AI ‘smart agents’ underutilized in fight against healthcare fraud
The authors of the report note that, in various other industries, machine learning and artificial intelligence “have yielded powerful tools to manage such complex matters” as fighting fraud, waste and abuse. “Yet these advanced computational systems have a long way to go in healthcare administration.”
Only 4.3% of the healthcare sector currently use AI, according to PYMNTS’ latest research. By comparison, close to 10% of financial institutions have adopted the technology.
AI applications stand to save billions in healthcare administration annually, the authors assert.
“Better fraud detection also reduces false positives, erroneous judgments that block legitimate transactions,” they add. “A system that effectively stops fraudulent transactions is better at letting good ones through, and institutions that adopt AI-based fraud detection platforms reduce instances of false positives by more than tenfold.”
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