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Medicare Will Start Paying AI Companies a Share of Any Claims They Automatically Reject (futurism.com)

submitted 2 days ago by cypherpunks@lemmy.ml to c/nottheonion@lemmy.world

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[–] humanspiral@lemmy.ca 1 points 22 hours ago (1 children)

This is definitely the wrong "motive structure" for administrative decisions from agency supposed to provide healthcare. Proof of grift as a goal.

By all means, use AI assistance to determine claims validity. But the AI service should be paid per query, or to licence whole model for unlimited use with medicare paying for the computers/gpus. Medicare should be choosing a model that is accurate instead of one that is paid to deny everything, because Homer Simpson's birdy automation can do that ultra cheap.

[–] traceur301@lemmy.blahaj.zone 5 points 16 hours ago (1 children)

Taking claim validity away from the doctor that's actually in charge of the patient's care is already fucked. AI cost cutting doesn't belong in medicine full stop. It shouldn't be a for-profit "industry" in the first place. We're so fucked nobody can even think about this without insane, anti-human framing coloring everything

[–] humanspiral@lemmy.ca 3 points 16 hours ago

Private medical insurance is corrupt as starting point. A public health insurance/payer system can still be subject to ineligible or fraudulent claims. Every medical provider demand for money automatically accepted is not the perfect model either. Systems, AI or not, should avoid improper denials is a standard only possible in public health systems.