What it the dystopian fuck is this headline
Using AI to negotiate a $195k hospital bill down to $33k
31–40 of 954 posts
Re: Using AI to negotiate a $195k hospital bill down to $33k
#32It seems like the AIs role was in applying lengthy and complex medicare billing rules - it did not do negotiating and it doesn't seem like the accuracy of its understanding of medicare practices was actually checked. The author reasonably accused the hospital of gouging and the hospital came back with a much lower offer. I'd be interested to hear from a charge coding expert about Claude's analysis here and if it was…
Totally agree that even this buggy expert can empower patients. But you better believe that hospitals all over the place are also using AI to find ways around Medicare/Insurance rules to maximize their profit too. The rules are probably going to get WAY more complex because they will rely less on a few humans, and more on very powerful AIs.
I suppose a saving grace there is that Medicare is incentivized to help people or at least not incentivized to provide the minimum amount of value for maximum profit.
Re: Using AI to negotiate a $195k hospital bill down to $33k
#33I've just ignored any medical bill I don't agree with or think was fair ($10k+ worth in the last 10 years). At least in new york state there has been no downside for me. It never went on my credit score and I bought a house a few years ago.
I want to stress that this is not universal, and in some states, medical providers are pursuing this debt aggressively. This is not to say you should not be aggressive in countering their claims (I do this for folks in a volunteer capacity), but you should be knowledgeable as to your potential credit and financial risk exposure before proceeding.
NPR Investigation: Many U.S. hospitals sue patients for debts or threaten their credit - https://www.npr.org/sections/health-shots/2022/12/21/1144491... - December 21st, 2022
Some Hospitals Kept Suing Patients Over Medical Debt Through the Pandemic - https://www.propublica.org/article/some-hospitals-kept-suing... - June 14th, 2021
Re: Using AI to negotiate a $195k hospital bill down to $33k
#34I had an odd but successful experience with medical billing recently. My daughter went to urgent care for an urgent problem; after things were mostly cleared up, they transferred her by ambulance to an ER (even though there was no emergency). Both the urgent care and ER were handled by our insurance but the ambulance company sent us a large bill ($4K for a short drive) which felt too large to us (they had already tried to get my insurance to pay, but insurance said it wasn't covered). My wife was going to call the ambulance company to try to negotiate it down, but I recalled that I had recently received a random piece of mail saying that my employer subscribed to a service that could negotiate medical bills.
We contacted the service and provided our info (the context of the situation, the billing information, the actions we'd taken so far, etc) and a couple weeks later, the service reported that they had converted the ambulance ride from an uncovered insurance to covered by insurance (since the transport was between a covered urgent care to a covered EHR) and had our insurance cover the majority- we ended up paying $500 to the ambulance company.
While I am not surprised that such a service exists, what did surprise me is that it's just a division of my insurance company: they literally have a division that negotiates with another part of the insurance cmpany to get better coverage for patients. I was pretty lucky to notice the mail about this- there's nothing on my employer's site saying we have this coverage(!) and the vast majority of people in the US likely don't have this service.
If there is anything that will bankrupt the US, it's excessive medical charges and a lack of knowledge of how to address them. Maybe AI will help, but I really doubt it long term.
Re: Using AI to negotiate a $195k hospital bill down to $33k
#35I don't know about using AI to win legal and procedural arguments outright, but it seems like an interesting way to at least help win the war of attrition that corporations and weaponized bureaucracies wage on us to make a buck and keep us from claiming ours.
Re: Using AI to negotiate a $195k hospital bill down to $33k
#36The real treat would be using AI to stop regulatory capture so you don't end up in a country where it's okay to be presented with a 195K bill that can be magically lowered if you insist hard enough.
I think there's more than just regulatory capture at play here, unfortunately. America is an odd place. I think a public option is the only feasible path forward.
Hospital billing involves the 'mafia'-like influence game of having good insurance (which means being hired at the right company, with the right 'influence' over the hospital network in question) and covering the costs of the other patients who cannot afford it and refuse to pay. Hospital billing has the least teeth of any debt in the US. If you haggle a billing department long enough, they'll desperately take anything you give them.
Re: Using AI to negotiate a $195k hospital bill down to $33k
#37I've just ignored any medical bill I don't agree with or think was fair ($10k+ worth in the last 10 years). At least in new york state there has been no downside for me. It never went on my credit score and I bought a house a few years ago.
>I've just ignored any medical bill
As a not-American, I wonder what are the rules of this "game". Can anyone in the US just ignore their bills and debt and it's all ignored anyway?
Because in most European countries, debt is a very serious thing. Even small debt like an unpaid 50 Euro bill can be sold to debt collectors who can seize your property or garnish your wage, pension or bank accounts to pay your debt plus the collection fee, so people here are incredibly weary of unpaid bills or taking debt for unnecessary things other than houses or cars.
Re: Using AI to negotiate a $195k hospital bill down to $33k
#38Earlier quoted context omitted.
It seems pretty messed up when a $30k bill is written up like a big win.
Their brother presumably didn't have insurance, and it sounds like some pretty major procedures involving specialists, equipment, and hospital intake. While the outcome was horrible, all of those people need to get paid for the services rendered somehow if we want folks in the US to continue receiving this standard of care.
Except everything in America is ludicrously priced. The cost of supplies and equipment is not even close to being realistic in America vs what you'd be charged for equal care in another country.
Re: Using AI to negotiate a $195k hospital bill down to $33k
#39There’s something absurd about a hospital charging 195k for 4 hours of work with the end result of the patient being dead.
Not saying the doctors did anything wrong but… oof