Saum Sutaria, M.D.

It's the poster child indication for more automation that requires controls, okay? And the government, of course, AI is new, and usually regulation doesn't catch up as quickly as the technology moves. So look at the last just seven days. You have an article in, I think, ProPublica that talked about

It's the poster child indication for more automation that requires controls, okay? And the government, of course, AI is new, and usually regulation doesn't catch up as quickly as the technology moves. So look at the last just seven days. You have an article in, I think, ProPublica that talked about

A business that is using AI and denying claims at an extraordinary rate because of the AI algorithms that are built in. All the insurers buy it, etc., etc.

A business that is using AI and denying claims at an extraordinary rate because of the AI algorithms that are built in. All the insurers buy it, etc., etc.

Well, I think it's a question of how the system is being used today. I don't think the system was originally created to do that, most likely. I mean, there is a balance between cost management and denying people what they need on an indications basis. I always think about the organizations in the ecosystem as starting with good intentions, but things can get away from people.

Well, I think it's a question of how the system is being used today. I don't think the system was originally created to do that, most likely. I mean, there is a balance between cost management and denying people what they need on an indications basis. I always think about the organizations in the ecosystem as starting with good intentions, but things can get away from people.

If you read what's in there and it's true, it's gotten out of hand. And I think many people, doctors, providers, et cetera, might feel that issues with preauthorization and denials and other things have gotten out of hand. And I'm not here to represent one side or the other, despite what I do. Look at the flip side.

If you read what's in there and it's true, it's gotten out of hand. And I think many people, doctors, providers, et cetera, might feel that issues with preauthorization and denials and other things have gotten out of hand. And I'm not here to represent one side or the other, despite what I do. Look at the flip side.

You had a major insurance company come out and say that, look, coding is getting aggressive. That's the provider side that maybe is pushing the envelope in a way that they see all the data and all the systems, and they're seeing something. I don't know how true it is any more than I know how true this other one is. Checks and balances in the system, when you have a private system, are required.

You had a major insurance company come out and say that, look, coding is getting aggressive. That's the provider side that maybe is pushing the envelope in a way that they see all the data and all the systems, and they're seeing something. I don't know how true it is any more than I know how true this other one is. Checks and balances in the system, when you have a private system, are required.

AI can either be an accelerant to reducing cost and being more efficient and effective, or if not controlled, could take one side or the other and move them in a direction that actually have negative consequences, over-coding or under-authorization of what people need, as an example. So we have to work better as an industry to actually get the right balance here.

AI can either be an accelerant to reducing cost and being more efficient and effective, or if not controlled, could take one side or the other and move them in a direction that actually have negative consequences, over-coding or under-authorization of what people need, as an example. So we have to work better as an industry to actually get the right balance here.

And that's why there's a lot of attention to this right now, because the balance is off. And you can't unilaterally blame one side or the other from that perspective, is my general viewpoint as I approach this problem. So If you think about the administrative cost side of it, yes, it's all people.

And that's why there's a lot of attention to this right now, because the balance is off. And you can't unilaterally blame one side or the other from that perspective, is my general viewpoint as I approach this problem. So If you think about the administrative cost side of it, yes, it's all people.

Yes, it's built on a system that has gotten infinitely more complex in terms of paying and submitting and getting paid for claims, both with government and with private insurance and a whole bunch of other administrivia that does have an opportunity to be fixed. At this point, collaboration between the two sides doesn't seem as high.

Yes, it's built on a system that has gotten infinitely more complex in terms of paying and submitting and getting paid for claims, both with government and with private insurance and a whole bunch of other administrivia that does have an opportunity to be fixed. At this point, collaboration between the two sides doesn't seem as high.

Technology has the potential of reducing that cost, but it is at the expense of job loss. If it happens.

Technology has the potential of reducing that cost, but it is at the expense of job loss. If it happens.

Yes. And does it have to be as large? No. But there would have to be some administration.

Yes. And does it have to be as large? No. But there would have to be some administration.