8 ways to be sure you select the best aca

8 WAYS TO BE SURE YOU SELECT
THE BEST ACA-RADV IVA AUDITOR
The first year of commercial risk adjustment has ended. Select an audit firm for the new
ACA RADV Initial Validation Audit requirements soon to lock in qualified resources.
Follow the checklist to ensure your IVA partner has the expertise
and resources to comply with CMS future guidance and enhance
your foundation for a sound risk adjustment strategy:
MA RADV Experience
Demonstrated ability to stay ahead
of changing CMS guidelines
Coding
Resources
A steady pool of trained,
experienced and
certified coders
Validation Tools
Experience and technology to combine
EDGE server data and chart images
RADV
834
Enrollment Files
Skills and resources
to validate original 834s with
EDGE server data
837 Claims and
EHR Data
Analytics
EDGE Server
Experience
Spot missed diagnosis
codes and improve risk score
data streams
Identify and prevent EDGE
server data-prep errors
Audit Expertise Beyond Chart Coding:
• Generally Accepted Government Audit Standards
(“Yellow Book”)
• American Institute of Certified Public Accountants
• Standards for the Professional Practice of Internal Auditing
developed by the Institute of Internal Auditors
• Information Systems Audit & Control Association Standards
ACA Risk
Model
Experience
Precisely analyze revised
risk scores beyond simply
applying the SaaS
(Software as a Service)
code.
Initial Validation Audit vendor selection and preparation takes months—
impacting IT, finance, risk adjustment and provider relations.
Enlist Altegra Health for your team now!
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