Medicare's new AI experiment sparks alarm among doctors, lawmakers

[Ms. Toad]

31. Nonsense.

And even if it were denied pending additional info, your doc will send in supporting documentation, measurements, skin product, many send photos of wounds especially for exceptionally long treatment. It will be approved within hours.

The point is that ANY delay is life-threatening. And it is kind of impossible to send photos of a wound that does not yet exist. The point is that the surgery would be delayed until approval for all components - including the graft - are obtained.

And the suggestion that approval would be granted within hours is pure fantasy. I've successfully appealed dozens of denials. (I've only lost one, which I ultimately decided wasn't the worth the continued fight.) Not a single one was granted within hours (even if you don't count the days or more it took to notify me of the denial). The longest took 8 months and over 200 hours of my time. The shortest, I believe, took approximately 3 weeks.

The tinkering with the codes to minimize damage should take place before any pre-authorization for medical care (other than treatment which doubles as cosmetic care) is imposed, not after it is implemented - and the damage has already been done. Anyone implementing a new computer system knows you run parallel systems until the bugs are worked out - you don't implement an untested program in mission critical situations. And medical care is about as mission-critical as it can get. The same standards should apply.