Interesting idea, but I imagine it suffers from similar issues to writing legal opinions: by signing your name to it, you're swearing that it's all true. Given AI's propensity for making things up, you need to check everything.
I wouldn't be surprised if 'knowingly filing a false appeal' is a reason to boot you off the plan in the first place.
It's still a lot easier to review and understand something you weren't able to write than to also write that same thing without knowing how to write it.
Indeed. Just need to remember that AI can and will hallucinate entire studies or court cases into existence.
I wouldn’t be surprised if ‘knowingly filing a false appeal’ is a reason to boot you off the plan in the first place.
For that to be an issue you would have to "know" it was false.
I think when you use AI to write the claim and there turn it to be errors even after you checked it, it could still be a case of negligence. Like, not that I think it necessarily should be, but I can see that one could make the argument.
Pictured: average Lemmy user.
I wish the average Lemmy user was writing open source tools that help people fight mega corps. That would be amazing!
might try that tbh, what're your ideas?
I’m not sure what you can do. But she wrote a cool tool that generates appeal letters automatically. Just find what is bothering you and work on it.
Same thing but to automatically send emails to your local political representative. Bonus points if I don't even have to know who it is
Tag yourself, I'm the dog
I'm calling the oddly placed bosu ball.
Too thin
Gave it a go. Seems like it has potential. I'm still working through an appeal. My wife ended up in the ER in May and was directly admitted to the hospital for emergency surgery. Ten days afterwards we received a letter from the insurance company saying they had decided it wasn't medically necessary so they wouldn't be paying the $67k bill.
It has been a journey trying to get the appeal together. I had hoped the hospital would at least assist with a letter from one of the many physicians that attended her, but nope. We got laughed at by the surgeons office and told condescendingly "Yeah, that's not how any of this works. "
My biggest concern from the AI generated appeals are being able to confirm the statements it is making isn't just a LLM hallucination. As a lay person, much of the things necessary to make an argument are paywalled out of reach. For example, the insurance company cited the "2023 InterQual criteria for Surgical Conditions" as the reason why they are denying it. The AI appeal that was generated states that per the 2023 InterQual criteria for surgical conditions that hospitalization was medically necessary.
The only way it seems you can actually get access to InterQual is as a medical provider / payer.
.... I thought most people actually just appealed most denials???
I was pretty sure this was already common knowledge?
90% of the time what happens is that you call up your insurance for some shit like hey my jaw be broken as fuck, and they go "nah thats cosmetic" and then you spend 2 weeks fighting with them until they cave and actually cover it.
you call up your insurance
They're "solving" this problem with less agents or customer service staff, automating the process so you have a robot to deal with that doesn't ever seem to understand what you're saying, and can't get you to the right place. Basically make it as hellish as possible to even get your issue reviewed. Then, they stone wall you and don't take yes for an answer no matter what
ah yes, this should be illegal, i don't care how much money it saves.
...This is just a network switch/router.
You sound like one of them fancy book reading types you get the fuck out! Lol
She's turning into Lain.
Also looks like a few enclosures on a lower shelf (which could be anything) but technically you can run WAN-exposed servers on most routers, not that it’s advised just possible.
We love some good news to start the day
Yeah, honestly the appeal is a standard step in the bottom surgery process in the states. I know one lady who had to explain to her insurer why removal of the penis was a necessary step in her vaginoplasty.
"are you sure it needs to be removed? Have you considered just taking it off first?"
The insurance, probably
"We heard that song. Aren't they all just detachable?"
detachable penis
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