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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

#391

Post by egorfine »

tpurves wrote: post #375
egorfine wrote: post #253

Earlier quoted context omitted.

[flagged]

America is trapped in a cycle where political parties have discovered that fear and anger drives voters whereas contentment with status quo does not motivate turnout. This leads to a scenario where parties will actively sabotage the resolution of painpoint issues such as immigration, healthcare, gun control etc. so long as it continues to create anger and fear that they can successfully blame on the other party. This…

So much this.

Also, this works for every people, not just American.

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

#392

Post by BeetleB »

tonymet wrote: post #273
BeetleB wrote: post #239

Earlier quoted context omitted.

> 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?

There are two “provider networks” in our region: BCBS & The United Healthcare network. BCBS is supposed to be better. Were we to switch, let’s say they did cover the 1/10 out of network cases, we risk losing the 9/10 that we currently have . The “whack a mole” is a good example. In this case it’s whack a mole and one could be $50-$100k worth of coverage gone. And more importantly, when you find a good doctor, you nee…

Ouch.

Is this a somewhat remote location? With all the insurance options I've had from work, the "in-network overlap" was something like 90-95%. People didn't change insurance to get access to providers - it was mostly a better rate, etc.

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

#393

Post by jobs_throwaway »

kwanbix wrote: post #348
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.

Well, everything is great if you have money. I was talking about the health care as a system.

If, as someone with money, you look across systems, the US is one of the best. That's the point I'm making. There's plenty of places where all the money in the world won't buy you the quality of care you can get in the US.

Quality of care available to wealthy people is an important factor in evaluating a system. In the US, there are many millions of wealthy people who the system is great for.

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

#394

Post by Aurornis »

zzzeek wrote: post #267
egorfine wrote: post #253

Earlier quoted context omitted.

[flagged]

not sure why you're getting downmodded. People will say M4A ("medicare for all") polls at super high levels, and they're right, it does. But poll those same people telling them "would you favor that your employer-based healthcare would be rescinded and you would instead get healthcare from a new government controlled plan, where there would be no other options", which is the assumption M4A's viability is based on, an…

> "would you favor that your employer-based healthcare would be rescinded and you would instead get healthcare from a new government controlled plan, where there would be no other options", which is the assumption M4A's viability is based on

No, that's just the condition for one proposal for Medicare For All.

As much as Americans complain about healthcare in general, most people don't want to give up their own health insurance once they have it. This is a known political trap that the previous M4A proposals walked right into, before crashing and burning.

When you say "Medicare for All" to people without details, they assume it means a Medicare option for all. When they start reading the details and realize they have to give up their current insurance, they don't like it.

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

#395

Post by yieldcrv »

mothballed wrote: post #330
throwaway0123_5 wrote: post #325

Earlier quoted context omitted.

> So like these are less serious issues if you are paid an extra $1-200k/ year Ok but to be fair most people in the US aren't making "extra $1-200k / year" over a person in Europe. They aren't even making $100k / year to begin with.

Almost 40% of the USA is on medicare, medicaid, or entitled to VA benefits or military healthcare. It's only a narrow majority that depends on unsubsidized private healthcare, and those people skew in the upper income levels.

And while European countries have various forms of nationalized welfare, their salaries are so low that they would be automatically eligible for the US' welfare too!

our blocs aren't that different

except in the US middle class and upper middle class

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

#396

Post by ericlang »

donatj wrote: post #379

I'm confused about some particulars here. Who was on the hook for the bill here? The wife? What state is this? At least in Minnesota my understanding is I'm not on the hook for my wife's medical bills if she were to pass.

probably the insurance payout can be grabbed from

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

#397

Post by BeetleB »

atourgates wrote: post #353
BeetleB wrote: post #247

It's nice they succeeded, but a word of caution: Medicare is not a good standard - it's often lower than what it costs them to provide the care. If everyone paid Medicare rates, lots of providers would go out of business. The usual benchmark is the "usual and customary" charges for a procedure. You can look it up for a procedure for your area. You then go to the hospital and point out these charges. My guess is they'…

I broadly disagree. Yes - Medicare is typically lower than private insurance plans, but if you can't deliver care for the reimbursement that Medicare offers as a health system/plan/office/provider, you're probably overcharging. More than that, Medicare is the de facto starting place for most reimbursement negotiations between providers and payers. One of its benefits is that it's transparent and readily available. Bl…

> One of its benefits is that it's transparent and readily available.

So is the usual and customary rate - I think it's been available since before Obamacare.

> Blue Cross isn't gonna tell you what it's contracted to pay an individual provider (and that individual provider often won't know what they'll be reimbursed untill after they submit a bill)

You'll find out when you get the bill :-) The bills I get have:

- Cost the provider is charging (e.g. $1000)

- Agreed upon cost with the insurance company ($600)

- Amount due ($60 assuming 10% and deductible met).

I don't know if they publish it transparently, but for common procedures, it's easy to find out. They're not going to prevent you from posting your bill online.

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

#398

Post by ericlang »

BeetleB wrote: post #247

It's nice they succeeded, but a word of caution: Medicare is not a good standard - it's often lower than what it costs them to provide the care. If everyone paid Medicare rates, lots of providers would go out of business. The usual benchmark is the "usual and customary" charges for a procedure. You can look it up for a procedure for your area. You then go to the hospital and point out these charges. My guess is they'…

Give me a break.

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

#399

Post by Izikiel43 »

nerdsniper wrote: post #63
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.

Aren't medical debts not supposed to be on your credit score?

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

#400

Post by NickC25 »

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…

the canadian system might suck but it's infinitely better than what we have in the USA.

we have a capitalist bastard child of for-profit "insurance" companies who are heavily subsidized (yet are still allowed to profit massively and turn profits over to shareholders) and in cahoots with hospitals who often employ more "billing specialists" and lawyers than they do actual doctors and nurses.

the whole thing is a racket.

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