CMS announced earlier that it would be using AI for prior authorization reviews, which the commercial insurers have been doing for some time. I mentioned this in a February post: "The Centers for Medicare & Medicaid Services (CMS) has launched a six-year voluntary model that will use artificial intelligence tools and human clinical reviews to test prior authorization of OM claims in six states: New Jersey, Ohio, Oklahoma, Texas, Arizona, and Washington. OM advocacy groups are skeptical that the program is voluntary or that humans will play a meaningful role in invoking prior authorization requirements."
I have not seen solid results yet from the six-state test. I will share them.
One, two of the links i clicked, while-alive wakes and shrinking socials, led me to summaries, not articles.
Two, a couple of friends with aggressive metastases, at least one with lungs attacked, have chosen home hospice not because they aren't fighters but because their cancers spread elsewhere and treament would extend struggling life so briefly. Stories such as these are lost in "50%" headlines.
So prior authorizations will now be made "electronically." As someone who teaches upper division premed undergrads, we talk about the radical changes to their world that are exploding, including this. So I would like to ask you, are we talking AI here? AI is helpful and potentially hurtful, both, as we all know. If AI, or whatever this is, would you please discuss the risks and not just give it a sentence? Thanks. Too important not to understand.
Would you please address facility use fees and whether, besides canceling one’s medical appointment and delaying needed medical treatment, is there any way to fight back against this scam and rip off of Medicare recipients living on a fixed income.
If the fees involve Part A, you should not be paying for them out of pocket. Can you give me details about this situation? Thanks.
CMS announced earlier that it would be using AI for prior authorization reviews, which the commercial insurers have been doing for some time. I mentioned this in a February post: "The Centers for Medicare & Medicaid Services (CMS) has launched a six-year voluntary model that will use artificial intelligence tools and human clinical reviews to test prior authorization of OM claims in six states: New Jersey, Ohio, Oklahoma, Texas, Arizona, and Washington. OM advocacy groups are skeptical that the program is voluntary or that humans will play a meaningful role in invoking prior authorization requirements."
I have not seen solid results yet from the six-state test. I will share them.
Funny. I clicked on the links and was taken to the full stories. Gremlins!
Phil, two notes.
One, two of the links i clicked, while-alive wakes and shrinking socials, led me to summaries, not articles.
Two, a couple of friends with aggressive metastases, at least one with lungs attacked, have chosen home hospice not because they aren't fighters but because their cancers spread elsewhere and treament would extend struggling life so briefly. Stories such as these are lost in "50%" headlines.
So prior authorizations will now be made "electronically." As someone who teaches upper division premed undergrads, we talk about the radical changes to their world that are exploding, including this. So I would like to ask you, are we talking AI here? AI is helpful and potentially hurtful, both, as we all know. If AI, or whatever this is, would you please discuss the risks and not just give it a sentence? Thanks. Too important not to understand.
Would you please address facility use fees and whether, besides canceling one’s medical appointment and delaying needed medical treatment, is there any way to fight back against this scam and rip off of Medicare recipients living on a fixed income.