Source: WJHL

WJHL reports on the increasing and often opaque use of artificial intelligence by health insurance companies to make critical decisions about patient care coverage. The article reveals that complex algorithms are now frequently used to determine whether to approve or deny claims for medical treatments, procedures, and hospital stays. These AI systems can process thousands of claims at high speed, flagging cases for denial based on internal criteria that are often hidden from both patients and doctors. This practice is raising significant concerns among patient advocates and medical professionals.

Critics argue that the use of these "black box" algorithms lacks transparency and accountability, making it nearly impossible for patients to understand why their care was denied or to effectively appeal the decision. There are growing fears that these systems are primarily programmed to cut costs for the insurer, potentially at the expense of necessary patient care. The report touches upon the legal challenges being mounted against this practice, which question the fairness and legality of allowing an algorithm to override a doctor's medical judgment without a clear and transparent process for review.