Beware the AI bot wars! Health plans are deploying artificial intelligence (AI) to review claims and prior authorizations and issue denials at a ‘superhuman pace’ while provider organizations are using AI to optimize their billing according to a recent article, Battle Of Hospital AI vs. Insurer AI Is Pushing Medical Costs Higher.

Like all wars, the escalation of the conflict is happening on both sides. One salvo is the use of AI by hospitals for billing – where AI is identifying more patients meeting the criteria for ‘medically complex.’ A recent study – Analysis Examines AI In Hospital Billing As Spike In Complex Patients Adds Nearly $1 Billion In Extra Costs – attributes these coding systems with an increase in spending…