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 ...

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 ...

Ever wondered about the unsung heroes of the healthcare system? The ones who make sure your medical bills are accurate, ...

Workforce shortages, regulatory complexities and economic challenges have put hospitals and health systems under immense pressure to improve operational efficiency, accelerate payments and reduce ...

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 ...