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
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
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
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...