What is a necessity when determining if beneficiaries were evaluated by a provider during the RADV/IVA audit?

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In the context of a RADV/IVA audit, it is essential to have documentation of provider credentials to ensure the legitimacy of the evaluation performed on beneficiaries. Provider credentials confirm that the individual conducting the assessment is qualified and licensed to provide such evaluations. This helps to verify the integrity of the treatment and diagnoses captured in the data, which is critical for accurate risk adjustment.

Having proper documentation of provider credentials lends credibility to the findings of the audit and supports compliance with healthcare regulations. It assures that beneficiaries received care from a qualified professional, which is an important requirement in the assessment process. Without proper documentation of provider credentials, the validity of the evaluations can be questioned, leading to potential discrepancies in the audit results.

The other options may include information relevant to patient care but do not directly address the specific requirement of documenting the provider's qualifications, which is a fundamental aspect of the audit process.

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