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www.congress.gov

    • PM_Your_Nudes_Please@lemmy.world
      11·
      5 days ago

      Yup, exactly this. Insurance companies don’t want to keep doctors on their payroll, because they’re expensive and inconvenient when the doctor occasionally says that medical care is necessary. But they want to be able to back up their claim denials, so they’ll need to keep some whipped doctors around who will go in front of an appeal and say “nah this person doesn’t actually need chemo. They’ll be fine without it. It’s not medically necessary.”

      Now they’ll be able to just spin up an AI, get it licensed, and then never let it actually say care is necessary. Boom, now they’re able to deny 100% of claims if they want, because they’re expensive have a “licensed” AI saying that care is never necessary.

  • Flying Squid@lemmy.world
    49·
    6 days ago

    I probably don’t need to point this out, but AIs do not have to follow any sort of doctor-patient confidentiality issues what with them not being doctors.

      • Adulated_Aspersion@lemmy.world
        7·
        6 days ago

        So why push to prevent abortion?

        Real question, no troll.

        Kill people by preventing care on one side. Prevent people from unwanted pregnancy on the other. Maybe they want a rapid turnover in population because the older generations aren’t compliant.

        With the massive changes to the Department of Education, maybe they have plans to severely dumb down the next few generations into maleable, controllable wage slaves.

        Maybe I just answered my own question.

        • blazeknave@lemmy.world
          2·
          5 days ago

          Lack of abortion kills women. Disproportionately women of color die with all things pregnancy and birth related.

          • Adulated_Aspersion@lemmy.world
            1·
            5 days ago

            I agree with both statements (and so do facts). I am trying to sound out why both actions are occurring simultaneously.

            My thought comes from a place thinking about the logic. Is it something like, “we don’t care if a handful (or even more) die in child birth, so long as we have a huge surge in fresh new population.”

            Maybe I am trying to understand logical reasoning that isn’t present.

  • Fermion@feddit.nl
    25·
    6 days ago

    Currently insurance claim denial appeals have to be reviewed by a licensed physician. I bet insurance companies would love to cut out the human element in their denials.

    • thallamabond@lemmy.worldOP
      6·
      6 days ago

      I’m really interested in seeing the full text whenever that comes out, I agree and think this would be one of the first places they would use it.

    • Adulated_Aspersion@lemmy.world
      4·
      6 days ago

      A real world response to denied claims and prior authorizations is to ask a few qualifying questions during the appeals process. Submit claims and prior authorizations with the full expectation that they will be denied, because the shareholders must have caviar, right?

      Anecdotal case in-point:

      You desperately need a knee surgery to prevent a potential worse condition. The Prior Authorization is denied.

      You have the right to appeal that ruling, and you can ask what are the credentials for the doctor who gave the ruling. If, per se, a psychologist says that a knee surgery isn’t medically necessary, you can ask them which specialized training they have received in the field of psychiatry that brought them to that conclusion.

  • BlueLineBae@midwest.socialEnglish
    12·
    6 days ago

    Very interesting. The way I see people fucking with AI at the moment, there’s no way someone won’t game an AI doctor to give them whatever they want. But also knowing that UnitedHealthcare was using AI to deny claims, this only legitimizes those denials for them more. Either way, the negatives appear to outweigh the positives at least for me.

  • Luci@lemmy.caEnglish
    9·
    6 days ago

    This is great for Canada. We won’t be loosing as many trained doctors to the US now.

    Thanks!!!

    (I’m so sorry this happening to you guys)

  • Solidoxygen@lemmy.world
    4·
    6 days ago

    I’m not 100% against this. Sure it is a risk some might not be willing to make - but if I can take a strept test on my own and goto a robot and get my antibiotics at 12:30 am on a Sunday and it doesn’t cost me $150 office visit -sign me up. Most of the time docs just give a test and prescribe a pill. I can do it. They aren’t hard tests - usually 3 steps. Just make the tests available over the counter!!!

    • thallamabond@lemmy.worldOP
      8·
      6 days ago

      But all this could be done without ai, or any sort of machine learning. If it is a simple positive negative test why not have a machine that vends and reads a colorful dots?

    • AA5B@lemmy.world
      3·
      6 days ago

      I’ll use myself as an even better example.

      I have to take medicine for a chronic condition

      • there is almost no chance of that changing, and the medicine wouldn’t be dangerous
      • it’s not addictive
      • not expensive
      • can’t be abused
      • it’s a common medicine with no black market value

      Yet every 30 days, the doctor needs to write a refill. I never talk to him, there are no tests, I just leave a voicemail and they send it to the pharmacy the next day. That doctor adds no value.

      Most of us would say I should at least be able to get 90 day supply or automatic renewal by the pharmacy. However a way to save the cost of that useless doctor without actually fixing anything is to have an “ai” do it. Or a cron job

      • amino
        2·
        3 days ago

        that’s in a fantasy world without capitalism. in the current one you’d be getting your refills denied both by your doctor and by your pharmacy.

        I do agree though that in cases like yours it should be more akin to an OTC experience