Episode Details

A nephrologist from Connecticut exposes health insurers use of AI to downcode claims, reducing reimbursements for complex cases. Despite the shift to rigid codes, he advocates for fair pay for evaluation and management services. The practice is causing financial strain on doctors, with average hits of $40 per claim adding up to $45,000 a year. Senate Bill three forty-two aims to ban this practice, ensuring thoughtful docs stay in the game and patients receive deep care.

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