Medicare contract-level risk adjustment data validation (RADV) audit is ongoing


From now through February, members of our Network Relations team may contact you to retrieve and review medical records of patients with ConnectiCare Medicare Advantage plans who were seen at your office in 2014.

The Centers for Medicare & Medicaid Services (CMS) asked ConnectiCare to undergo a contract-level risk adjustment data validation (RADV) audit on a small sample of members enrolled in a Medicare Advantage plan. To verify the accuracy of diagnosis date submitted, this audit requires us to submit supporting medical records on a limited population of members covered by the audit. The dates of service requested will be between Jan. 1, 2014 and Dec. 31, 2014.

ConnectiCare will contact your offices to coordinate chart retrieval and set the date when the records must be received.

Please respond to the requests for records promptly. This is a federally-mandated audit. Notice of the need for these reviews and your required compliance are included in your contract with ConnectiCare.

We appreciate your help. If you have questions, please call our provider services department at 1-877-224-8230.