Hacker News Board Hacker News, browsed like a classic message board
Live data from Hacker News

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

threads.com

Post reply on HN
Print view View original

251–260 of 954 posts

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

#251

Post by almosthere »

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…

So you're saying one solution is to get rid of all insurance and make hospitals charge a reasonable price. Sounds good to me. You sound conservative!

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

#252

Post by bonoboTP »

vincnetas wrote: post #174
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…

this looks like shopping in Moroccan bazaar with no price labels. But here you bargaining not for couple fruits but for your health and price range is in thousands. WTF :)

Yeah at this point this is more like a cultural ritual. You know like howin some cultures you have to refuse a gift 5 times with increasingly stubborn facial expressions, and the gift giver has to insist through it all, and then accept and say thanks. As the default.

Or where you as a guest announce that you now go home, and the hosts have to insist you stay for some more tea or whatever and then you have to again and again say you're now going really and they insist you stay so you chat more in the hallway etc. And it's just how it always is and it would be super rude to just leave or if the host didn't demand that you stay.

Similarly the US developed this traditional ritual that the first bill is outrageously expensive and everyone knows that everyone know, but the ritual protocol say you gotta start with that, we are civilized people, we say hello, so in Healthcare the hello is the huge price, and the interaction always ends in a lowered rate, because that's also part of the protocol.

It's just a cultural difference.

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

#253

Post by egorfine »

chrisgeleven wrote: post #245

I fought insurance over this past summer after they declined covering a life saving surgery for my 6-year-old child at the last minute. We were in despair that my child's life was at risk each day we waited because of insurance incompetence. ChatGPT literally guided me through the whole external appeal process, who to contact outside of normal channels to ask for help / apply pressure, researched questions I had, hel…

[flagged]

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

#254

Post by astrange »

wbronitsky wrote: post #127
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,…

Matt Stoller, a journalist who blogs about monopolies, just wrote all about the pricing issue this week: https://www.thebignewsletter.com/p/monopoly-round-up-obamaca... America has doubled down on middlemen controlling the prices of medical care and making sure that there is no set price for anything. With the ACA effectively falling apart in the new budget, we do have a chance to move to a different reality, one whe…

Matt Stoller is properly described as an insane person who thinks every single problem in the world is caused by monopolies (yes, including whatever random problem you're thinking of now).

His most notable attributes on Twitter are he constantly lies about everything and that he spends all his time promoting Republicans who are clearly not going to implement his anti-monopoly agenda.

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

#255

Post by rkomorn »

BeetleB wrote: post #239
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,…

> 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, supposedly). Even with insurance it will be at least $50k/yr out of pocket I can see them being out of network this year, but can't you change insurance in the following year to one where it will be in network?

Does that

- turn into whackamole every year?

- expose someone to "preexisting conditions aren't covered" issues?

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

#256

Post by aeturnum »

ageitgey wrote: post #162
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…

> I'd be interested to hear from a charge coding expert about Claude's analysis here and if it was accurate or not. There's also some free mixing of "medicare" v.s. "insurance" which often have very different billing rates. The author says they don't want to pay more than insurance would pay - but insurance pays a lot more than medicare in most cases. I'm a cofounder of Turquoise Health and this is all we do, all day…

Thanks for your insight!

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

#257

Post by dragonwriter »

astrange wrote: post #254
wbronitsky wrote: post #127

Earlier quoted context omitted.

Matt Stoller, a journalist who blogs about monopolies, just wrote all about the pricing issue this week: https://www.thebignewsletter.com/p/monopoly-round-up-obamaca... America has doubled down on middlemen controlling the prices of medical care and making sure that there is no set price for anything. With the ACA effectively falling apart in the new budget, we do have a chance to move to a different reality, one whe…

Matt Stoller is properly described as an insane person who thinks every single problem in the world is caused by monopolies (yes, including whatever random problem you're thinking of now). His most notable attributes on Twitter are he constantly lies about everything and that he spends all his time promoting Republicans who are clearly not going to implement his anti-monopoly agenda.

I haven't paid a lot of attention to Stoller particularly, but the rest of that line of thinking frequently correlates with also believing that monopolies are exclusively a result of active government regulation, a belief which is naturally attracted to Republican deregulatory rhetoric.

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

#258

Post by lotsofpulp »

xp84 wrote: post #178
Aloisius wrote: post #158

Earlier quoted context omitted.

> one way for insurance companies to make more money is to have inflated health care prices to justify increasing premiums This only makes sense if they have no competitors since another insurance company would just steal their customers by having lower rates. The truth is though, healthcare providers are ultimately responsible for prices.

> since another insurance company would just steal their customers by having lower LOL. Meanwhile, in real-life America, there are only four or five major carriers that control the market, and none of them are incentivized to do this "competition" thing you speak of by engaging in damaging price wars. Why would they when continuing to be part of the problem makes them more and more profits each year? See also: milita…

>Why would they when continuing to be part of the problem makes them more and more profits each year?

In real-life America, they don't even earn enough profit to earn their shareholders a better return than SP500:

https://news.ycombinator.com/item?id=45736978

And in real-life America, the only people health insurance companies engage in price wars with is the state insurance regulator who gets to deny requested price increases.

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

#260

Post by themafia »

gpm wrote: post #143
pbhjpbhj wrote: post #138

Earlier quoted context omitted.

A code is not an artistic expression and so can't be copyrightable. The layout of a book of codes, for sure, but the information in it... might be protectable with other IPR but not copyright. Does not stop people threatening you though. This is my opinion only, not legal advice, and does not relate to my employment.

Judging by Judge Alsup's ruling even if the codes were copyrighted it would most likely not be copyright infringement to train on them either, and as such even if they are copyrightable and they do own copyright on them it remains beyond their abilities to forbid training on them. (Also opinion, also not legal advice, I'm also not a lawyer and sort of doubt the person I'm responding to is).

> not be copyright infringement to train on them either

Copyright is about reproduction. It does not cover uses. Once you bought it, it's yours, as long as you don't reproduce it outside of fair use.

The problem with most language models is they will often uncritically reproduce significant portions of copyrighted works.

Post reply on HN