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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

#421

Post by arjvik »

teaearlgraycold wrote: post #332
tptacek wrote: post #317

Earlier quoted context omitted.

Yes, a challenge for major structural alterations to the American system is that the median American family is probably better off under this system than they would be under any of the European-style systems: the wage premium enjoyed by many Americans and the lower tax level offsets the cost of insurance and copays. So when you're talking about how bad the American system is, you're really talking about a minority of…

I don’t know if the median American would be worse off with a European style system. Certainly the 1% don’t need it. I’ve been on the Google health insurance before and it made me feel like I had $10 million in the bank.

Can I ask what the Google health insurance is like?

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

#422

Post by magicalhippo »

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…

Relative recently had their baby come several months early. The baby needed intensive care for a couple of months, and breathing support (CPAP) for another two. Mom lived at the hospital hotel for the duration.

Baby got regular inspections of the heart, lungs and eyes (too much oxygen in the blood can lead to problems with the cornea or something), including after checkout.

They got billed exactly zero.

Both parents even got full pay during the hospital stay, so didn't have to worry about the economy.

Ok, so I pay a fair bit of taxes here in Norway, and some of it is used on stupid stuff. But overall I like knowing my life won't be ruined because of some random event forced me into insolvency.

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

#424

Post by pcthrowaway »

mirthflat83 wrote: post #315
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.

You just don’t pay. Hospitals eat the cost.

I assume it'd get sold to a collection agency for something like $500, which would then try to get you to pay as much as possible, possibly settling for as low as $2000).

So the hospital is still getting paid something, and the billee has the option to take a bigger credit hit or to negotiate down

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

#425

Post by yieldcrv »

interesting, the alternate headline "using AI to negotiate a $33k hospital bill down to still $33k" would have been pretty egregious too

what would the outcome of the charity option have been? they did not change any practice here, the hospital almost got caught, once, for one bed that was occupied for 4 hours in a single day

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

#427

Post by pastureofplenty »

noir_lord wrote: post #142
jimbohn wrote: post #3

The real treat would be using AI to stop regulatory capture so you don't end up in a country where it's okay to be presented with a 195K bill that can be magically lowered if you insist hard enough.

As someone with medical conditions from a country with universal publicly funded health care, while it may not be flawless (though in terms of actual medical treatment, no complaints either) it sure does seem to be a whole hell of a lot better than the alternative. Not once have I had a sleepless night since been diagnosed over a decade ago about insurance, co-pay or how to afford my drugs/medical treatment. I’m on t…

Look at when all the "No Kings" protests are happening: on the weekend. Because there is no way the vast majority of Americans can go on strike, because healthcare is tied to employment. This is why healthcare is never getting "fixed" in America--it's doing its job quite well.

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

#428

Post by rkomorn »

epistasis wrote: post #411
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,…

Oddly enough the big rhetorical push against a universal system from prior decades was about "death panels" deciding what care somebody would get. And guess what's happened with insurance? Death panels! The propaganda spin on the health care system in the US has been on overdrive ever since Hillary Clinton wanted to implement some reforms in the 1990s, leading to absolutely massive resistance to any change whatsoever…

> And guess what's happened with insurance? Death panels!

The insurance death panels already existed at the time. It didn't even happen after.

That's what made the whole thing so ridiculous in the first place.

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

#429

Post by rancar2 »

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…

I was going to say please use and donate to 'Dollar For' [1] which provides this service, which is likely a better choice for this type of problem than trying DIY.

[1] https://dollarfor.org

EDIT: adding in a link to 'Dollar For'.

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

#430

Post by tonymet »

BeetleB wrote: post #392
tonymet wrote: post #273

Earlier quoted context omitted.

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.

So there’s nuance to this. We live near Portland —- great provider & insurance networks.

The common perception of “providers” and “network coverage” are the frontline doctors you visit.

But in this case, and what is common, is that there are many degrees of providers. Your doctor refers to pathologist refers to lab 1 refers to lab 2.

So 95% doesn’t tell you much. If only 1-2 of your providers are out of network (e.g. specialized labs ) , that’s $10k+ right there.

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