AI Solutions for Healthcare
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...
AI Alert October 2024

AI Alert October 2024

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...
September AI Alert 2024

September AI Alert 2024

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...
August AI Alert 2024

August AI Alert 2024

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...
July AI Alert 2024

July AI Alert 2024

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...