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Risk Adjustment (RA) FAQ

Guidance for FAQ regarding Risk Adjustment Operations and Reports

Program Area: Risk Adjustment (RA)

Question: Why should I submit an informal discrepancy if it isn't required?

Answer: Submitting an informal discrepancy will help both issuers and CMS prepare for the formal discrepancy reporting process, and can address issues well in advance of final payment calculations. For more information, see the discrepancy reporting and DQAR webinar from 1/28 at https://www.regtap.info/uploads/library/RA_RI_DR_DQARslides_012815_5CR_020415.pdf in the REGTAP Library.

Issued by: Centers for Medicare & Medicaid Services (CMS)

Issue Date: February 09, 2015

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DISCLAIMER: The contents of this database lack the force and effect of law, except as authorized by law (including Medicare Advantage Rate Announcements and Advance Notices) or as specifically incorporated into a contract. The Department may not cite, use, or rely on any guidance that is not posted on the guidance repository, except to establish historical facts.