Denial—Artificial Intelligence Tools and Health Insurance Coverage Decisions

Abstract

Health insurers are increasingly interested in the potential for artificial intelligence (AI) tools to improve processes of reviewing requests to approve insurance coverage of specific healthcare services. Some insurer practices have attracted lawsuits and federal investigations due to alleged wrongful denials of coverage. This article examines challenges in ensuring fair, accurate adjudications of insurance claims using AI.

Details

Author(s):
Publish Date:
March 7, 2024
Publication Title:
Journal of the American Medical Association Health Forum
Format:
Journal Article Volume 5 Issue 3
Citation(s):
  • Michelle M. Mello & Sherri Rose, Denial-Artificial Intelligence Tools and Health Insurance Coverage Decisions, 5 JAMA Health F. e240622 (2024).
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