Some limits on how the assessments are used for adding new diagnosis codes might be justified to ensure Medicare Advantage plans aren’t overpaid, researchers wrote. Under MA, insurers contract with ...

Medical coding requires a deep understanding of medical terminology and procedures, as well as the ability to make judgment calls when necessary. Human coders are better equipped to handle these tasks ...

In today’s tech-driven healthcare landscape, artificial intelligence (AI) is transforming how healthcare organizations process data, manage workflows and optimize outcomes. Among the most promising ...

Differential coding in MA plans results in higher risk scores and increased payments compared to TM, with significant insurer variation. UnitedHealth Group's risk scores were significantly higher than ...