From Pymnts · PYMNTS · · 1m 10s
AI Medical Coding Adds $1 Billion to Blue Cross Costs
AI tools used by healthcare providers increased Blue Cross costs by nearly $1 billion over two years.
In brief
AI tools used by healthcare providers increased Blue Cross costs by nearly $1 billion over two years. AI-generated medical coding added $653 million in extra costs for Blue Cross insurers between 2024 and 2025. Originally reported by Pymnts.
AI Medical Coding Costs
AI tools used by healthcare providers identified secondary medical conditions, adding nearly $1 billion in costs for Blue Cross Blue Shield insurers over two years.
Cost Breakdown
Between 2024 and 2025, providers billed for secondary conditions, driving $653 million in extra costs for Blue Cross companies.
Intensive Care Costs
More intensive care overall accounted for $942 million in additional costs over the two-year period compared with 2023.
AI Systems Used
Providers used ai technology including ambient-scribe systems to identify secondary conditions, resulting in higher insurance payments.
Blue Cross Blue Shield Association
The Blue Cross Blue Shield Association represents 31 insurers serving over 100 million people.
Luke Chalker's View
Luke Chalker, BCBSA’s senior vice president of product and data science, said increased conditions may indicate sicker patients.
The short version
AI-generated medical coding added $653 million in extra costs for Blue Cross insurers between 2024 and 2025.
