nH Predict is a computer program developed by naviHealth that implements an algorithm that has allegedly been used by health insurance companies including United Healthcare and Humana[1][2] to automatically deny coverage to patients.[3][4][5] It is reported to work by cross-correlating patient health records with those of other patients.[6] The software allegedly has a 90% error rate.[7][8]
It is estimated that such software automates away 50–75% of human labor that would be involved in such tasks.[9]
A class action was filed in 2023 against UnitedHealth Group regarding this software.[10][11] UnitedHeath Group have stated that the lawsuit is unjustified.[11]
References
edit- ^ Mole, Beth (8 February 2024). "AI cannot be used to deny health care coverage, feds clarify to insurers". Ars Technica.
- ^ "AIAAIC - NaviHealth nH Predict post-acute care predictions". www.aiaaic.org. Retrieved 2024-12-06.
- ^ Michelle M. Mello, Sherri Rose (7 March 2024). "Denial—Artificial Intelligence Tools and Health Insurance Coverage Decisions". JAMA Forum.
- ^ Al-Sibai, Noor (December 5, 2024). "Murdered Insurance CEO Had Deployed an AI to Automatically Deny Benefits for Sick People". Yahoo News.
- ^ Stanton, Andrew (December 5, 2024). "A year before CEO shooting, lawsuit alleged UHC used AI to deny coverage". Newsweek.
- ^ Jaffe, Susan (2023-10-05). "Feds Rein In Use of Predictive Software That Limits Care for Medicare Advantage Patients". KFF Health News. Retrieved 2024-12-06.
- ^ "Murdered Insurance CEO Had Deployed an AI to Automatically Deny Benefits for Sick People". Futurism. December 5, 2024.
- ^ Mole, Beth (2023-11-16). "UnitedHealth uses AI model with 90% error rate to deny care, lawsuit alleges". Ars Technica. Retrieved 2024-12-06.
- ^ "UnitedHealth uses faulty AI to deny elderly patients medically necessary coverage, lawsuit claims - CBS News". www.cbsnews.com. November 20, 2023.
- ^ Talia, Domenico (July 2024). "Algorithms That Can Deny Care, and a Call for AI Explainability". Computer. 57 (7): 109–112. doi:10.1109/MC.2024.3387012. ISSN 0018-9162.
- ^ a b "Lawsuit Filed Against UnitedHealth Group, Subsidiary for Use of AI to Deny Care". wha.org. Retrieved 2024-12-06.
 | This article related to health software is a stub. You can help Wikipedia by expanding it. |