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 ...

For the research, Mount Sinai's Icahn School of Medicine evaluated the potential application for large language models in healthcare to automate medical code assignments – based on clinical text – for ...

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 ...