AdventHealth Shawnee Mission, the Merriam-based hospital, is suing Blue Cross and Blue Shield of Kansas City, accusing the insurance provider of withholding more than $2 million in payments by wrongfully denying hundreds of medical diagnoses made by its physicians.
Attorneys for the hospital said the insurance provider, also known as Blue KC, had contracted with Apixio, a firm that touts its use of artificial intelligence to review claims, to do audits of AdventHealth’s diagnoses.
The hospital’s lawsuit, originally filed in Jackson County Circuit Court and moved to U.S. District Court in Kansas City last week, pointed to more than 350 instances in which the insurance provider found medical diagnoses were “clinically invalid and unsupported.”…