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Six HI Questions to Ask Your EHR Vendor for High-Volume Payer Requests

September 19, 2023
Journal of AHIMA

Health information (HI) professionals nationwide anticipate a looming tsunami of payer requests for medical records. The Centers for Medicare and Medicaid Services (CMS) Medicare Advantage Risk Adjustment Data Validation (RADV) audit season peaks from March through April every year. During a RADV audit, CMS confirms that any diagnoses submitted by payers for risk adjustment are supported in the enrollee’s medical record. And each new season brings an increasing number of payer requests.