Is AI in Prior Authorization Promising or Dangerous?

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Health insurers are starting to use AI for prior authorization decisions, sparking debate on transparency and potential biases in the algorithms. Experts at a KFF panel discussed concerns about outdated data, lack of transparency, and potential delays in patient care. While some see AI as a way to improve efficiency, others worry about the impact on marginalized populations and trust in the healthcare system. The panelists emphasized the need for transparency, understanding the algorithm’s decisions, and ensuring that AI benefits patients. Despite concerns, some believe that AI could ultimately improve the prior authorization process, reducing delays and improving patient outcomes.

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