this post was submitted on 06 Dec 2024
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United States | News & Politics
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I don't know if the number was real but someone posted a picture that their denial rate was 32% whereas the lowest provider was 9%
Their denial rate was 8% when Brian Thompson became CEO and jumped to 22.7% after one year of his leadership. 32% is believable after 3 years, especially if it's true that the decision to train an LLM for the purpose of auto rejecting claims was his directive
Why a LLM when an autoreply of "Denied" would work?
Presumably because the LLM can give a justification as well, rather than just a straight "no". Doesn't mean it's a good justification but I'm sure they have metrics that say when it looks somewhat plausible that more people don't challenge it.