Saving time-fighting insurance denials with AI
Jun 7, 2023, 3:18 PM | Updated: 3:41 pm
SALT LAKE CITY — Those who have had to fight a medical bill or to get a preauthorization from their insurance know it can take months, even years, to get approval.
KSL Investigators have heard from many Utahns fighting the battle of medical appeals over the years.
With the financial burden often comes a time burden.
That time burden is now a thing of the past for Dr. Jonathan Tward.
A radiation oncologist at Huntsman Cancer Institute, Dr. Tward regularly writes appeals and preauthorization requests to insurance companies on his patients’ behalf.
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“Something that physicians battle with a lot, especially those doing specialty procedures in cancer, are often getting insurance denial letters from insurers who don’t want us to perform whatever the treatments that we think are best for our patients,” Tward said.
Most of the time, Tward said those appeals are an arbitrary hurdle: the insurance company will usually agree to pay once an appeal is filed.
Could A.I. fight with your insurance company for you? I'll show you tonight on KSL 5 News at 10PM.@KSL5TV @KSLInvestigates pic.twitter.com/ZrrQtwRRWD
— Get Gephardt (@KSLGephardt) June 7, 2023
“It’s very time-consuming for the physicians to go through the process of the appeals,” Tward said. Enter artificial intelligence, or AI.
While Tward is using this technology in the treatment and diagnosis of patients, he’s also using it to greatly reduce the amount of time he spends writing medical appeals. “ChatGPT almost instantaneously writes beautiful insurance denial appeal letters on our behalf,” Tward explained, “and that has saved us a lot of time so that we can concentrate on what matters, which is patient care.”
It’s the same program that’s made news for writing essays or clever work-appropriate emails. Tward says using this AI tech saves his team several hours weekly.
“We have all this personnel, not just physicians, but back office staff, wasting hours and hours of time trying to get coverage for treatments that we know are care standards,” Tward said. “It might be giving us a 5% savings of our time, but it wouldn’t surprise me if just a few years from now, we see that move up to 15%.”
Not all doctors write insurance appeals, and ChatGPT may come in handy if you aren’t sure how to start writing your own insurance denial appeal. If not, maybe KSL Investigators can help.
Have you experienced something you think just isn’t right? The KSL Investigators want to help. Submit your tip at investigates@ksl.com or 385-707-6153 so we can get working for you.
