Lyric CEO Rajeev Ronanki, M.S., on Human and Artificial Intelligence

In this fourth segment of an interview with Managed Healthcare Executive, Lyric CEO Rajeev Ronanki, M.S., discusses the use of artificial intelligence (AI) in finding errors in medical claims. "What we're doing is finding the billions of things that could go wrong in terms of human error or system error or a combination of the two," he said.

Lyric is finding inconsistencies between what's permissible and recommended by what's publicly available and in guidelines and then how the claim itself has been codified relative to those guidelines. "Imagine humans trying to ferret through all of that. It's going to be nearly impossible, right? So AI is essentially helping us find those patterns and detect those anomalies," Ronanki said. Humans are good at seeing a unique thing without much data because we instinctively know something is off, Ronanki said. Think of that as a sparse data problem. "What AI is really good at is looking at billions of data points in an instant and finding all the anomalies across everything that it has seen. Putting humans and AI together can "make a really powerful combination in our industry," Ronanki said.

Ronanki stressed that technology should play a supporting role in making clinical decisions. "When it comes to determining what's necessary and appropriate, that should be between a doctor and a patient," he said.