AdventHealth Shawnee Mission sued Blue Cross and Blue Shield of Kansas City (Blue KC) in federal court in Missouri, alleging the insurer used an AI claims-review tool from vendor Apixio to wrongly reject more than 350 physician diagnoses and withhold over $2 million in payments owed to the hospital. The lawsuit claims the automated review system’s criteria were never disclosed in advance, relied on outdated or irrelevant medical literature, and that appeals were rejected without meaningful human review. The hospital is seeking payment of the withheld amounts, damages, and an order barring Blue KC from using the AI validation model to deny claims going forward.