A Connecticut doctor is claiming he’s the victim of repeated under-reimbursements by insurance companies, a practice called “downcoding” that he said cost him close to $100,000. “This is insane,” said ...

Anthem Blue Cross of California is extending the pause on its upcoming evaluation and management claim downcoding policy until April, the insurer confirmed to Becker’s Feb. 27. A Feb. 23 news release ...

One method for doing this is known as upcoding — where insurers increase the number of diagnoses for patients to make them appear sicker or at higher risk. To compensate for this, the government ...

As audits and downcoding become more common, audit defense isn’t a back-office function. It’s a financial imperative.” — Moghis Uddin, CEO of AlethianAI ...