A Risk Adjustment Data Validation (RADV) audit is scheduled to begin this summer. This will be the first RADV audit for AmeriHealth New Jersey commercial members. The audit is being held in accordance with the Centers for Medicare & Medicaid Services (CMS) requirements and will validate enrollment and medical information. CMS will generate a random sample of AmeriHealth New Jersey members required for the audit. AmeriHealth New Jersey has contracted with a medical record retrieval vendor that will be collecting medical charts on AmeriHealth New Jersey's behalf in order to authenticate the diagnosis codes on submitted claims.

We appreciate your cooperation throughout this process. If you have any questions regarding the RADV audit, please contact Customer Service at 1-888-YOUR-AH1 (1-888-968-7241).