Artificial Intelligence
As health plans increasingly rely on technology to deny treatment, physicians are fighting back with chatbots that synthesize research and make the case.
At his rehabilitation medicine practice in Illinois, Dr. Azlan Tariq typically spent seven hours a week fighting with insurance companies reluctant to pay for his patients’ treatments.
He often lost.
There was the 45-year-old man who spent five months in a wheelchair while his insurer denied appeal after appeal for a prosthetic leg. Or the stroke survivor who was rehospitalized following a fall after his insurer determined his rehab “could be done at home.”
Over the course of Dr. Tariq’s 12-year career, these stories had become more common: The list of treatments that needed pre-approval from insurers seemed ever broadening, and the denials seemed ever rising.
So in an effort to spare his patients what he deemed subpar care, and himself mountains of paperwork, Dr. Tariq recently turned to an unlikely tool: generative A.I.
For a growing number of doctors, A.I. chatbots — which can draft letters to insurers in seconds — are opening up a new front in the battle to approve costly claims, accomplishing in minutes what years of advocacy and attempts at health care reform have not.
“We haven’t had legislative tools or policymaking tools or anything to fight back,” Dr. Tariq said. “This is finally a tool I can use to fight back.”