AI Technology & Data Disclaimer
Effective Date: June 24, 2025
Last updated: June 24, 2025
MedBillHero utilizes advanced artificial intelligence and proprietary algorithms to analyze your Medicare claims and provide insights. This disclaimer explains how our AI technology works, its capabilities, and important limitations you should understand.
🤖 Our AI Technology
MedBillHero employs sophisticated artificial intelligence systems that include:
- Proprietary Claim Analysis Algorithms: Our custom-built technology analyzes billing patterns, identifies potential errors, and flags unusual charges.
- Natural Language Processing: We use OpenAI GPT-4, Anthropic Claude, and proprietary algorithms to interpret medical codes, provider notes, and claim descriptions to provide plain-English explanations.
- Pattern Recognition: Our algorithms detect anomalies in billing practices and identify potential cost-saving opportunities.
- Conversational AI: Our chat assistant uses large language models including OpenAI GPT-4 and Anthropic Claude to answer questions about your specific claims and coverage.
🔒 Training Data & Privacy Protection
Your Privacy is Protected: Your personal health information is never used to train third-party AI models. We use AI services configured to prevent data retention and model training.
All AI models we use are configured with enterprise-grade privacy settings that ensure:
- Your health data is not stored by third-party AI providers
- No personal information is used to improve or train external AI models
- All processing happens in secure, isolated environments
- Data is only used for your specific analysis and then discarded
📊 Data Accuracy & Sources
Your Medicare Data is 100% Accurate: All claims, coverage, and billing information is imported directly from Medicare's official databases. This data is not modified or interpreted by our AI, it's your official Medicare record.
However, our AI-generated insights, analysis, and recommendations are interpretations based on this data and should be understood as:
- Algorithmic assessments that may not capture all nuances of your specific situation
- Pattern-based analysis that could miss context-specific factors
- Automated suggestions that require human judgment to validate
⚕️ Medical & Legal Disclaimers
Not Medical Advice: MedBillHero is a billing analysis tool, not a medical service. Our AI insights do not constitute medical advice, diagnosis, or treatment recommendations.
Important Limitations:
- Our AI cannot replace consultation with healthcare professionals, insurance specialists, or legal advisors
- Billing error detection is algorithmic and may produce false positives or miss certain issues
- Appeal recommendations are generated suggestions, not legal advice
- Always verify AI-generated insights with official sources before taking action
⚠️ Known AI Limitations & Bias
While our AI technology is sophisticated, it has inherent limitations that users should understand:
Important Limitations: Our AI models may exhibit bias toward common billing patterns, show reduced accuracy with rare medical conditions, and have limitations in understanding complex medical contexts.
- Billing Pattern Bias: AI models are trained on common billing scenarios and may not recognize unusual but legitimate billing patterns
- Rare Condition Limitations: Analysis accuracy may be reduced for uncommon medical conditions or specialized treatments
- Context Understanding: AI may miss nuanced medical or personal circumstances that affect billing appropriateness
- False Positives/Negatives: The system may flag legitimate charges as errors or miss actual billing problems
- Evolving Medical Practices: AI knowledge may lag behind the latest medical procedures or billing practices
🔧 How Our AI Enriches Your Claims
Our proprietary claim enrichment process includes:
- Code Translation: Converting medical procedure codes (CPT) and diagnosis codes (ICD-10) into understandable descriptions
- Cost Analysis: Comparing charges against typical ranges and identifying potential overcharges
- Risk Assessment: Flagging claims with billing patterns that commonly indicate errors
- Coverage Verification: Analyzing whether services align with your Medicare benefits
- Trend Identification: Spotting patterns across your claims history that might warrant attention
This enrichment process is automated and runs continuously as new claims are processed by Medicare.
💬 AI Chat Assistant
Our conversational AI is designed to help you understand your claims by:
- Answering questions about specific claims, providers, and procedures
- Explaining insurance terms and billing concepts in plain language
- Helping you navigate your Medicare benefits and coverage
- Providing general guidance on common billing issues
Chat Limitations: While our AI has access to your specific claims data, responses are generated by AI models and may occasionally contain inaccuracies. Always cross-reference important information with official sources.
🛡️ Your Role & Responsibilities
To get the most value from MedBillHero while staying protected:
- Verify Important Information: Cross-check AI insights with official Medicare documents, EOBs, and provider statements
- Consult Professionals: For complex billing disputes or medical questions, consult with healthcare providers, insurance specialists, or legal counsel
- Understand Limitations: Remember that AI analysis is a tool to assist your understanding, not a substitute for human expertise
- Stay Informed: Keep your Medicare account information current and review all communications from Medicare and providers
🔄 Continuous Improvement
Our AI systems are continuously learning and improving. We regularly update our software based on new data patterns, user feedback, and advances in medical billing analysis. However, this means that insights and recommendations may evolve over time as our technology becomes more sophisticated.
📞 Responsible Disclosure & Support
Report Dangerous or Incorrect AI Outputs: If you encounter potentially dangerous or clearly incorrect AI outputs, immediately contact support@medbillhero.com or use the flag feature. For urgent medical concerns, contact your healthcare provider directly.
If you have questions about our AI technology, need help interpreting insights, or want to report potential inaccuracies:
- Immediate Action Required: For potentially harmful AI outputs, contact support immediately and do not rely on the information
- Flag Feature: Anywhere you see the thumbs up, thumbs down, or flag icons, you can click them to provide feedback to us
- General Support: Contact our support team at support@medbillhero.com
- Self-Service Help: Visit our Help Center for detailed guides
- Medical Emergencies: For urgent medical concerns, always contact your healthcare provider directly - do not rely on AI analysis for emergency situations