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CMS has issued a major announcement that’s reshaping how Medicare Advantage plans approach risk adjustment audits. A new era of oversight is here. Defined by tighter timelines, expanded audit scope, and heightened expectations around data accuracy. Along with the announcement, a detailed compliance memo introduces new submission deadlines that demand immediate attention from health plans. This shift has wide-reaching implications for compliance strategy, resource allocation, and revenue protection.
In this bonus episode, we unpack what’s changed, why it matters, and what plans need to consider next. Listen now.
About Our Guest:
Amanda Proctor is the Director of Coding Quality and Risk Mitigation and has over 14 years’ experience in Risk adjustment and holds multiple certifications in Coding, Auditing, and Compliance and is an AAPC Approved Instructor. She specializes in Risk Mitigation, RADV Audits, Coding Compliance and Education.
By Sponsored by UST HealthProof5
1010 ratings
CMS has issued a major announcement that’s reshaping how Medicare Advantage plans approach risk adjustment audits. A new era of oversight is here. Defined by tighter timelines, expanded audit scope, and heightened expectations around data accuracy. Along with the announcement, a detailed compliance memo introduces new submission deadlines that demand immediate attention from health plans. This shift has wide-reaching implications for compliance strategy, resource allocation, and revenue protection.
In this bonus episode, we unpack what’s changed, why it matters, and what plans need to consider next. Listen now.
About Our Guest:
Amanda Proctor is the Director of Coding Quality and Risk Mitigation and has over 14 years’ experience in Risk adjustment and holds multiple certifications in Coding, Auditing, and Compliance and is an AAPC Approved Instructor. She specializes in Risk Mitigation, RADV Audits, Coding Compliance and Education.

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