What happens when insurance companies start using AI models and tools to deny medical claims? Well, it's already happening.
David Loshin takes us on a journey through the risks that insurers open themselves up to by using patient data and AI tools to make healthcare decisions. The quality of data is never more important than when people's well being is on the line. If you've had a claim denied or have ever just used health insurance, you'll want to check out this deep dive into the inner workings of the insurance system.
Articles referenced:
• "Congressional Committee, Regulators Question Cigna System That Lets Its Doctors Deny Claims Without Reading Patient Files" (ProPublica):
• "How Cigna Saves Millions by Having Its Doctors Reject Claims Without Reading Them" (ProPublica)
• "Yet another health insurance company is using AI to deny medical claims." (un-covered)
• "UnitedHealth uses faulty AI to deny elderly patients medically necessary coverage, lawsuit claims" (CBS News)
• "AI May Not Be So Smart When Payors Use It To Deny Medical Claims" (Specialty Pharmacy Continuum)
• "AI gone astray: How subtle shifts in patient data send popular algorithms reeling, undermining patient safety" (STAT)
Information Risk is a podcast hosted by Doug Atkinson featuring David Loshin, a renowned data strategy consultant and director at the University of Maryland. David explores theoretical and real-world examples of 'information risk', the different types of risk that misuse and misinterpretation of data can pose to organizations.
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