CMS Data Validation: Using Pre-Assessments and Other Best Practices to Maximize Your Scores

Presenters: Jason Hoyme, Data Validation Manager; Sarah Boughton, Data Validation Auditor; Nick Wieland, Data Validation Auditor

CMS requires Medicare Advantage Organizations (MAOs) to annually (in February) submit data from three Part C and four Part D reporting sections from the previous year. Failure to comply with this Data Validation (DV) requirement – or failure to have this data later mesh up accurately against a yearly independent audit -- can lead to CMS Corrective Action Plans or a reduced Medicare Star Ratings Score.

In this webinar, The Burchfield Group’s CMS data validation experts will detail CMS’s latest scope of Data Validation (DV) requirements (subject to change annually) and implications for MAOs. They will also discuss what MAOs should do now to meet the new submission requirements and share other best practices to help MAOs maximize their DV scores. You will learn:  

  • How to prioritize resources and implement more standardized processes across and within your organization to create efficiencies now and in the future.

  • How to avoid a last minute, poorly orchestrated scramble to meet CMS deadlines (which often lead to poor results).

  • How a pre-assessment of your Data Validation process conducted by an outside, professional review can assist, and what to look for when choosing an outside firm.

  • How to use the Data Validation process as a litmus test to assess your performance and make improvements to internal data, systems, and processes.

  • How to anonymously ask CMS specific questions about the DV process and get the answers you need to stave off potential problems.


This webinar recording can be accessed here.

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