Medicare Advantage RADV Audits and Provider Documentation Risk

CMS enforcement activity around Risk Adjustment Data Validation (RADV) audits is increasing, and providers are feeling the impact. This webinar explains how Medicare Advantage payments are calculated, how risk adjustment works, and why provider documentation plays a critical role in compliance and reimbursement. PYA professionals walk through the flow of funds from CMS to health plans and providers, outline key RADV audit risks, and explain how documentation, coding, and contractual obligations can affect audit outcomes. Viewers will gain a clear understanding of how to evaluate their current processes and identify areas of potential exposure as audit activity continues to expand. Viewers will learn how Medicare Advantage risk adjustment works, how RADV audits are conducted, what documentation is required to support diagnoses, and what steps providers can take to reduce compliance and financial risk.