It's called upcoding. It's been happening with or without AI or SV's help for well over 40 years. [0]
Interestingly, whistleblowers can recoup a big chunk of the recovered funds in a False Claims Act suit when medical providers do this to defraud Medicaid / Medicare [1]. Could be a lucrative long-term play if you get employed at a company whose sole purpose is helping hospital chains bill for care that an AI thinks may have been provided.
Interestingly, whistleblowers can recoup a big chunk of the recovered funds in a False Claims Act suit when medical providers do this to defraud Medicaid / Medicare [1]. Could be a lucrative long-term play if you get employed at a company whose sole purpose is helping hospital chains bill for care that an AI thinks may have been provided.
[0] https://pmc.ncbi.nlm.nih.gov/articles/PMC10759668/ [1] https://en.wikipedia.org/wiki/False_Claims_Act_of_1863