In November 2023, UnitedHealth was sued for improperly denying claims using an artificial intelligence algorithm, nH Predict, that critics say has a 90% error rate. The result, which impacts patients with Medicare Advantage, was that people who needed care didn’t get it — or they had to pay exorbitant fees.
Imagine the uproar if Doctors used AI and were this bad at it. "Mr. Howrigon, I didn't actually exam you or look over any of your test results, our wonderful AI system has diagnosed you. The system realized that you have not had your period. Congratulations the AI system has concluded that you are pregnant." Seriously, why do payers get to deny care so carelessly when the doctor actually providing the care are held to a much higher standard?
Imagine the uproar if Doctors used AI and were this bad at it. "Mr. Howrigon, I didn't actually exam you or look over any of your test results, our wonderful AI system has diagnosed you. The system realized that you have not had your period. Congratulations the AI system has concluded that you are pregnant." Seriously, why do payers get to deny care so carelessly when the doctor actually providing the care are held to a much higher standard?
Just so disgusting! Remind me why the United States is the greatest country on earth?
We are way behind most of the world when it comes to healthcare.
Fight fire with fire, and include the patient's voice----the only one that matters. #WarrisBokhari
Do they use AI on claims for MediGap plans, too? Or do they have to pay for whatever Medicare approves?
the latter is my understanding
Yes, Medigap follows Medicare rules as far as what they will pay on. The amount may vary from plan to plan.