The Centers for Medicare and Medicaid Services (CMS) require Medicare Advantage Organizations (MAOs) such as HPSM to collect, review and submit medical records for RADV audits they conduct to validate the accuracy of payments. To support this process, HPSM may request medical records from provider offices.
It is mandatory for network providers to share medical records for all regulatory audits. If you receive an RADV-related notice of medical record collection from HPSM, please respond by or before the deadline, as CMS maintains stringent audit timelines.
RADV requests from HPSM will be different from other medical record requests you may have received from us.
If you have questions, email our Risk Adjustment Program Unit.