Medicare to Require Prior Authorization Using AI
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So, Medicare recipients, tell me how much you love this.
Medicare Will Require Prior Approval for Certain Procedures
The federal government plans to hire private companies to use artificial intelligence to determine whether patients would be covered for some procedures, like certain spine surgeries or steroid injections.
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I've been working on a project like this for a couple years now involving a private insurer. It's an excellent
application of AI as long as there is a human-centric appeals process. It will make routine approvals instantaneous. My concern would be for the not-so-routine cases which are certain to occur, and I'm not crazy about hiring private companies to do it. The latter concern is due to one tech company I've been working with who has not met my expectations.
