How often should healthcare organizations prepare for a RADV audit?

Healthcare organizations should prepare for a RADV audit regularly, as part of their ongoing quality assurance processes. This proactive approach ensures that the organization is consistently adhering to regulations and maintaining accurate risk adjustment data throughout the year. Regular preparation helps identify and rectify any discrepancies in the data before an actual audit occurs, thereby minimizing the risk of penalties and ensuring compliance with federal regulations.

Maintaining an ongoing audit readiness enhances the organization’s ability to deliver quality care and support its financial viability by accurately reflecting the health status of its members. Moreover, regular preparation fosters a culture of accountability and attention to detail across the organization, promoting continuous improvement in coding practices and data management. This systematic approach is far superior to only preparing when notified of an impending audit or scheduling limited reviews infrequently, as it ensures that the organization is always compliant and ready for scrutiny.