Inteligência Artificial atuando como auditor médico

Jean C. Raduenz, Anita M. Fernandes

Resumo


Abstract. All operators need to evaluate what their clients are requesting and for this the teams of auditors must evaluate each situation to approve or deny the client's request. Likewise the payment process with the hospitals and clinics that need a medical analysis by the operator to know if it makes sense to pay the account or not. The article proposes the development of an intelligence that can know what is relevant to each case and that should not be paid. Facilitating the process of the operator in the time of response for the client, cost of the operator and standardization in the responses to the clients.

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