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Using AI to negotiate a $195k hospital bill down to $33k

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Re: Using AI to negotiate a $195k hospital bill down to $33k

#51

Post by kwanbix »

Having lived in Europe 10 years (I am from south America), it is crazy that the rest of the world doesn't follow Europe's health coverage: everybody is covered, all the time, you can be covered either by public insurance (was my case) or private. There are no preconditions. Kids get covered for almost everything up until they are 18 or 21 (don't remember), drugs for adults is only 5 euro each. No matter the cost. And it just works.

By the way, Private is cheaper when you are younger, gets more expensive when you are older. So if you choose private, under very phew circumstances you can switch to Public.

In the other side, you have the US health care which is probably one of the worst in the world. Crazy.

Re: Using AI to negotiate a $195k hospital bill down to $33k

#52

Post by giancarlostoro »

jack_tripper wrote: post #37
cm2012 wrote: post #13

I'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…

Homeless people do. Personally I rather pay something, but I'm not spending tens of thousands if that's not what everyone else is paying uniform. This is why there's no transparency on hospital prices, because nobody is ever billed the same, ever. Someone's bill is offsetting the losses from someone else.

Re: Using AI to negotiate a $195k hospital bill down to $33k

#53

Post by misiti3780 »

tonymet wrote: post #48

We suddenly woke up in the Kafka-esque purgatory of critical American healthcare billing. We’re in our 50s and had been perfectly healthy, then suddenly we got diagnosed with what will be over $500k in treatment over the next 12 months— and multiple millions for the foreseeable future. We have insurance, but many of the required procedures are “out of network” and there’s no way to tell (we have “the best” insurance,…

our healthcare system is so fucked up, someone needs to burn it to the ground and start over.

Re: Using AI to negotiate a $195k hospital bill down to $33k

#54

Post by harrall »

jimbohn wrote: post #3

The 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’m not sure there is regulatory capture at play necessarily.

I notice regular doctors and dentists do this too. They’ll bill my insurance for extras in case they’ll pay and when insurance says no, the doctor doesn’t bill me either.

Everyone is just trying to suck the most money out of everyone else. It sucks if you’re self-pay because you don’t have the weight of a whole company to do that due diligence for you.

Re: Using AI to negotiate a $195k hospital bill down to $33k

#55

Post by cpursley »

mjr00 wrote: post #42
ibash wrote: post #12

Earlier quoted context omitted.

The thing is the prices are all made up anyway. The hospital hallucinates prices, so they don’t blink an eye when an llm does the same.

Yeah, US hospital billing is based on the idea that the patient has insurance and won't really care about what their insurer gets charged. (The wider implications of this are left to the reader.) For the uninsured this sort of thing is actually really common. Had an online friend who had to get emergency treatment and they sent him a bill for $20k. His response was, "lol I'm uninsured and don't give a fuck about my c…

A large portion of the US economy is based on this entire grift pipeline (settling before getting to court). And it's very costly and pushes up insurance costs and costs in general for everyone else.

Re: Using AI to negotiate a $195k hospital bill down to $33k

#57

Post by sanj »

aeturnum wrote: post #8

It 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…

> Yes, AI assistants can hallucinate and give you garbage. So I didn’t rely on it. I spot checked by looking up its big findings myself and found it was right.

Re: Using AI to negotiate a $195k hospital bill down to $33k

#58

Post by bgirard »

candiddevmike wrote: post #26
xnorswap wrote: post #16

Earlier 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.

> Another was a code that was inpatient only and because it was an emergency he had never been admitted.

The threads says this was 4 hours of work and they billed for things that weren't even used.

Re: Using AI to negotiate a $195k hospital bill down to $33k

#59

Post by sidewndr46 »

aeturnum wrote: post #8

It 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…

having hired an expert in this field, I can tell you they aren't really that sophisticated. I found myself with an absolute mountain of cash after an accident as part of a settlement. My medical insurance won't pay claims until I've exhausted that cash. The claims I had were much higher than even the mountain of cash. The lawyer I hired use a pretty effective strategy: he contacted all of the claims against me and told them we could engage in N-way negotiations amongst all the parties until we came to a settlement so everyone got their nibble of the pie. Or they could get X today, where X was some amount that was a bit less than the rate the industry actually gets paid for those services. They all accepted.

The discounts he negotiated left me with tons of cash & were in excess of the fee he charged me.

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