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 ...
In this paper, a methodology for automatic coding is suggested which is fairly general. An application in the area of business applications has served as the inspiration for the approach is described.
Intensive coding by Medicare Advantage (MA) plans raised enrollees' risk scores and may have allowed companies to pocket tens of billions of dollars more than if traditional Medicare had covered the ...
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