AI Fights Back Against Algorithmic Health Insurance Denials
Rising insurance denials in the US, fueled by AI-powered algorithms, are prompting lawsuits against major insurers like UnitedHealth and Cigna, alleging widespread improper claim denials. The extremely low appeal rate, despite a high reversal rate upon appeal, highlights the system’s inherent flaws and the difficulty patients face navigating complex appeals processes. New AI tools are emerging to automate appeals, but lasting change requires broader healthcare reform, addressing high costs and ensuring equitable access to coverage. Experts emphasize the need for human oversight of automated systems and industry standardization to reduce denials stemming from administrative errors.
John Q. Hosedrinker