PwC Report: AI Making Medical Bills Higher
5 hours ago
- #healthcare
- #medical-billing
- #AI-costs
- AI is being used to increase medical billing by documenting more diagnostic details, leading to higher severity codes and costs.
- An analysis found that the billing code for acute posthemorrhagic anemia in new mothers rose from 4% to 12.3% of maternity admissions from 2022 to 2025, despite no increase in related treatments.
- Audits revealed that fewer than 20% of cases with this higher code met clinical criteria, coinciding with AI adoption for billing, adding $22 million to maternity spending in three years.
- While AI is a top new cost pressure, factors like labor and supply costs remain bigger overall drivers, and AI may eventually reduce costs through automation and early diagnosis.
- AI optimizes healthcare billing for higher charges, reflecting a trend where companies leverage AI for self-interest rather than efficiency gains.