Lawsuits Allege Health Insurers Misuse AI to Wrongly Deny Claims
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Lawsuits filed against health insurers Humana and United Healthcare allege improper use of AI tool nHPredict to deny coverage.
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nHPredict was created by NaviHealth to provide care recommendations, but lawsuits claim it's being used to determine coverage.
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Use of nHPredict has allegedly led to disciplining of employees who go against its recommendations.
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Advocates claim rise in denial of insurance claims corresponds with adoption of AI tools by health insurers.
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Lack of disclosure requirements around insurers' claims review processes makes it difficult to confirm if AI is directly responsible for more rejections.