Jan 7, 2025 | Forensic AI Alerts
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...
Dec 5, 2024 | Forensic AI Alerts
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...
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...
