Feb 27, 2026 | Forensic AI Alerts
Unsupported laboratory services linked to various referral patterns and inappropriate business relationships remain prevalent schemes, with numerous civil and criminal prosecution cases brought by the U.S. Department of Justice. Some referring providers for...
Feb 2, 2026 | Forensic AI Alerts
The American Medical Association’s (AMA) 2026 Current Procedural Terminology (CPT) code set includes 418 changes, consisting of 288 new codes, 84 deletions, and 46 revisions. Among the most impactful updates are significant expansions to Remote Patient Monitoring...
Jan 9, 2026 | Forensic AI Alerts
When a patient’s medical condition requires emergency transportation or the patient is non-ambulatory, ambulance services are the preferred method to ensure the patient receives the necessary level of care during the trip and arrives at the nearest, appropriate...
Oct 28, 2025 | Forensic AI Alerts
The Add-On Epidemic: Fighting Fraud, Waste, and Abuse Beyond the Pandemic When COVID-19 testing became routine, some laboratories began attaching high-cost “add-on” laboratory tests. While the public health emergency may have ended, the billing patterns it created...
Sep 30, 2025 | Forensic AI Alerts
Don’t be fooled by the “Two Midnight Rule” for single-day inpatient stays A single-day inpatient stay typically refers to an admission lasting one night, often for procedures or conditions such as childbirth, heart attack, stroke, bone fractures, or other acute...
Sep 3, 2025 | Forensic AI Alerts
Care Management Services are for the support and management activities delivered either directly by a physician or qualified healthcare professional (QHCP) under their supervision. These services are provided to patients living at home, in a domiciliary setting, a...
