EMSI Health provides a full-service solution to ensure your audits go smoothly. Under the ACA, the initial validation audit (IVA) encompasses 200 members identified by HHS for each contract in each state the plan operates. Using selected client data such as demographics information, claims information, as well as provider information, we run analytics to identify and prioritize charts to substantiate the audited HCC. Working in collaboration with our client, EMSI Health distributes a request packet to each provider or facility. Through a combined methodology using fax back, mail back and onsite retrieval, we retrieve and perform a blind review on each record, capturing all HCCs that meet HHS guidelines. Once completed, we provide all audit results and information in a HHS edge server compatible submission file or flat file format for client use. Submission can also be customized based on client preference.
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