Blair Compass

THE BLAIR COMPASS INTELLIGENCE SERIES

Lookout.

Medicare Audit & Scrutiny Intelligence

Before your coding department sends you a 14-page bulletin, Blair Compass tells you in 60 seconds whether Medicare just changed what it is scrutinizing.

FREE & PUBLIC SOURCE-LINKED NO PATIENT DATA

SURVEILLANCE STATUS

Loading source status…

No claim about current audit activity is made until source data loads.

See what is monitored ↗
Last complete source checkNot available
Time since last material signalNot yet loadedAwaiting verified source data
Detected changes since baselineNot yet loaded
Verified public-source recordsNot yet loaded

Lookout monitors public CMS RAC topics, Novitas JH/TPE, SMRC current projects, OIG Medicare A/B reports, CERT, and selected CMS medical-review/program-integrity updates. Confidential or unpublished investigations remain outside coverage. A public signal is not evidence that your organization is under audit.

Confirmed review / scrutiny signal

A verified active review focus, approval, or review escalation.

Early-warning signal

An oversight finding or developing signal that may precede contractor action.

Review / policy update

A verified policy, measurement, or program update. Increased scrutiny is not assumed.

PATH A · THE 60-SECOND SCAN

Your audit intelligence.

Start with the change. Open the evidence when it matters.

Loading verified records…

Texas relevance includes national signals, Texas/JH items, and qualified or unresolved matches. Confirm the exact service, jurisdiction, and date conditions in each primary source.

PATH B · FROM SIGNAL TO SELF-CHECK

Does this affect
your organization?

You do not need another alarm. You need a sensible way to decide whether to act.

Use your approved internal systems for analysis. Do not enter patient information here. Lookout does not accept claims uploads.

01

Find the service

Do you bill it? Match the codes, modifiers, setting, contractor, and relevant dates.

02

Size the exposure

Do you know your volume, allowed amounts, and the clinicians or facilities involved?

03

Test the pattern

Compare like with like. Utilization variation is a signal to examine, not a finding of misconduct.

04

Check the record

Review a focused sample. Confirm policy fit, documentation, coding, and the next responsible owner.

TRUST STARTS WITH VISIBILITY

What Lookout is watching.

Every monitored public-source family shows its current collection status and record count.

RSS change feed ↗

Source coverage is loading. Treat monitoring status as unverified.

Monitoring cadence: daily. Lookout automatically checks its monitored public sources once each day. New or changed items are published only after collection passes validation. The Last complete check timestamp shows the most recent successful full monitoring cycle. If a source check fails or is incomplete, Lookout keeps the last verified information and does not treat the failure as an all-clear. Lookout is not real-time. Confidential, unpublished, and provider-specific investigations may not appear in public-source monitoring.

READ THE SIGNAL CORRECTLY

Evidence before alarm.

What counts as a change from normal?

Each source family establishes a verified baseline. Later checks compare substantive source fields and current listings. Historical 2026 records are shown with their original source dates and do not become breaking alerts merely because Lookout imported them. A new RAC approval, new TPE/SMRC review signal, or review escalation can be confirmed; OIG findings remain early-warning signals unless a review contractor separately confirms action.

What is normal RAC activity?

RACs review Medicare fee-for-service payments for improper payments. Automated reviews use claim data; complex reviews involve records. Existing duplicate-service, frequency, coding, medical-necessity, and payment-setting reviews remain part of the baseline. An issue's approval does not measure review volume or prove a crackdown.

CMS Recovery Audit Program ↗

How do dates and jurisdiction work?

CMS's approval or proposal date, Lookout's first observation, and the last successful verification are separate fields. Approval is not an implementation date. Texas matching is conservative: national topics are included; conditional wording is preserved; unresolved jurisdiction is labeled. Novitas JL is not treated as Texas JH. All-state views do not imply all local contractors are monitored.

How current is Lookout?

Lookout checks monitored public sources daily. Source dates, first observation, and last verification are tracked separately so an older policy or review is not presented as newly announced. A failed or partial source check does not erase previously verified information.

What happens when a source fails?

Previously verified content stays available with its real verification time. Failed new records are held back. Coverage is marked partial, and the page marks data stale after 36 hours without a complete check. Silence, an empty response, or a failed job never means that Medicare has no new audit activity.

Who writes the self-check recommendations?

Primary-source facts are distinguished from Blair Compass classification and guidance. Self-checks use deterministic templates and service-specific prompts, not an unconstrained AI writer. Recommendations are educational triage, not CMS requirements, legal advice, audit findings, or a guarantee of payment. Apply the policy version relevant to the service date.

What is free, and what comes next?

The public intelligence and self-checks are free. Additional state and MAC views can reuse the same surveillance model. Organization-specific, local claims analysis is a separate future phase. No paid analyzer, claims upload service, or private leadership workspace is included in this release.

GUIDED BY SERVICE. BUILT FOR CARE.

Know what changed.
Know what to check.

Public intelligence for physicians, practice leaders, compliance teams, and ACOs.