MetaStar Readiness Series

The MetaStar Readiness Series is a suite of proactive service offerings designed to help health plans, providers, and healthcare organizations prepare for regulatory audits, data validation reviews, and performance reporting before formal oversight activities begin.
Built on decades of validation and abstraction expertise, each service line in the Readiness Series is designed to reduce risk, enhance documentation and data quality, and strengthen internal capabilities so your organization is audit-ready, every time.

Why Readiness Matters

Healthcare audits and performance validations are increasing in frequency, complexity, and consequence. Organizations that take a reactive approach often face operational disruptions, financial penalties, and reputational risk.
MetaStar’s Readiness Series flips the script by providing a proactive, structured framework to:

• Identify gaps in documentation and coding before audits occur.
• Educate internal teams on evolving regulatory requirements.
• Simulate audit scenarios to uncover vulnerabilities.
• Improve performance metrics and compliance posture.

Our approach is collaborative, compliance-first, and tailored to each regulatory domain.

Readiness Series Offerings:

• Medicare RADV Readiness
  Preparation support for the Centers for Medicare & Medicaid Services (CMS) Medicare Risk Adjustment Data Validation (RADV) audits. We help Medicare Advantage plans validate submitted diagnosis codes, assess documentation compliance using Monitor, Evaluate, Assess/Address, Treat (MEAT) criteria, and strengthen readiness prior to CMS audit initiation.
• HEDIS Readiness
  Readiness support for organizations reporting HEDIS data, including medical record abstraction practice, documentation gap reviews, and measure interpretation education to reduce audit risk and improve measure reporting accuracy.
• Medicare Data Validation (Part C & D) Readiness
  MetaStar’s Medicare Data Validation readiness offering, designed to help Prescription Drug Plans (PDPs) and Medicare Advantage Organizations prepare for CMS Part C & D Data Validation audits with proactive file preparation and data quality review.
• Initial Validation Audit RADV Readiness
  Structured readiness services for Affordable Care Act (ACA) Qualified Health Plans undergoing U.S. Department of Health and Human Services (HHS)-RADV. Includes simulation of Initial Validation Audit (IVA) coding review, file formatting coaching, and guidance aligned with CMS IVA protocol (5CR).
• URAC Data Validation Readiness
  Preparation support for organizations undergoing URAC Data Validation, especially for Specialty Pharmacy accreditation. Includes test file review, documentation quality checks, and validator-style guidance on meeting URAC’s file structure and completeness standards.

What Makes the Readiness Series Different?

• Independent and Trusted – We bring the same rigor we use as official audit and validation entities, without compromising your compliance.
• Proven Methodology – Our readiness services mirror real audit protocols to give clients a true sense of where they stand.
• Customizable and Scalable – Whether you’re preparing for one product line or enterprise-wide oversight, we tailor our approach to your needs.
• Pre-Audit Only – We intentionally do not support live audit responses, protecting neutrality and CMS alignment.

Let’s Get You Ready

Interested in learning more about a specific Readiness service line? Contact us to schedule a discovery call and explore how MetaStar can help your organization stay ahead of the audit curve.