Wiki Medicare Advantage Rad V Audit Question

[Kinsley]

I am new to Med Adv line of business, and wondered if there are any guidelines out for Audits related to coding, and Rad V process or resources, for example: Is offshore coding allowed? My expectation is all coders must be Certified, but do they have a requirement as to how long they have been a certified coder to be acceptable?
Any information or resources you can direct me to would be very much appreciated.

Thank you,

 

[jmjansen]

Hi Kinsley,
There are no rules about on vs off shore coding for RADV, as far as I know. Remember RADV is more about supplying enough evidence for captured codes on paid risk adjustable codes. You will need to have processes in place to ensure you are reviewing the correct documentation for the benefit year that is being reviewed for the RADV. Do you need assistance finding good coding who is familiar with the RADV process for Med Adv? Send me a message and happy to help.

 

[Kinsley]

Thank you for your response. We are interested in coder software that is specific to rad V Coding, and offers coding guidelines and resources directly at the coders fingertips. I would be interested in what programs you would recommend for support also, we have interviewed and demo'd several but have not made a decision to date.
Thank you again for your initial response.