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Sadly this story is 3 years old and nothing has changed for the better. AI algorithms steering claims to automatically approved versus "needs checking" technically do not deny a claim but these systems reward clinicians based on throughput.

PlottingFuture

30 июл., 17:46

The only way the AI pays for itself is if humans go faster, performing less diligence on their checks. Also look at Navi-Health (owned by UHG), decision making for rehab stays. The managers there pressured staff who overturned incorrect AI recommendations. Not all failures are AI, but system fails.

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