AI Alert April 2025

AI Alert April 2025

Peeling Back the Layer of Skin Substitutes Background  A skin substitute is a material used to replace or support damaged skin tissue. Skin substitutes may be allogeneic, xenogeneic, synthetic or a combination of these types of materials. When used appropriately,...
AI Alert March 2025

AI Alert March 2025

Bridging the data gap between medical and dental claims  What fraud, waste, and abuse concerns are common to dental claims?  The increased coverage and spend for dental services by health plans and health agencies will expand the opportunity for fraud, waste, and...
AI Alert February 2025

AI Alert February 2025

Understanding the Impact of Coding Changes on Psychological and Neurological Testing  New codes for psychological and neurological testing services since 2019 provide clarification of non-face-to-face work by professionals. The codes have been enhanced with...
AI Alert December 2024

AI Alert December 2024

Identifying Potential Risks with New or Returning Pharmacy Providers  Every month, new pharmacies enter and bill your network. Quickly identifying this pharmacy activity is crucial for your plan to assess potential risks to the network. By conducting proactive reviews...
AI Alert November 2024

AI Alert November 2024

Dental Procedure Updates You Need to Know for 2025  The American Dental Association (ADA) released its Code on Dental Procedures and Nomenclature for 2025 (CDT 2025) on September 13, 2024. As in previous releases, some new codes have been added, while other existing...