AI tools generated nearly $1B in extra costs, Blue Cross insurers say(www.reuters.com)

19 pointsby EA-31679 hours ago3 comments

itopaloglu835 hours ago
Reminds me of the GameStop controversy where the “wrong” set of users used the existing market tools.
I presume the insurance providers thought they would be the only ones using the AI tools to auto-process (find creative ways to reject) insurance claims.
Even just the fact that people might learn about their rights, or find better ways to express their issues with correct wording would yield higher approvals, which would mean lesser profit margins for providers. And of course they will lobby for additional government subsidies.
lp928 hours ago
Sounds like insurance companies just want yo preserve their bottom line and using AI as a scapegoat.
- sinuhe697 hours ago
  More like the healthcare providers found a way to milk the insurance. The most important aspect that is amiss is the outcome of the patient's treatment. But if the practice of background mining to upgrade the claims is correct, I don't see how it can help the patients.
  - cyanydeez31 minutes ago
    Nothing in America's healthcare system is designed around helping the patient.
- SpicyLemonZest8 hours ago
  Rising healthcare costs are bad for both insurers and consumers, yes. I'm not sure why you say AI is a "scapegoat" here - they seem to be making a plausible case that the AI tools are directly causing this cost increase and it doesn't correspond to an increase in services provided.
- ulfw8 hours ago
  Sounds like AI ROI is overpromised and underdelivering
  - timoshishi6 hours ago
    It sounds like the ROI from the doctors standpoint is great, it's the insured that end up bearing the cost without receiving a corresponding increase in care
Rebelgecko7 hours ago
Since their profits scale linearly with costs, this is a big win for the industry.
- gfrecvh5 hours ago
  They're talking about their own costs.
  - 4 hours ago
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