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AI to eliminate bias in SA health sector

JOHANNESBURG – AN analytics and artificial intelligence (AI) company has underscored the urgency of eliminating bias through the use of ethical AI, in response to the growing concerns around automated claim processing in the healthcare sector.

The recommendation by SAS comes as the South African healthcare industry wrestles allegations of bias in the algorithms medical schemes use to detect fraud, waste and abuse.

Most recently, an interim report by an independent panel raised concerns about racial discrimination against black medical service providers.

“We view such allegations seriously and understand the concerns about algorithmic bias. At SAS, we are wholly committed to ethical AI,” said Essie Mokgonyana, Country Manager and Sales Director for SAS in South Africa.

SAS says it is recognised for its AI and advanced analytics solutions that equip healthcare organisations with the tools to effectively manage medical costs, identify potential fraud, waste, and abuse, and make higher-value referrals to regulators and law enforcement.

These capabilities are said to have never been more crucial.

As AI continues to transform how medical schemes process vast volumes of claims, the necessity to ensure transparency, fairness and impartiality in AI systems is paramount.

Mokgonyana said SAS develops AI technologies with a focus on transparency and interpretability, which the official said means they can explore what goes into the company’s models, understand why they make certain decisions, and critically, ensure they are free of bias.

“Our goal is to enhance the health care industry with AI that is responsible, reliable, and ethical,” Mokgonyana emphasised.

Mokgonyana noted that AI, while powerful, is only as good as the data it learns from.

In the wake of recent developments, SAS has assured dedication to helping the local industry navigate challenges.

The company offers SAS Payment Integrity for Health Care, which uses advanced analytics combined with embedded AI and machine learning algorithms to detect fraud and reduce false positives, all while optimising payment integrity.

Mokgonyana said SAS solutions were engineered to provide a consolidated view of fraud risk, identifying linkages among seemingly unrelated claims, allowing healthcare organisation to prevent major losses early.

“We believe that with transparency, constant improvement, and stringent ethics in AI, we can create an environment of trust and fairness in healthcare,” Mokgonyana added.

– CAJ News

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