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Medicare is using AI to approve claims. The result has been ‘alarmingly high denial rates.’

A pilot program using artificial intelligence to approve care for Medicare beneficiaries has resulted in high levels of denials and delayed decisions and prompted warnings from a vendor about a lack o

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AI SUMMARY

# Medicare AI Claims Denial Summary Medicare's pilot AI program for claim approvals has generated alarmingly high denial rates and processing delays, raising concerns from vendors about insufficient oversight and decision transparency. The system's elevated rejection levels threaten to create access barriers for beneficiaries and operational strain on healthcare providers relying on timely reimbursements.

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