HHS · no agency ID · record R0747
Complaint Analysis
Department of Health and Human Services · HHS/CMS/OPOLE
Overview
- Development stage
- PilotSource: b) Pilot – The use case has been deployed in a limited test or pilot capacity.
- High-impact designation
- Not high-impactSource: c) Not high-impact
- Impact justification
- Not reported
- Start date
- 2024-02 (month precision)Source: Feb-24
- Withheld from public reporting
- NoSource: a) No
Mission
- Topic area
- Health and Medical
- Operational functions
- No function tag matched Derived by keyword rules; see methodology
Problem the AI is intended to solve
Conduct high volume case analysis to identify root causes/trends that can be validated by SMEs and act as a workforce multiplier.
Expected benefits
Reduce repeat issues delaying benefits or access to care, and improve health plan compliance with federal rules and regulations.
System outputs
Identify trends, applicable regulatory citations, sample for validation, and recommended next steps.
Technology
- AI classification
- Natural language processingSource: Natural Language Processing: AI that processes, interprets, and shares information in human language.
- System name(s)
- CMS AI Workspace
- Custom-developed code
- Yes
- Public source code
- Not reported
Sourcing
- How it was built
- Developed in-houseSource: b) Developed in-house
- Vendor (as reported)
- Not reported
- Vendors (standardized)
- None on the standard list
A vendor is the supplier named by the agency. It does not identify the underlying model or AI technology.
Data and privacy
- Involves PII
- Yes
- Privacy Impact Assessment
- Not reported
- Authorization to Operate
- Yes
- Demographic features
- k) None of the above
- Training and evaluation data
- data extracts from HPMS/CTM, and manually validated results based on standard criteria
- Federal Data Catalog
- Not reported
Governance
0 of 8 minimum-practice questions answered. A blank answer means the agency reported nothing; it does not mean the practice is absent.
Pre-deployment testingNo answer reported
AI impact assessmentNo answer reported
Independent reviewNo answer reported
Ongoing monitoringNo answer reported
Operator trainingNo answer reported
Fail-safeNo answer reported
Appeal processNo answer reported
User and public consultationNo answer reported
Potential impacts and how they were identified
Not reported