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Tag: Insurance Claims

Rural Hospitals Deploy AI to Fight AI as Claim Denials Add Financial Pressure
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Colorado Politics, Approved, State

Rural Hospitals Deploy AI to Fight AI as Claim Denials Add Financial Pressure

By Thelma Grimes | Colorado Politics Editor’s Note: Colorado’s healthcare system is entering a period of accelerating instability — a “tsunami,” as multiple leaders describe it — driven by collapsing hospital finances, shrinking Medicaid reimbursements, disappearing services and a political fight over who is responsible for this unraveling. Healthcare Freefall is a multipart series examining how Colorado arrived at this moment, what H.R. 1 will do next and why communities across the state are bracing for deeper shocks. Rural hospitals in Colorado say they are being pulled into a technological fight they didn’t choose. Hospitals said insurance companies have deployed artificial intelligence to deny claims faster and more efficiently, and they are scrambling to adopt the...
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Colorado Supreme Court Limits Reach Of Insurance Consumer Protections
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The Denver Gazette, Approved, State

Colorado Supreme Court Limits Reach Of Insurance Consumer Protections

By Michael Karlik | The Denver Gazette The Colorado Supreme Court ruled on Monday that the legislature’s consumer protections requiring insurance companies to take certain steps before they allege a policyholder failed to cooperate do not apply to any obligation specifically laid out in the policy. In 2020, the legislature changed state law to limit insurance companies’ ability to assert a failure-to-cooperate defense when they are sued for withholding benefits. Among other things, an insurer must give a policyholder time to address any specifically identified failures to cooperate in the claim investigation. Plaintiff Anthony Wenzell and the groups supporting him argued the law captures an insurer’s allegation of noncooperation across the board, including ob...
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