The AI model, nH Predict, is the focus of another lawsuit against UnitedHealth.

Humana also using AI tool with 90% error rate to deny care, lawsuit claims::The AI model, nH Predict, is the focus of another lawsuit against UnitedHealth.

  • @Daxtron2@startrek.websiteEnglish
    3•11 months ago

    Is there proof of this? My mom works for Humana doing LTC and neither she or the medical directors she forwards cases to use this tool?

    • @Cheers@sh.itjust.worksEnglish
      7•11 months ago

      It’s probably on claim submission.

      My company operates as an LTC pharmacy. We pay for every claim submission whether reject or success.

      I was on the phone the other day with my pharmacy (optum) and they did a “test” claim which was free for them. I know optum owns the pharmacy, insurance, and pbm, but either their abusive their vertical integration or they have an “ai” to test claims.