Congratulations to Ph.D. student Mr. Lui Sheng Jie, supervised by Associate Professor Xiang Cheng from the Department of Electrical and Computer Engineering, who was awarded the Innovative Application of Artificial Intelligence (IAAI) Deployed Application award by the Association for Advanced Artificial Intelligence (AAAI) on 24 February 2024 (https://aaai.org/aaai-conference/iaai-24-program/).
The research paper titled “KAMEL: Knowledge Aware Medical Entity Linkage to Automate Health Insurance Claims Processing,” authored by Sheng Jie Lui, Cheng Xiang, and Shonali Krishnaswamy, was presented during the 36th Annual Conference on Innovative Applications of Artificial Intelligence (IAAI-2024) in Vancouver, Canada, which took place from 22 to 24 February 2024. The conference, known for recognizing deployed applications that significantly benefit from AI integration, celebrated the paper for its pioneering methodology (https://aaai.org/about-aaai/aaai-awards/).
The award was merited by the paper’s advanced machine learning strategy to discern the relationship between Underwriting (UW) exclusions in health insurance policies and the diagnostic details of subsequent claims, denoted by ICD-10CM medical codes. Central to this research is the KAMEL framework which adeptly combines both implicit and explicit domain knowledge from pre-trained language models and medical ontologies. This combined knowledge facilitates reasoning beyond the limits of the training dataset, marking a critical breakthrough for associating narrative medical texts with medical codes – a notable challenge in conventional data-driven machine learning approaches. This approach has been successfully implemented in the operational processes of various real-world health insurance applications, significantly enhancing its automation.