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The potential decrease in revenue for insurance companies is indeed a consequence of findings from a Risk Adjustment Data Validation (RADV) audit. RADV audits are conducted to verify the accuracy of diagnoses submitted by Medicare Advantage plans for their members. If the audit reveals that claims were improperly documented or that diagnoses were inaccurately reported, it can lead to a decrease in the risk-adjustment payments that the insurance company receives from Medicare. These payments are based on the health status of the enrolled population, and inaccuracies can result in financial penalties or the need to return overpayments, directly impacting the revenue of the insurance provider.

Receiving negative findings from a RADV audit can create financial strain on insurance companies as they are held accountable for claims that may not have been supported by proper medical documentation. This revenue decrease could also impact the resources available for services and benefits offered to members, although it does not specifically refer to the loss of individual member benefits. Other outcomes might involve improvements in documentation practices or adjustments to encourage better patient care, but the direct consequence that arises from the audit findings themselves is primarily associated with the financial implications for the insurers.