When AI in claims review overcalls a valid claim
A medical emergency call is never just a phone call. On the other side of the line, there may be chest pain, shortness of breath, trauma, fear, confusion, or a family member trying to describe symptoms without medical vocabulary. The first information is often incomplete. The situation may change within minutes. A decision has to be made quickly, but it cannot be made blindly.
In São Paulo, Brazil, where I work …
When AI in claims review overcalls a valid claim
