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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

#451

Post by dekhn »

codegeek wrote: post #386
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.

I don't know, I don't run an ambulance company- what should the cost be (either to me, my insurance company, or to the government)? Can't be cheap to fully staff an ambulance with EMTs.

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

#452

Post by tptacek »

jkartchner wrote: post #414
mothballed wrote: post #330

Earlier quoted context omitted.

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.

You believe the top 60% of the nation skew in the upper income levels? Median pay is $61k a year for the entire country. The top 1% skews to the upper income levels. The rest are charged $30 for a dose of aspirin and can't afford it.

There are numbers on this, and their comment is probably directionally correct; the median household with private insurance earns more than 400% of household FPL (KFF). By subtracting Medicaid and fixed-income seniors from the picture, you are sharply biasing the median upwards.

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

#453

Post by dboreham »

noisy_boy wrote: post #116
lifeisstillgood wrote: post #108

The rest of the western world just looks at this as wonders why Americans put up with this. Using the latest in technology to move an a bill from existential to merely crippling

What I wonder is people are ok paying hundreds of dollars and going bankrupt but they haven't heard of taking a flight to a location that doesn't bleed them dry? They haven't heard of medical tourism?

It happens. A friend flew to France to have a tricky heart procedure done. But most people aren't going to have the time or resources to do that.

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

#454

Post by Aurornis »

basisword wrote: post #384
kwanbix wrote: post #363

Earlier quoted context omitted.

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).

> 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).

Like most things learned from movies, you're not getting the full picture. Most US universities charge on a sliding scale based on family earnings. For larger universities, tuition can actually be free depending on parental earnings. At the extreme end, some Ivy League universities like Harvard have $0 tuition for families earning less than $200K/year.

We also have community colleges and state-run universities with subsidized in-state tuition. It's still more expensive than free, but the tuition is in the range where as long as you're smart with your degree selection the ROI of getting the degree will more than make up for any loans you have to take on. That said, you can get yourself into trouble if you take out loans to study for a degree that doesn't translate to a job.

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

#455

Post by hollerith »

dboreham wrote: post #453
noisy_boy wrote: post #116

Earlier quoted context omitted.

What I wonder is people are ok paying hundreds of dollars and going bankrupt but they haven't heard of taking a flight to a location that doesn't bleed them dry? They haven't heard of medical tourism?

It happens. A friend flew to France to have a tricky heart procedure done. But most people aren't going to have the time or resources to do that.

Did he have French citizenship or similar connection to France?

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

#456

Post by chinathrow »

dekhn wrote: post #451
codegeek wrote: post #386

Earlier quoted context omitted.

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.

I don't know, I don't run an ambulance company- what should the cost be (either to me, my insurance company, or to the government)? Can't be cheap to fully staff an ambulance with EMTs.

What's "short" in your context? 20min?

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

#457

Post by tptacek »

egorfine wrote: post #346
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…

> about how bad the American system is, you're really talking about a minority of its users It sure seems that way if a wealth family with top level insurance can still get bankrupt by medical bills. Examples of that are right here in comments.

Are you referring to the comment that roots this thread?

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

#458

Post by ethbr1 »

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…

Amazingly happy to hear you were able to drive the process! FWIW, surgical centers usually have to do the exact same thing for their patients (typical role: coordinator), and they do it the same way you did (plus knowing a few counterparties because they work together regularly).

The lack of data standardization in health insurance is atrocious. (In the US, CMS/Congress pushing what it can, but at a glacial pace)

The strongest argument for single payer is that a diverse marketplace has demonstrated a fundamental inability to interoperate.

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

#459

Post by nonfamous »

Aurornis wrote: post #438
kwanbix wrote: post #363

Earlier quoted context omitted.

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. One thing that's hard to understand from the outside is that almost nobody actually pays those mind-blowing $60K/year tuition prices. US universities charge on a sliding scale based on the applicants' families' ability to pay. For an extreme example: Harvard's tuition is nominally $60K per year, but for families earning $200K or less it's $0. Many prestigious universities follow simi…

One thing that's hard to understand from the outside is that almost nobody actually pays those mind-blowing $200K hospital bills. US hospitals charge on a sliding scale based on the applicants' families' ability to pay.

(I don’t mean to belittle your comment about universities which is factual and helpful. I’m just pointing out that US education system is just as fucked up as the US healthcare system the OP is talking about.)

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