Sep 28, 2021 | Forensic AI Alerts
Identifying Common Allergy & Immunology Billing Schemes An allergy is a form of exaggerated sensitivity or hypersensitivity to a substance that is either inhaled, ingested, injected or comes in contact with the skin or eye. Allergic or hypersensitivity disorders...
Aug 30, 2021 | Forensic AI Alerts
Identifying Schemes within Personal Care Services When billing fraud schemes, abuse, and neglect of vulnerable Medicaid beneficiaries, there are things to look for regarding Personal Care Services (PCA) attendants (hereinafter referred to as attendants). PCA services...
Jul 29, 2021 | Forensic AI Alerts
Metformin: Stay Informed on High Generic Costs and FDA Recalls Metformin: Background When we talk about prescription Fraud, Waste, and Abuse (FWA), we think of emerging schemes such as topical pain/scar creams, compounds, ingredients for foot baths, high-cost wellness...
Jun 8, 2021 | Forensic AI Alerts
Foot Baths are ‘Afoot’ Foot Baths: Background One of the biggest emerging schemes within healthcare prescription fraud is drugs involving foot baths. The Centers for Medicare and Medicaid Services (CMS) in collaboration with the Investigations Medicare Drug Integrity...
May 21, 2021 | Forensic AI Alerts
New Prolonged Service Codes Effective Jan 1, 2021 The CPT coding guidelines indicate that the new CPT code, 99417, effective 1/1/2021, is to be used in association with 99215 or 99205. Due to these changes, it is recommended that you monitor for continued use of...
Apr 19, 2021 | Forensic AI Alerts
Behavioral Analysis Treatment Codes Autism Spectrum Disorder (ASD) is a developmental disability that can cause significant social, communication, and behavioral challenges. The differences in how ASD affects each person means that people with ASD have distinct...
