Risk Mitigation

What are the financial risks of a Data Validation Audit?


Financial risk in a represented sample:

  • CMS and HHS assume the rate of unsupported HCCs in its sample

  • That sample is representative of the error rate in your overall population

  • Penalty is applied proportionately

Minimize revenue loss by.....


Mitigating Risk:

  • Identify and quantify the conditions and providers who are putting the plan at risk

  • Identify conditions that are less apt to be coded correctly

  • Identify conditions that are more susceptible to being audited

To Create actionable results


Primed for:

  • Research

  • Correction

  • Provider education