Hospitals’ growing use of AI to assign medical billing codes contributed close to $1 billion in extra costs for Blue Cross Blue Shield health plans between 2023 and 2025, according to a new analysis from the insurer’s trade association. 70 percent of the additional cost involved additional diagnoses that did not change patients’ actual care, according to the insurer, which describes the situation as a “clear disconnect between coding and treatment.”
\n\nCNBC reports that the Blue Cross Blue Shield Association (BCBSA) says AI-assisted coding helped drive $942 million in additional costs over that span, much of it from secondary diagnoses that pushed patients into higher-paying reimbursement categories. Medical coders translate procedures and diagnoses into standardized codes used for insurance claims and billing, and the rise in what BCBSA calls “complex coding” lines up with a period when roughly 60 percent of hospital systems adopted AI coding tools.
\n\nAbout 70 percent, or $653 million, of the billing BCBSA flagged involved additional diagnoses that came with no change in a patient’s actual care, according to Luke Chalker, the association’s senior vice president of product and data science. Many of these secondary diagnoses, the BCBSA report said, “may be derived from single laboratory…
Original source: https://www.breitbart.com/tech/
