Managing Editor
@ShahidNShah
@ShahidNShah
AI Is Shaping Medical Coverage Decisions. Here’s How To Tell The Story
Whether a health insurer denies or approves a medical procedure, there’s a good chance AI was involved in the review. Increasingly, insurers are using artificial intelligence for prior authorization, concurrent review and retrospective and utilization review — terms MedCity News recently defined in an overview of utilization review.
Medigy Insights
AI is becoming a major factor in health insurance coverage decisions, particularly for prior authorization and medical reviews, raising concerns about transparency, accountability, and the potential for inappropriate denials of care. With many insurers expanding AI use to reduce costs, scrutiny is growing over how these algorithms influence patient access to treatment.
Continue reading at healthjournalism.org
Make faster decisions with community advice
- Can Integrated Care Interventions Strengthen Primary Care And Improve Outcomes For Patients With Chronic Diseases?
- Hospital@Home: Improving Discharge Management And Reducing The Risk Of Rehospitalizations In Multimorbid Patients – Protocol For A Randomized Clinical Trial
- Medical-Legal Partnership as Value-Based Primary Care: Interprofessional Teamwork for Health-Related Social Needs
- New Issue Brief Documents What’s At Stake If Medicaid HCBS Are Cut
- PACE-It: An Integrated Multidisciplinary Technology-Assisted Approach to Person-Centered Care for Individuals with Complex Care Needs
