Thread regarding Cigna layoffs

AI usage

There was a recent discussion of change in the process for how client cases are being closed that is rather questionable.

Prior to my leaving Cigna, staff had been educated that they would soon begin sending cases to an AI for review prior to closure, instead of sending to an actual person to review. From how it's been described, it would actually make the process longer and more tedious. However, what is more concerning is that higher ups have been advised to tell staff not to chart anything regarding the AI reviewing the cases for closure in the documentation.

On top of taking away work from an actual person, it sounds like this would likely raise flags during an audit if it were made known.

With all the past lay offs Cigna has had, it seems like this is one more tool to help eliminate jobs.

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| 1311 views | | 4 replies (last March 25, 2024) | Reply
Post ID: @OP+1rF1WeLW

4 replies (most recent on top)

Based on the struggle to just maintain basic IT and devices like ServiceNow and JIRA, using AI to close cases is going to be a disaster. AI might save money on administrative costs but it takes a lot to keep running properly and when we can’t hire enough people to keep things running AI will start failing. I can’t wait to see the M1 come in for that.

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Post ID: @3azu+1rF1WeLW

It's a shame how much has changed over the past two years.

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Post ID: @3hbz+1rF1WeLW

The CM case closure bot only reviews for specific admin stuff to be completed in the case then gives you the okay to close. And yes, it is tedious bc there are built in failures where they KNOW it will fail in certain circumstances and you’ll have to do basically double work on the closure etc.

There is no quality feedback before given the okay to close anymore- since it’s a bot, no more customer-specific feedback on the work you did in the case before closure.

I’m guessing that’s why they want to keep it secret from auditors, it’s not customer centric.

And yes, here in CM we are basically training the AI that will eventually take our jobs. I’ve already seen ads for AI nurses in the telehealth field. And what we do really isn’t groundbreaking.

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Post ID: @3nuz+1rF1WeLW

https://www.medicaleconomics.com/view/cigna-using-ai-to-reject-claims-lawsuit-charges

The lawsuit, filed July 24 in the U.S. District Court for the Eastern District of California, alleges that Cigna used an AI algorithm called PXDX to screen thousands of claims for treatments that didn’t match certain pre-set criteria, after which its doctors would deny the claims without individually reviewing them.

UnitedHealth has done the same.

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Post ID: @llq+1rF1WeLW

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