State-of-the-art artificial intelligence systems known as large language models (LLMs) are poor medical coders, according to researchers at the Icahn School of Medicine at Mount Sinai. Their study, ...

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 ...

A new study published in Therapeutic Innovation & Regulatory Science provides crucial insights into the design and ...

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 ...

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