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Related Concept Videos

Impression Management Techniques III: Aligning Actions01:29

Impression Management Techniques III: Aligning Actions

Aligning actions are communicative strategies individuals employ to maintain social harmony and preserve personal identity in the face of potential disruptions to social norms. These actions are particularly important in managing social impressions when one's behavior might be seen as inappropriate, incompetent, or morally questionable.Types of Aligning ActionsThe three principal types of aligning actions are disclaimers, accounts, and apologies.DisclaimersDisclaimers are preventive; they are...
Fixing Double-strand Breaks02:04

Fixing Double-strand Breaks

The double-stranded structure of DNA has two major advantages. First, it serves as a safe repository of genetic information where one strand serves as the back-up in case the other strand is damaged. Second, the double-helical structure can be wrapped around proteins called histones to form nucleosomes, which can then be tightly wound to form chromosomes. This way, DNA chains up to 2 inches long can be contained within microscopic structures in a cell. A double-stranded break not only damages...
Fixing Double-strand Breaks02:04

Fixing Double-strand Breaks

The double-stranded structure of DNA has two major advantages. First, it serves as a safe repository of genetic information where one strand serves as the back-up in case the other strand is damaged. Second, the double-helical structure can be wrapped around proteins called histones to form nucleosomes, which can then be tightly wound to form chromosomes. This way, DNA chains up to 2 inches long can be contained within microscopic structures in a cell. A double-stranded break not only damages...
Testing a Claim about Population Proportion01:24

Testing a Claim about Population Proportion

A complete procedure for testing a claim about a population proportion is provided here.
There are two methods of testing a claim about a population proportion: (1) Using the sample proportion from the data where a binomial distribution is approximated to the normal distribution and (2) Using the binomial probabilities calculated from the data.
The first method uses normal distribution as an approximation to the binomial distribution. The requirements are as follows: sample size is large...
Fundamental Attribution Error01:14

Fundamental Attribution Error

According to some social psychologists, people tend to overemphasize internal factors as explanations—or attributions—for the behavior of other people. They tend to assume that the behavior of another person is a trait of that person, and to underestimate the power of the situation on the behavior of others. They tend to fail to recognize when the behavior of another is due to situational variables, and thus to the person’s state. This erroneous assumption is called the fundamental attribution...
Mismatch Repair01:20

Mismatch Repair

Organisms are capable of detecting and fixing nucleotide mismatches that occur during DNA replication. This sophisticated process requires identifying the new strand and replacing the erroneous bases with correct nucleotides. Mismatch repair is coordinated by many proteins in both prokaryotes and eukaryotes.
The Mutator Protein Family Plays a Key Role in DNA Mismatch Repair
The human genome has more than 3 billion base pairs of DNA per cell. Prior to cell division, that vast amount of genetic...

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A Contusive Model of Unilateral Cervical Spinal Cord Injury Using the Infinite Horizon Impactor
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Published on: July 24, 2012

AI cannot fix a broken claims paradigm.

Manijeh Berenji1, Michele Kowalski-McGraw2, Larry Ozeran3

  • 1School of Medicine and Joe C. Wen School of Population and Public Health, University of California, Irvine, 856 Health Sciences Quad, Ste 5600, Irvine, CA 92697.

The American Journal of Managed Care
|June 23, 2026
PubMed
Summary
This summary is machine-generated.

Artificial intelligence (AI) shows promise for improving healthcare claims processing. However, AI alone cannot resolve systemic issues in the claims paradigm, requiring a more comprehensive approach.

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Last Updated: Jun 25, 2026

A Contusive Model of Unilateral Cervical Spinal Cord Injury Using the Infinite Horizon Impactor
07:28

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Published on: July 24, 2012

Using Eye Movements Recorded in the Visual World Paradigm to Explore the Online Processing of Spoken Language
09:27

Using Eye Movements Recorded in the Visual World Paradigm to Explore the Online Processing of Spoken Language

Published on: October 13, 2018

Area of Science:

  • Health Informatics
  • Artificial Intelligence in Healthcare

Background:

  • Healthcare claim denials are increasing due to data inaccuracies, staffing shortages, and outdated systems.
  • Economic pressures and declining collections necessitate faster and cleaner claims processing.

Purpose of the Study:

  • To evaluate the perceived and actual impact of artificial intelligence (AI) on healthcare claims processing.
  • To identify barriers to AI adoption in managing healthcare claims.

Main Methods:

  • Analysis of a feature article discussing AI's role in reducing claim denials.
  • Review of cited reasons for claim denials and provider concerns regarding AI implementation.

Main Results:

  • Providers anticipate AI can strengthen the claims lifecycle, but adoption remains low.
  • Key concerns hindering AI adoption include accuracy, compliance, and training requirements.
  • Providers are exploring AI solutions to stabilize finances and streamline operations amidst changing policies.

Conclusions:

  • Artificial intelligence (AI) is viewed as a potential tool for improving healthcare claims, but it is not a standalone solution.
  • Addressing the "broken claims paradigm" requires more than just AI; systemic improvements are essential.