Is your health plan subject to Department of Health and Human Services Risk Adjustment Data Validation (HRADV) audits under the Affordable Care Act? If so, are you still using manual means to prepare for an HRADV audit?
There’s good news if you are still relying on people-powered audit preparation: by partnering with an HRADV initial validation audit (IVA) company like Reveleer, you can use technology to simplify preparation, and obtain accurate results.
Advancing HRADV Technology Won’t Wait for You – You Must Keep Up
In almost every profession, except perhaps the performing arts, doing things manually when others are using tools puts you at a disadvantage that deepens the further behind you get technologically. When the technology gap becomes big enough, you could even find yourself regulated out of business. For example, there is a reason why you can’t find a dentist anymore who still uses a bottle of whiskey and a pair of pliers. He’s not just obsolete. If he gets caught, there’s a good chance he’ll be in trouble, too.
For health plans subject to HRADV audits, the situation is the same. Staying competitive in this era of value-based medicine and benchmark comparisons is not the only reason to invest in the latest technology. It can also avoid trouble. Especially today, when the Federal government is intensely scrutinizing health plan claims for improper payments, technology-assisted HRADV-IVA preparation gives you audit peace of mind that manual preparation cannot.
Use Technology to Maximize HRADV Audit Compliance
How exactly does the use of technology provides more accurate HRADV audit outcomes? Here are five ways it gives you compelling advantages:
- Scalability: Accessing large volumes of healthcare data is not as difficult as it used to be. HRADV audit software is a force multiplier that unlocks the potential of existing personnel to maximize data collection activities.
- Accuracy: Human beings, when processing large amounts of data through repetitive processes like manual record reviews, eventually become physically and mentally fatigued. This leads to coding inaccuracies and errors in clinical documentation and claim submissions. Compare this to an NLP-driven software, which thrives on data and never gets tired. Indeed, the more data it gathers, the better it performs.
- Interoperability: Healthcare data sources are not always compatible with each other. Technology overcomes the problem of data silos – information scattered across multiple databases, networks, and other systems – by reading data in structured and unstructured forms like medical images, test results, and physicians’ notes. It then integrates all these scattered data points into a comprehensive pool of mineable information.
- Productivity: NLP-driven software for HRADV-IVA not only mitigates the risk of human error, it also helps avoid HRADV inaccuracies.
With the availability of HRADV-IVA partners like Reveleer and its advanced and scalable NLP-driven software, the age of laborious, time-consuming, expensive, and mistake inviting manual HRADV audits is over.