Use of Artificial Intelligence (AI)-Based Algorithms in Health Care Service Reviews

Date: 12/18/25

Ambetter Health uses AI and machine learning systems to improve operations, enhance member experience and strengthen clinical support. We ensure these tools are designed and used responsibly, prioritizing human well-being, fairness, accountability and transparency.

AI-based algorithms may be used to assist in approving certain health care service requests. These tools are not used to make denial decisions and are not the only factor considered in any review.

Ambetter Health does not use AI-based algorithms as the sole basis to deny, delay, or modify health care service requests. These determinations are made by appropriately licensed clinicians.

If you have questions about this disclosure, please contact Member Services at 1-833-890-0329 TTY 711.