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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

#381

Post by tclancy »

nonethewiser wrote: post #89
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…

> 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 a…

"But fight with knowledge. My $20/month subscription to Claude more than paid for itself. 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. I also had ChatGPT, to which I subscribed for one month just to do this, read the letter and fact check it. No notes."

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

#382

Post by dboreham »

EvanAnderson wrote: post #122
joshstrange wrote: post #92

Earlier quoted context omitted.

> Absolutely no one will tell you how much things are, and when you ask, they sass you that it is a ridiculous question. > You’ll be asked to take a diagnostic not knowing whether it will cost $10 or $15000 I feel this in my bones and it makes me irrationally (or maybe it's rational actually) angry. Find me any other industry where you can get away with not telling how much something will cost (or even a realistic ra…

> I got an eye roll, a lengthy and exasperated lecture... This is the part that is galling to me. Apparently no healthcare worker I've ever spoken with about billing has ever had the same considerations I do re: finances. My inquiries have almost always been met with zero empathy and contempt that I would even be so gauche as to ask. (It's 1000x worse when you're talking to them about your child's medical care. My da…

A family member had a procedure a few years ago. Provider told the patient that they had contacted their insurer and received confirmation it would be covered. Went ahead with the procedure.

Bill arrives and the insurer denies coverage. Provider says "oh well you owe us $$$ now".

Since I am the resident argumentative asshole in the family I dig into the situation a bit. After many phone calls I am eventually told that the hospital routinely records all phone calls with insurance companies and furthermore has found the recording where they gave advance guarantee of coverage for the procedure.

At this point I realized we are being shaken down by a corrupt/criminal enterprise. Even with the recorded phone call the insurer refused to pay and so the patient had to pay off the $$$ over many months.

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

#383

Post by jobs_throwaway »

bboozzoo wrote: post #358
jobs_throwaway wrote: post #302

Earlier quoted context omitted.

> 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.

Isn't it universally true that if you're rich your life can be much easier? With enough wealth the actual health care system does not matter much. Neither does the country in which health care services are rendered. You just pay and get things done, and maybe even take some vacation while at it. However, given that not every one of us is rich, the point is to optimize the whole thing such that the little folk can sti…

No that isn't universally true. There's plenty of countries (eg Cuba) with entirely state-run healthcare systems where more money won't get you better care.

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

#384

Post by basisword »

kwanbix wrote: post #363
georgeecollins wrote: post #278

Earlier quoted context omitted.

I think the reason is that people know it is a problem but ideologically they really disagree about what to do about it. The impasse creates an opportunity for profit driven actors to fight reforms. Also, democracies do dumb things sometimes. See Brexit. But also, sometimes people from other countries-- I am thinking parts of Europe-- underestimate how well paid people in the US often are. They compare the averages,…

As a non-american (from South America) who lived in both USA an Europe: Yes, in USA you get much more money, like you said 2x~5x, but then: University is expensive as fck. Health care is expensive as fck. You have 5 days of paid sick leave per year in most companies. You have 10 days of paid holidays per year in most companies. In contrast, in Europe: University was cheap or free. Healthcare is cheap and universal. I…

>> University is expensive as fck.

While healthcare is brought up all the time this is usually ignored. The idea of parents saving a 'college fund' for their child is something I only know from movies. It's such a strange idea that access to education would be something you either need to be able to afford or need to get a 'scholarship' for (another strange concept).

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

#385

Post by antisthenes »

JohnMakin wrote: post #327
antisthenes wrote: post #306

Earlier quoted context omitted.

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.

I make a good living. I have some of the "best" available health insurance. It's just bordering on scam/fraudulent. Not aware of what programs you're talking about other than medi-cal (medicaid). Which I do not qualify for. As I alluded in another post I do often let debt go to collections. The issue is often not the collections calls, but that your provider will be even more aggressive about demanding up front payme…

> Not aware of what programs you're talking about other than medi-cal (medicaid)

I was talking about individual hospital programs. They typically have those programs as part of whatever hospital system that is.

Something like this:

https://www.adventisthealthcare.com/patients-visitors/billin...

But you would probably not qualify for something like this due to income. I happened to have a minor accident while unemployed (<$10k income that year) about 10 years ago, and the hospital financial aid forgave most of the cost.

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

#386

Post by codegeek »

dekhn wrote: post #34

I had an odd but successful experience with medical billing recently. My daughter went to urgent care for an urgent problem; after things were mostly cleared up, they transferred her by ambulance to an ER (even though there was no emergency). Both the urgent care and ER were handled by our insurance but the ambulance company sent us a large bill ($4K for a short drive) which felt too large to us (they had already tri…

I hear you that you didn't have to pay something crazy but the fact that you ultimately paid $500 for a short ride and you think it was "successful experience" is how they fool us. You think you got a deal when they are still laughing all the way to the bank for charging you $500 for a short ride.

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

#387

Post by egorfine »

svobodovic wrote: post #372
egorfine wrote: post #352

Earlier quoted context omitted.

Ah, so Americans are okay with that system as well. Got it.

How did you come to this conclusion from the previous answer/comment?

Because they don't want/don't change the electoral system

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

#388

Post by NickC25 »

ryanjshaw wrote: post #45
candiddevmike wrote: post #2

While it's an interesting story, I doubt they needed Claude to work a hospital bill down to that amount. Hospital billing folks are acutely aware that the initial bill is outrageous and indefensible from their end. I've heard a ton of cases where folks basically "pay what they can" for the bill and that's good enough for both parties. I doubt the reasoning Claude provided was ultimately what got the hospital to knock…

I’m confused why - if this is indeed common practice - it’s not considered fraud on the part of the hospitals?

the medical insurance industry and the hospitals do this whole song-and-dance charade where they pretend that they are charitable, public-protecting institutions who serve noble goals of helping sick people.

in truth, they are doing nothing but racketeering.

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

#389

Post by sdsd »

liendolucas wrote: post #295

$33k is still lot of money! What happens if you don't have that sum? How does the system allow to be arbitrary charged on health? I'm Argentinian and while we might be a country lagging behind in so many things these kind of ripoffs do not happen. How come the US government allows this? From other stories sometimes posted, the US seems to be one of the worst countries in the world to either die or get sick.

>How come the US government allows this?

Allows? The government works for the wealthy and powerful. That includes the masses, who (if they organize) have their own power, but it also includes every other powerful group or individual.

Why would the government want to stop this? It's the average person who would want to disallow this, and they'd have to pressure the government enough that the pain of popular opposition outweighs the brazillions of dollars they're making.

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

#390

Post by BrenBarn »

jb1991 wrote: post #377
BrenBarn wrote: post #371

Earlier quoted context omitted.

> The United States is a democracy, but more specifically, a representative democracy. As your following explanation makes clear, it's actually an unrepresentative democracy.

There are very few countries in the world that are not a representative democracy. Switzerland is a well-known example of a country where citizens directly vote on most legislation, but in most other countries, you have a parliament, congress, etc that represents the people.

That doesn't really have anything to do with the ways in which the US is an unrepresentative democracy.
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