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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

#801

Post by franczesko »

diob wrote: post #671
magicalhippo wrote: post #422

Earlier quoted context omitted.

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…

A lot of folks are looking at the higher US comp but aren't correctly pricing in the long-term risk. You can be fine for years, but a single, major medical event can zero out those salary gains and lead directly to bankruptcy. It's a systemic flaw that isn't obvious until it's your turn to deal with it.

Horrible system.

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

#802

Post by hattmall »

ksclarke wrote: post #556
magicalhippo wrote: post #422

Earlier quoted context omitted.

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…

The whole time I was reading this, as someone from the U.S., I was wondering what country the writer was from, because it sure as #$@! wasn't written by someone in the U.S. When I got to that part, I was, "Oh. Okay. That makes sense."

Realistically it's much more likely that someone in the US would be telling this story vs someone from Norway.

Norway has only 50k births a year. The US has 3.6 Million, and >40% of those are 100% free to Medicaid recipients. So 1.4 million each year, meaning a story like this is about 28 times more likely to be told from someone in the US than Norway.

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

#803

Post by lelanthran »

phyzix5761 wrote: post #798
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…

I'm curious, where do you live that denies a child a life saving surgery just because insurance won't cover it? Because in the US there's laws against that.

> I'm curious, where do you live that denies a child a life saving surgery just because insurance won't cover it? Because in the US there's laws against that.

Maybe I'm just too skeptical, but

a) This is a very new account with exactly 1 other posting 3 months ago, and

b) They don't refer to their child with any sort of gender. They even used slightly awkward sentence construction just to avoid gender. Few parents think of their child as an "it".

So either this is a sleeper bot, or the surgery in question was gender reassignment.

Or this poster routinely refers to their child as an "it", not a "he" or a "her".

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

#804

Post by cycomanic »

tptacek wrote: post #659
StackRanker3000 wrote: post #593

Earlier quoted context omitted.

> 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 similar patterns resulting in a large percentage of students paying no tuition, the middle ground of students paying some fraction, and a small number of students from wealthy families subsidizing everyone else. As someone from a country (Sweden) that to a larger…

There's always this subtext that Europeans solve these problems just by caring more about human values, but the truth usually involves interesting sets of tradeoffs. So in Europe the norm, besides free university, is extensive tracking: in the US, your choice of major is essentially a consumer decision, where in many European systems it's fixed at a relatively early age by your performance on things like the Abitur.…

I don't quite understand what you mean by "tracking". Speaking of Germany, because you mentioned the Abitur. Yes your ability to enter certain universities and studies depends on your performance during the Abitur. That is to enter e.g. law or medicine at you chosen university immediately (there is a wait time multiplier, so you can wait if you don't get in immediately) requires a certain grade point average. However I don't understand how this is different from SAT scores in the US (except for maybe the ability to bypass SAT requirements by being super wealthy, but I'm not sure that would be a good thing). In my experience kids in the US tend to be obsessed about their university choices much earlier than the ones in Europe.

Also talking about Germany, unless things changed dramatically in the last few years, most natural sciences and engineering degrees don't require a grade point average.

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

#805

Post by heavyset_go »

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…

The other side of this is that your LLM interaction can be leveraged to train adversarial models that find ways to still deny or delay your claim despite your LLM-advised actions.

Insurance companies, or the companies they pay to launder their involvement, would pay a lot more for that than the public would be able to.

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

#806

Post by heavyset_go »

diob wrote: post #671
magicalhippo wrote: post #422

Earlier quoted context omitted.

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…

A lot of folks are looking at the higher US comp but aren't correctly pricing in the long-term risk. You can be fine for years, but a single, major medical event can zero out those salary gains and lead directly to bankruptcy. It's a systemic flaw that isn't obvious until it's your turn to deal with it.

You can be a small business owner, employer and (low) multimillionaire, and still have it go down the drain via an accident, illness or disability that affects you and/or your family. Over time, disabilities can cost millions of dollars. Surviving a heart attack can cost hundreds of thousands to a million dollars. Long-term care insurance can still deny coverage based on pre-existing conditions, and long-term care is very expensive.

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

#807

Post by seethedeaduu »

magicalhippo wrote: post #422
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…

The norwegian healthcare is really bad at specific sectors if they deem you as a 2nd class citizen (for example trans healthcare, where there is a lot of malicious gatekeeping and multi-year long waitlists)

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

#808

Post by diob »

rootusrootus wrote: post #792
diob wrote: post #671

Earlier quoted context omitted.

A lot of folks are looking at the higher US comp but aren't correctly pricing in the long-term risk. You can be fine for years, but a single, major medical event can zero out those salary gains and lead directly to bankruptcy. It's a systemic flaw that isn't obvious until it's your turn to deal with it.

You can use the difference in comp to buy a Cadillac level plan with zero deductible, zero out of pocket max. You won’t be going bankrupt.

Does such a thing exist these days? If so I can't find it.

More importantly, it doesn't solve the real problem. You're still subject to the same system. Fighting for prior authorizations, staying in-network, and navigating all the other administrative friction.

More than likely they'd find a way to make you go bankrupt rather than pay up. That or deny till you die.

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

#809

Post by heavyset_go »

hattmall wrote: post #802
ksclarke wrote: post #556

Earlier quoted context omitted.

The whole time I was reading this, as someone from the U.S., I was wondering what country the writer was from, because it sure as #$@! wasn't written by someone in the U.S. When I got to that part, I was, "Oh. Okay. That makes sense."

Realistically it's much more likely that someone in the US would be telling this story vs someone from Norway. Norway has only 50k births a year. The US has 3.6 Million, and >40% of those are 100% free to Medicaid recipients. So 1.4 million each year, meaning a story like this is about 28 times more likely to be told from someone in the US than Norway.

Medicaid isn't paying parents to not work. New parents will still have to worry about paying bills and the economy.

When those parents die, any potential generational wealth for their children will be taken by the state to pay back the benefits they received from Medicaid.

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

#810

Post by Turskarama »

15155 wrote: post #797
im_down_w_otp wrote: post #795

Earlier quoted context omitted.

This helps with the denials how exactly? You can pay a lot of money in premiums, have a $0 deductible, and now OoP maximum, and still end up having claims denied.

Do you think countries with even the most coveted universal healthcare just approve everything blindly? Should everyone (anyone?) receive monoclonal antibodies, gene therapies, biologic medications? What criteria should be used to make these determinations?

Everything? No. But routine stuff will NEVER be denied. If your doctor thinks you need a scan, you're getting the scan. I have quite literally NEVER heard of someone in my country (Australia) going bankrupt from medical bills. It can happen but the rate is so low it's not something anyone ever worries about happening to them.
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