Medicare Data Validation Audit


Organizational Needs:

Medicare Part C & D Validation Audits (DVA) are designed to confirm the accuracy and completeness of reported results used in decision making or performance reporting. Examples of DVA include Risk Adjustment for commercial and Medicare plans and performance reporting by Medicare Advantage Organizations (MAOs), Cost Plans, Medicare-Medicaid Plans (MPP), and Part D sponsors to the Centers for Medicare and Medicaid Services (CMS).

Learn more about CMS’s Part C & D Data Validation

Meeting Your Data Validation Needs:

Attest has been conducting DVA projects since 1997. In 2016, Attest performed approximately one-third of all Medicare Advantage Data Validation Audits.

Attest has the ideal background and skills to successfully assess data validation standards. Our large market share has enabled us to continually refine our internal processes and tools to reflect best practices. As such, our reputation of excellence and client satisfaction is reflected in our client growth and retention. Our clients include Medicare Advantage sponsors as well as Part D sponsors. We conduct centralized reviews for PBMs to reduce the burden on plan resources.

A core audit team is assigned to each audit to serve as the primary reviewer. Additional resources for source code review and census/sample validation assist as needed. Access to greater staff expertise allows for efficient completion of documentation review and responses to your communications throughout the year. For example, Attest’s source code reviewers average over 10 years of programming experience and possess the ability to review all major software packages and programming languages.

We have never missed a reporting deadline. In 2016, Attest marked all 158 contracts final several days in advance of the CMS deadline. We assure client agreement with the data validation results via ongoing tracking and plan review of draft findings prior to submission to CMS.

One of the biggest challenges with data validation is ensuring the reporting reflects the updates required by the specifications. Attest works with clients on any questions they may have and submits clarifications to ensure a plan’s specific questions are answered completely. Attest shares these questions and answers on a monthly basis to ensure all plans have equal access to additional information. Attest is available for clarifications throughout the year and not just during the annual review period.

Attest is committed to involving clients throughout the process and keeping them apprised of any possible findings. Attest shares a regular issue log beginning in April to show what is still expected to be submitted as well as any concerns about documentation submitted and reviewed. We believe in no surprises right before the June deadline.

Trust Attest to conduct your Data Validation review in an open, efficient and reassuring manner.


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