Risk Adjustment Audit Checklist Form
Complete this checklist to assess the quality and completeness of risk adjustment records. Please review each item carefully and provide your findings.
Audit Date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Reviewer Name
*
First Name
Last Name
Record/Case ID
*
Is the record complete?
*
Yes
No
Documentation is clear and legible
*
Yes
No
N/A
Coding is accurate
*
Yes
No
N/A
All supporting documentation is attached
*
Yes
No
N/A
Comments or findings
Overall audit outcome
*
Pass
Fail
Needs Review
Submit Checklist
Should be Empty: