enrolled members. By regulation, MAOs must submit risk adjustment data that characterize the content and purpose of items and services […]

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