Oct 29, 2024 | Forensic AI Alerts
Bladder Beware: Flushing out Healthcare Fraud for Urinary Catheters Urinary catheters and external urinary collection devices are generally covered for patients who have acute (non-routine), permanent urinary incontinence or permanent urinary retention. CMS defines...
Oct 1, 2024 | Forensic AI Alerts
Ensuring Accountability: The Critical Role of Supervision in Preventing Fraud, Waste, and Abuse in Home and Community-Based Services Home health aides (HHAs) provide critical support for the elderly, disabled, and individuals recovering from illness. Their role...
Aug 29, 2024 | Forensic AI Alerts
The Hidden Costs of Overlapping or Excessive Monthly Services Monthly management of patient care Monitoring and coordinating care for patients with chronic conditions, such as heart disease or kidney disease, may be managed monthly by their primary care or a...
Jul 31, 2024 | Forensic AI Alerts
Emergency Room CPT Coding: An Overview Some of the most used CPT codes in the Emergency Department (“ED”) setting are the Evaluation and Management (“E/M”) code set (99281-99285). Emergency Medicine providers treat a wide array of patients resulting in a range...
Jun 27, 2024 | Forensic AI Alerts
Decoding the “ACGT” of genetic testing referrals Deciphering our past and potential future using genetic testing. ACGT is the acronym for the four types of bases found in a DNA molecule: adenine (A), cytosine (C), guanine (G), and thymine (T). Genetic code is...
May 24, 2024 | Forensic AI Alerts
Payment Integrity Audit: Facility vs. Non-Facility Place of Service Codes Under the Medicare Physician Fee Schedule (MPFS), some procedures have separate rates for physicians’ services when provided in facility and non-facility settings. In general, the...
