Why choose Valiant Health?

  • 100% U.S. based staff and consultants
  • Exceeds IVA senior coder requirements by internally requiring 5 years of experience and RHIA/RHIT certifications
  • Over 40 years of medical coding/audit experience for federal government contracts
  • Over 40 years of experience performing chart and record reviews
  • By focusing on our exclusive role as IVA we avoid conflict of interest concerns
  • Independent Review Organization (IRO) Certification (provisional accreditation)
  • URAC Accreditations
  • QIO-Like Entity Certification
  • Extensive CMS regulatory compliance knowledge

Qualifications of Initial Validation Auditors

The selection of a qualified IVA is important because they will be evaluating the diagnostic and demographic data of the existing risk adjustment efforts. The data generated by the IVA will be evaluated via a Secondary Validation Audit or SVA. HHS has referred to best practices and standards for independent auditors as noted on the Federal Register:

“…we considered existing best practices and standards for independent auditors, such as those of Medicare Quality Improvement Organizations…when establishing our standards for initial validation auditors.” – Federal Register / Vol. 79, No. 47 / March 11, 2014 / Rules and Regulations Page 13758

“…we directed the issuer to ensure that the initial validation auditor is reasonably capable of performing an initial validation audit, and is reasonably free of conflicts of interest, such that it is able to conduct the initial validation audit in an impartial manner with its impartiality not reasonably open to question.” – Federal Register / Vol. 79, No. 47 / March 11, 2014 / Rules and Regulations Page 13758

“One commenter requested that HHS prohibit vendors that provide risk adjustment services from serving as initial validation auditors.” – Federal Register / Vol. 79, No. 47 / March 11, 2014 / Rules and Regulations Page 13759