Introducing the 30-Day Revenue Integrity Reset from RVA Healthcare Consulting

CMS-HCC Version 28 (V28) will take full effect starting January, marking the completion of the three-year phase-in from V24. In 2026 (payment year), 100% of Medicare Advantage risk scores will be calculated using V28, based on 2025 dates of service. This means tighter clinical documentation requirements, the permanent removal of commonly reported Hierarchical Condition Categories (HCCs), and even greater scrutiny on how chronic conditions are monitored, evaluated, assessed, and treated (MEAT) each year. For many healthcare organizations participating in Medicare Advantage, the blended phase-in during 2024 and 2025 has already highlighted documentation gaps, leading to lower Risk Adjustment Factor (RAF) scores and reduced reimbursement. Now, with the full transition imminent, these gaps could result in significant revenue impacts and heightened exposure during Risk Adjustment Data Validation (RADV) audits. The Real Threat Isn’t the Codes—It’s the Documentation Behind Them Under full V28 implementation, revenue leakage rarely stems from using the “wrong” code. Instead, it comes from documentation weaknesses that fail to meet CMS standards:

• Missing or incomplete MEAT (Monitor, Evaluate, Assess, Treat) elements

• Diagnoses reported without sufficient clinical support in the current year

• Lack of specificity when capturing and reassessing chronic conditions

• Inconsistent monitoring of conditions previously reported

These issues will directly translate into RAF loss and increased RADV vulnerability in 2026, where unsupported diagnoses can trigger substantial payback demands. Introducing the 30-Day Revenue Integrity Reset from RVA Healthcare Consulting To help practices prepare for the full V28 era and swiftly address these challenges, RVA Healthcare Consulting offers the 30-Day Revenue Integrity Reset. A focused, actionable program designed to strengthen documentation, recapture appropriate revenue, and reduce audit risk in just one month. Our proven process targets three high-impact areas: 🔹 Targeted Chart Review Our expert clinical documentation and coding specialists conduct thorough reviews of a representative sample of charts. We identify missed diagnoses, MEAT/TAMPER gaps, unsupported codes, specificity opportunities, and overall accuracy issues. 🔹 Comprehensive Documentation Gap Report You receive a detailed, provider-specific report that highlights trends, recurring documentation vulnerabilities, frequently missed chronic conditions, and potential audit risks—giving you clear, prioritized insights to drive improvement. 🔹 Customized Clinician Education Session We deliver practical, engaging training tailored to your team, covering best practices for documenting chronic conditions, mastering MEAT/TAMPER criteria, avoiding common pitfalls, and preparing for audits. By the end of the 30 days, your practice will have actionable steps to close documentation gaps, improve HCC capture accuracy under full V28, and build greater confidence in your risk adjustment submissions. Ready to Strengthen Your Documentation and Protect Your Revenue in 2026? If your organization is bracing for the full effects of V28, whether through RAF impacts, audit concerns, or opportunities to better reflect patient complexity, now is the critical time to act. Let’s connect. Contact RVA Healthcare Consulting today to learn more about the 30-Day Revenue Integrity Reset and how we can help your practice achieve stronger documentation integrity, optimized reimbursement, and reduced audit exposure in 2026 and beyond. We’re here to partner with you for long-term revenue integrity and compliance success.