It’s raining RACs. And many other third party auditors. It seems like every submission of medical records is being scrutinized for omission and commission. Then enter artificial intelligence (AI). The use of AI in auditing, although relatively new, is here to stay. How is your facility faring compared to your peers? More audits? Less auditing? More denied claims? More money being recouped? Now you can see for yourself how you’re doing comparing to others. Thanks to the annual benchmark ...
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It’s raining RACs. And many other third party auditors. It seems like every submission of medical records is being scrutinized for omission and commission. Then enter artificial intelligence (AI). The use of AI in auditing, although relatively new, is here to stay. How is your facility faring compared to your peers? More audits? Less auditing? More denied claims? More money being recouped? Now you can see for yourself how you’re doing comparing to others. Thanks to the annual benchmark ...
Healthcare compliance just shifted fundamentally. Traditional whistleblowers who needed inside access are being replaced by artificial intelligence (AI)-powered relators who mine public datasets and flag statistical anomalies that could signal fraud. The U.S. Department of Justice (DOJ) logged 979 qui tam cases in 2024, many of which were reportedly triggered by mathematical outliers, rather than insider tips. Government agencies, such as the Centers for Medicare & Medicaid Services (CMS)...
Monitor Mondays
It’s raining RACs. And many other third party auditors. It seems like every submission of medical records is being scrutinized for omission and commission. Then enter artificial intelligence (AI). The use of AI in auditing, although relatively new, is here to stay. How is your facility faring compared to your peers? More audits? Less auditing? More denied claims? More money being recouped? Now you can see for yourself how you’re doing comparing to others. Thanks to the annual benchmark ...
