AI tools generated nearly $1B in extra costs, Blue Cross insurers say

Discussion (8 Comments)Read Original on HackerNews

itopaloglu83•25 minutes 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.

lp92•about 3 hours ago

Sounds like insurance companies just want yo preserve their bottom line and using AI as a scapegoat.

sinuhe69•about 2 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.

SpicyLemonZest•about 3 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.

ulfw•about 3 hours ago

Sounds like AI ROI is overpromised and underdelivering

timoshishi•about 2 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

Rebelgecko•about 2 hours ago

Since their profits scale linearly with costs, this is a big win for the industry.

gfrecvh•about 1 hour ago

They're talking about their own costs.

AI tools generated nearly $1B in extra costs, Blue Cross insurers say

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Discussion (8 Comments)Read Original on HackerNews