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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

#301

Post by tonymet »

aprdm wrote: post #107
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,…

I am sorry to hear that. A friend of mine who moved from US to Canada moved after his mother had cancer on her 60s. She was retired by then after having a very successful career (C level on some manufacture company). His mom died poor. Crazy country.

We had felt invulnerable until we weren’t. I’m sorry about your friend’s mom it’s vile and even more infuriating that there’s no clear “villain”. But you reach a point where you focus on what you have. Good doctors, admirable and compassionate nurses , loving and supportive family. The money is toilet paper really – we conceded that a long time ago. Make the most of it while you can but you can’t hold onto too tightly.

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

#302

Post by jobs_throwaway »

kwanbix wrote: post #51

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…

> US health care which is probably one of the worst in the world

Not really. If you have money, the US system is one of the best. It just really, really sucks if you don't have money.

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

#303

Post by Aloisius »

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…

Four or five competitors is plenty for a healthy market.

Where I live, they do compete on price - prices vary by about 30% for similar coverage. They can't engage in the kind of price war you're thinking of since insurance companies, by law, have to maintain a fund able to cover costs, have to get rate changes approved by regulators and are largely banned from price discrimination.

I understand the desire to shift blame entirely onto insurance companies rather than providers. After all, one is all about money and the other is seemingly all about healing.

Heck, when a provider does bill people directly because an insurance company refused to pay, we blame insurance companies - even when the charges on those bills are highway robbery - like those in the article itself.

The fact is, the net cost of health insurance was about $279 billion in 2022. Meanwhile, $3.7 trillion went to healthcare providers, pharmacies and the like for care. The ones who stand the most to gain from higher prices are providers.

Frankly, decades of lobbying from the healthcare provider lobby to enrich themselves should have made it this obvious, but sadly, people see doctors as selfless angels and it blinds them.

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

#304

Post by ryandrake »

lateforwork wrote: post #169

When UnitedHealthcare CEO was killed the public sentiment was that the health insurance companies are the bad guy—and the CEO deserved what he got. Then when stories like this come out we realize no, it is actually the hospitals. In reality the whole system is broken. Some people think single payer system is the solution but then when they talk to Canadians they realize that's not the solution either. I think the cor…

> Some people think single payer system is the solution but then when they talk to Canadians they realize that's not the solution either.

I don't know a single Canadian who would swap their system for the USA's. Theirs might not be perfect, but nobody argues that it isn't at least better than the literal worst system the world has ever come up with.

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

#305

Post by ellisv »

The most impressive part to me is finding the right channel to communicate with the hospital. We had to dispute a billing issue with our hospital and it simply wasn't possible to talk to any person that wasn't part of the "patient relations" team. Billing problems went through patient relations who talked to the billers.

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

#306

Post by antisthenes »

JohnMakin wrote: post #234
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,…

I feel a great deal of sympathy for you. A medical event wiped out my meager life savings - I’m a tad younger but I worked my whole life for much of it just to go “poof” because of exactly what you are describing. I don’t feel I have a hope at retiring anymore and it makes me really depressed.

1. There are assistances available for low-net-worth and low income individuals. Have you tried those options?

2. Refuse to pay. Medical debt doesn't count against your credit and, based on my own experience, is almost impossible for the other party to collect, except some annoying phone calls.

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

#307

Post by tonymet »

Workaccount2 wrote: post #148
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,…

Last time I had blood work done, my doctor and I decided on a set of cholesterol related markers beyond your typical cholesterol assay. It took me a week and hours of phone calls to figure out what would be covered, and how much the non-covered tests would cost. The doctor pointed at the lab, the lab pointed at insurance, insurance pointed at the doctor. Finally it was the lab that was able to produce numbers. And wh…

It’s just so insane that the entire industry accepts that no one knows how much things are. Even the “financial services” team will just say “yeah that estimate is wrong” and not blush. What are you guys all doing?

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

#308

Post by zarmsdos »

gosub100 wrote: post #299
zarmsdos wrote: post #262

Earlier quoted context omitted.

Decades of right-wing propaganda, unfortunately. They tend to have an emotional reaction against any sort of socialized anything, including healthcare.

Left wing won't solve it either. They profit from the crisis by promising each election and not delivering.

That's true. I wouldn't even call them left-wing, to be honest.

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

#309

Post by spelk »

lateforwork wrote: post #169

When UnitedHealthcare CEO was killed the public sentiment was that the health insurance companies are the bad guy—and the CEO deserved what he got. Then when stories like this come out we realize no, it is actually the hospitals. In reality the whole system is broken. Some people think single payer system is the solution but then when they talk to Canadians they realize that's not the solution either. I think the cor…

>Some people think single payer system is the solution but then when they talk to Canadians they realize that's not the solution either.

I'm sorry but I don't understand this discourse. While we have gripes with the state of some hospitals that fall short of first world standards (e.g. Gatineau Hospital) and wait times for specialists for non-urgent care (it can take 2-3 months to see a dermatologist after referral for non-cancerous skin conditions in Manitoba for example), I really can't think of more than 3 Canadian residents having ever said in my lifetime that they prefer the US system (and for all of them, their objection had to do with the fact that the government funds treatments they don't like for gender dysphoria and abortions, not that they felt the US system was an effective economy of scale).

On top of that, there is a myth perpetuated in the US that we are constantly at the brink of a healthcare system collapse. We are certainly not - there is room for improvement and health inequalities that we must address, but to say that we're all an ER wait away from dying is simply untrue. [1]

I have been on the receiving end of health care inequalities here in Canada (in Manitoba and Quebec), but I don't go as far as to write off the achievement of having set up an effective single payer health system in a federal state.

[1] https://www.npr.org/2020/10/19/925354134/frame-canada

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

#310

Post by tonymet »

nradov wrote: post #147
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,…

Yes, it is a huge mess. For patients who do have health insurance it's worth checking your health plan's online cost estimator tool before any elective treatments. Most payers are now legally required to offer an estimator to members under federal cost transparency rules. It can be confusing to know what to search for but at least worth a try for something like an MRI.

in every single case those estimates have been wrong. In most cases by 200% or more. And a many case there are no figures.
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