Walk into RADV Audits
with Confidence
RAAPID’s AI-powered solution enables health plans to efficiently manage and streamline RADV audits
The RADV Audit Challenges
Medicare Advantage plans face unprecedented RADV audits compliance pressures with zero tolerance for
errors and massive financial exposure.
10-12
Weeks to Complete the entire
CMS audit response
Time-Sensitive Deadlines
$4.7B
Clawback with extrapolated penalties on HCC coding errors
Projected Recoveries
550
All Medicare Advantage Plans
to be Audited
RADV Audit Coverage
0%
FFS adjuster eliminated, requiring perfect HCC documentation
Zero Error Tolerance
RAAPID RADV Audit Solution
RAAPID streamlines RADV audits with intelligent automation and expert accuracy, offering tailored
tools and comprehensive full-service support for your organization’s CMS compliance needs.
Audit Management Tool
An intuitive workflow tool serving as an Integrated RADV Audit Console for real-time visibility and proactive alerts.
✔ RADV Compliant workflow
✔ Auto chase list generation
✔ Real-time dashboard
✔ Submission-ready records
AI Audit Solution
A complete solution combining our AI-Integrated workflow with the expertise of certified auditors for end-to-end Medicare Advantage support.
✔ AI-powered chart reviews & validation
✔ HCC-based ranking for submission
✔ CMS standard submission-ready records
✔ Expert oversight for defensible findings
What is your Business Case?
Adapting to your health plan’s immediate needs, whether you’re defending against a RADV audit
or proactively preparing for CMS compliance.
Audit Defense
When you've received an official CMS audit notification, RAAPID's solutions help you prepare a precise and defensible response, mitigating potential recoupments.
Audit Readiness
When you're proactively assessing risk before an official CMS audit, RAAPID's solutions support internal mock audits and comprehensive reviews to identify HCC documentation gaps.
Complete RADV Audit Workflow
Manage every stage of your CMS Risk Adjustment Data Validation audit process in one centralized platform
CMS Notification
Initial receipt and processing of
CMS audit notifications
Chase List Preparation
Generation of comprehensive lists
for chart retrieval
Record Management
Management of medical charts
after retrieval
Chart Reviews
Facilitation of chart review
and
HCC validation
Audit Reports
Generation and preview of CMS-compliant audit submission reports
CMS Submissions
Tracking of data submissions & rebuttals for CMS audits
Capabilities Built for RADV Excellence
Comprehensive RADV audit tools designed specifically for Medicare Advantage organizations’ CMS compliance needs
Neuro-Symbolic AI
Leverage advanced AI to automate chart review, HCC validation, and intelligent coding recommendations for audits. Significantly reduce time spent on manual processes while ensuring audit defensibility.
Enrollee Management
Import directly from CMS CDAT files or manually manage enrollee data. Support for 35-200 enrollees per RADV audit project with granular tracking.
Enterprise Security
Full compliance with healthcare regulations for audit processes, including HIPAA, SOC2 Type II, and HiTrust certifications. Secure SSO integration and audit trails.
Real-time Analytics
Interactive dashboards with proactive alerts, RADV compliance reporting, and actionable insights. Monitor multiple CMS audits simultaneously with complete visibility into project status.
Chart Management
Leverage automated chart review, HCC validation, & intelligent coding recommendations for audit compliance & reduce time spent on manual processes.
Dedicated RADV Expert
Personalized guidance from certified RADV audit specialists throughout your CMS audit process ensures strategic decision-making & compliance.
Measurable Impact on Your Bottom Line
Reduce audit risk, improve CMS compliance, and protect your organization from costly penalties
98%
Accuracy
AI validation ensures accurate HCC coding & RADV compliance, protecting against costly extrapolated penalties.
$2.5M
Average Risk Reduction
Prevent audit failures with proactive risk management and audit-trail documentation.
40%
Resource Efficiency
Streamlined RADV audit workflow and automation reduce staffing needs, enabling strategic focus.
Hours
Project Efficiency
Replace spreadsheet-driven management with automated workflows to cut administrative stress.
Resources & Insights
Stay informed with the latest
RADV audit requirements and best practices
Navigating the New Era of RADV Audits
Stop scrambling when CMS audit notifications arrive. This essential guide provides the exact framework health plans need to navigate new audit requirements with confidence and avoid costly penalties.
Conquer RADV Chaos
Explore how RAAPID streamlines RADV audits with AI-driven automation, real-time insights, and certified auditor oversight. Download the brochure to learn more.
Beyond the RADV Checklist: Short-Term Survival & Long-Term Revenue Protection
Are you ready for what CMS’s expanded RADV audits mean for your bottom line.
2025 RADV Audit Preparedness Industry Benchmarking Report
New survey reveals critical gaps in RADV preparedness, with 65% struggling with documentation and 62% lacking coding confidence.
Get Started
Connect with our RADV audit experts to discuss your organization’s specific needs
Webinar: Mastering RADV Documentation Before CMS Comes Knocking