The technology can speed up the process, allowing physicians to draft appeal letters in seconds. Some experts told the Times the process could become an “arms race,” where insurers will use AI technology to deny requests.
Robert Wachter, MD, chair of the department of medicine at the University of California, San Francisco, told the Times he has “tremendous confidence” insurers will use AI to get better at denying prior authorization requests.
“Their AI will deny our AI, and we’ll go back and forth,” Dr. Wachter said.
Jeff Levin-Scherz, MD, an assistant professor at the Harvard TH Chan School of Public Health, said AI tools could make it easier for ill-intentioned players to request medically unnecessary treatments. Dr. Levin-Scherz said he thinks most health plans are evaluating ways to use AI in claims appeals in a denial, if they have not already implemented the technology.
A spokesperson for AHIP told the Times the trade association representing insurers welcomes efforts from providers to speed up the prior authorization process, including appropriate use of AI.
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