4 ms·
> I think you vastly underestimate how much low-hanging fruit there is in this field, and how difficult getting and maintaining good data (so you can find the t
by exelius 10y ago
> I think you vastly underestimate how much low-hanging fruit there is in this field, and how difficult getting and maintaining good data (so you can find the things you can do) really is :)
100% agree. Health insurance data is about as garbage of data as you can get.
Many providers still fill out claims by hand and fax them in. A good many more have an EMR system that just automatically faxes it for them. All this faxing and handwriting and manual data entry means numbers get transposed and data is wrong all the time. Add to this the fact that the people at the doctor's offices filing the claims often have no idea what they're doing and will often file things completely incorrectly (i.e. under a provider code instead of a facility code), leading to a rejection.
I cannot overstate how shitty this data is. Across the board. EMR systems are getting better, but generally only younger doctors in independent practices use the more cloud-based/big data ones. Big hospitals and the like are still generally on proprietary EMR systems (and that doesn't mean it's any better; different departments can have different billing practices that still screw things up).
It will take AI to clean up this mess. It's just too complex for humans to tackle.