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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

#61

Post by lovelearning »

timenotwasted wrote: post #17

It does feel like AI has really started to level the playing field for some of these industries that are black boxes. Close family members have fed medical data to Claude and ChatGPT and had much more useful interactions with care providers than previously possible. Was it possible to sort this out before? Sure, but not without a lot of research, now it is become much more accessible and that is a great thing.

For now.

But not hard to imagine United Health "investing" in OpenAI and Anthropic to "curate" the information they generate.

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

#62

Post by fatnoah »

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…

>The wider implications of this are left to the reader.

IMHO, it's actually worse than we realize. The Medical Loss Ratio requirement is good because it requires insurance companies to spend 80% or 85% of premiums on health care. It's bad because one way for insurance companies to make more money is to have inflated health care prices to justify increasing premiums so they can get 80% of a bigger pie. It also gives them incentives to provide care themselves so they can capture some of that 80% spend.

> 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.

I experienced this personally with my own insurance. My bill was over $20k, and it took a year to convince the insurance company that removing a few feet of my intestines was actually emergency surgery. I ended up paying $800. My roommate in the hospital had no insurance and ended up not paying anything (which I did not begrudge them at all, since the reason for no insurance was debilitating back pain that led to unemployment)

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

#63

Post by nerdsniper »

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,…

> And we all just accept the bills and pay them.

I got a bill for $250,000. Uninsured at the time. I have refused to pay it (due to inability), consequences to my credit be darned.

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

#64

Post by enraged_camel »

sanj wrote: post #57
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.

The funniest bit about all this is that this is all just laziness all the way down. People complain about AI-written articles. When the article is written about a human, they fall over themselves to point out potential flaws, like "well it looks like AI hallucinated" and it gets voted to the top. Then it turns out that they themselves did not read the article. Just a damning indictment of the quality of online discourse in year 2025.

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

#65

Post by jacquesm »

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,…

That's bad news. Medical billing in the USA is utterly insane. What really gets me is that if they do list the prices they seem quite reasonable, and then after the fact you get hit with a bill that is 10x or even more of what the listed price was due to all of these factors you mention.

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

#67

Post by sixothree »

cpursley wrote: post #55
mjr00 wrote: post #42

Earlier quoted context omitted.

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.

When people talk about government inefficiency, I always think of how prevalent these kinds of shenanigans really are. I think they are more costly than inefficient government.

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

#68

Post by hooverd »

SoftTalker wrote: post #43
jayd16 wrote: post #32

Earlier quoted context omitted.

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.

Lol. Who do you think makes the Medicare rules?

CMS?

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

#69

Post by bobtheborg »

xnorswap wrote: post #16
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.

It seems pretty messed up when a $30k bill is written up like a big win.

$30K NOT counting some expenses (cardiologist, ER docs)???

> Bills were a few thousand here for the cardiologist, another few there for the ER docs, a bit for the radiologist. I helped my sister-in-law negotiate these down but they weren’t back breakers. Then the hospital bill came: $195k. This is a story about that.

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

#70

Post by dcchambers »

Here's the fundamental problem I have with this: This is treating the symptom and not addressing the problem.

The problem is that America's healthcare system is ridiculously broken. The symptom of that problem is that prices are astronomically high.

I am happy AI is useful for things like this, but I want to focus on CURING the problem and not just making the symptoms more tolerable.

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