Certified Risk Adjustment Coder (CRC)

What is necessary for RADV/IVA audits regarding documentation?

1. Provider signature and credentials

2. Two patient ID's such as name and DOB

3. Printed provider name only when the signature is illegible

4. All of the above

The correct answer is: All of the above

For Risk Adjustment Data Validation (RADV) and Institutional Validation Audit (IVA) audits, having comprehensive and accurate documentation is crucial to ensure compliance and validate the coding and diagnoses submitted for reimbursement. Including a provider signature and credentials is necessary as it authenticates the document and confirms that the services rendered are endorsed by a licensed professional. This requirement helps to maintain the integrity of the documentation and ensures that there is accountability for the information presented. Additionally, documenting two patient identifiers, such as the patient’s name and date of birth, is essential for confirming patient identity. This practice enhances the accuracy of the medical record, preventing mix-ups or errors related to patient information. Having the printed name of the provider can also be important, especially when the signature is not clearly legible. This ensures that there is no ambiguity regarding who has provided the care and documented the patient’s information. All of these elements work together to provide accurate, comprehensive, and verifiable documentation necessary for RADV/IVA audits, making it evident why all the listed components are required.