Risk Adjustment (RA) FAQ
Guidance for FAQ regarding Risk Adjustment Operations and Reports
Program Area: Risk Adjustment (RA)
Question: Do Risk Adjustment (RA) reports include the entire population of data on the External Data Gathering Environment (EDGE) server or only the data in last batch?
Answer: Immediately after medical claim file submission to the EDGE server, the RA claims selection reports will be generated for every accepted medical claim file. In addition, 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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