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Ear, nose, & throat journal

Using an AI Chatbot to Generate Cochlear Implant Insurance Appeal Letters: An Assessment of Accuracy and Citation Reliability

This study prompted ChatGPT to generate zero-shot appeal letters for cochlear implant insurance denials in asymmetric hearing loss or single-sided deafness across 30 prompt variations, had three cochlear implant providers score them against American Cochlear Implant Alliance guidelines, and checked citation accuracy; 96.6% of responses listed multiple benefits of cochlear implants and 79.3% partially aligned with the guidelines, but 51.7% contained hallucinated benefits and only six of 96 citations (6.3%) accurately referenced peer-reviewed sources, with the rest hallucinated (57.3%), erroneous (24%), or irrelevant (10%), indicating that human verification is needed before clinical or advocacy use.