• theherk@lemmy.worldEnglish
    31·
    1 month ago

    I actually think this is just further manifestation of the massive scam that is health insurance.

    • chuckleslord@lemmy.worldEnglish
      9·
      1 month ago

      I mean yeah, but this is a decision that the hospitals made to try and get more reimbursement for the same care. The fact that an insurer is tattling on them is telling, though. “How dare you try to take more money from us when we’re trying to take more money from you!” Is the energy, what with AI being used to supercharge denials from the insurer’s side.

  • DrBeerFace@lemmy.worldEnglish
    6·
    1 month ago

    I hate AI, but this is just sour grapes from an insurance company. Medical providers and insurance companies are in a constant battle over payment with insurance companies trying ever more creative ways to deny payment and services (which I think anyone who has been a patient in the US can vouch for). This article claims that the providers are using AI guidance to justify better compensation from the insurance companies. If the compensation to providers for the same medical procedure didn’t keep dropping down every year, this arms race wouldn’t need to exist. What we really need is a purge of non-clinical hospital administrators (whose numbers have exploded over the past 2 decades) and of insurance personel with multi-million dollar salaries.