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Stock impact report

US insurers and hospitals turn to new AI for age-old battle over charges vs payments [Yahoo! Finance]

Centene Corporation (CNC) 
Last centene corporation earnings: 4/28 06:00 am Check Earnings Report
US:NYSE Investor Relations: centene.com/investors.html
Company Research Source: Yahoo! Finance
U.S. healthcare systems that want to be paid more for medical procedures and insurers who want proof the services were necessary, and experts are having a hard time predicting a winner. Centene, an insurer focused on ?the Medicaid program for low-income people, recently raised the issue, saying hospitals were aggressively or even improperly using revenue software to trigger reimbursement. "There have been some of these pockets ?where folks coming into the emergency department with a fever, all of a sudden all have sepsis," Centene CEO Sarah London said at a September investor conference, referring to a life-threatening condition that triggers a host of medical interventions. A Blue Cross Blue ?Shield analysis of its commercial hospital claims found that roughly $663 million in inpatient spending and at least $1.67 billion in outpatient spending may be tied to more aggressive, AI-enabled coding practices nationwide. "We are seeing more AI tools used at different points in the c Show less Read more
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