ABOUT THE AUTHOR
Dr. Tim Wetherill trained as a General/trauma surgeon at the University of Kansas. He worked as a general surgeon in both private practice and the VA before transitioning to BCBS of Montana and HCSC where he led major transformations around utilization management, payment integrity, and pharmacy. He also served as the Chair of the Medical Policy Committee and the creator of the Vendor Clinical Validation Committee.
Because artificial superintelligence is still the stuff of science fiction, LLMs need proper guidance in order to be useful to medical professionals, researchers and others in the healthcare industry.
In this podcast, Tim explores how deeply embedded incentives, inefficiencies, and subjectivity in the current claims adjudication process create opportunities for manipulation and inefficiency.
Traditionally, payers have cast wide nets and asked providers to navigate hurdles only to claw back money after a payment has been made.
The last decade has seen AI’s escalating impact on a variety of industries take shape, and perhaps no vertical has been impacted as much as healthcare.
Translating clinical guidelines into AI-compatible formats requires understanding the guideline’s intent and how AI applies rules at scale.
Artificial Intelligence (AI) is often hailed as the savior of healthcare, but can it really handle modern medicine? Here are three big reasons AI might stumble before it soars.
Healthcare is now facing its own innovator’s dilemma. Can the healthcare industry adapt or will it continue to cling to fax machines?
Explore how the new Physicians Make Decisions Act (PMDA) is reshaping conversations around liability, ethical boundaries, and the integration of AI into clinical practice.
AI—as it stands today—excels only at certain tasks, like understanding large swaths of data and making judgements based on well-defined rules.
Understanding the root causes of provider abrasion is crucial for improving relationships between providers and health plans.