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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

#82

Earlier quoted context omitted.

>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…

It would be quite hard to run up a million euros in debt to a hospital in Europe, but in the USA that is not at all unheard of.

You're missing the point completely. I was not talking about why hospital debt is big, but the difference in how debt in general of all sizes gets collected.

Because in most of Europe even a 50 Euro debt will be collected, medical or not. while in the US it seems you can live just fine with a lot of debt that somehow nobody bothers to collect.

And your hospital in Europe DOES collect the half million Euro bill, for say a heart transplant, from your insurance company. You just never see the massive bill because it goes directly to your insurer but someone always pays.

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

#83
post #79

Earlier quoted context omitted.

It seems like every time consumers automate against the-powers-that-be, the powers change the rules. - Can’t just cancel credit cards to reset subscriptions/memberships, because new card info now gets forwarded to your vendors. - Chargebacks are now much less successful, even when the consumer has clearly been wronged.

I think a lot of "let's use technology to solve a social problem" takes forget to assume that both sides have access to technology.

This is not lost on me [1] [2]. I am a technologist (and hacker at heart), but also behind the scenes in politics (outcomes > status). I've commented, quite frequently here, that you cannot fix political and social issues with tech: wrong OSI layer of the stack. But, this change takes time, months, years, sometimes half a decade or more (election cycles, and then policy implementation lag). In the meantime, tactical solutions require technology, and that is what I am proposing in my top subthread comment.

Politics are strategic, long term system improvements. Technology serves for tactical solutions in the near term.

[1] https://news.ycombinator.com/item?id=40346506

[2] https://news.ycombinator.com/item?id=28571755

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

#85
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.

Hot off the presses: Judge Scraps Rule Eliminating Medical Debt on Credit Reports

https://www.nytimes.com/2025/07/17/business/medical-debt-cre...

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

#86
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.

Phase 1 is well underway, no worries

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

#89
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…

> 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.

Im increasingly of the opinion that AI gives people more confidence than insight. The author probably could have just thought of the same or similar things to assert to the hospital and gotten the same result. However, he wouldn't have necessarily though his assertions would be convincing, since he has no idea whats going on. AI doesn't either, but it seems like it does.

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