Risk Adjustment (RA) FAQ
Guidance for FAQ regarding Risk Adjustment Operations and Reports
Program Area: Risk Adjustment (RA)
Question: When are the Risk Adjustment (RA) reports on the External Data Gathering Environment (EDGE) server generated?
Answer: Most RA reports are generated when CMS executes a remote command to initiate the risk score and transfer extract batch job. After execution, the EDGE server generates and stores the following RA reports in the issuer's output directory: RA Risk Score Detail (RARSD), RA Risk Score Summary (RARSS), RA Transfer Elements Extract (RATEE) and RA Data Validation Population Summary Statistics (RADVPS) reports. The EDGE server generates the RA Claims Selection Detail (RACSD) and the RA Claims Selection Summary (RACSS) reports after medical claim file ingest. CMS will also run a RA claims selection remote command against all accepted medical claims before we send the risk score and transfer extract batch job. When this remote command runs a new RACSD and RACSS report are generated.
Issued by: Centers for Medicare & Medicaid Services (CMS)
Issue Date: January 25, 2019
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