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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

#11

Post by toomuchtodo »

A_Duck wrote: post #9

It's really terrifying that someone less savvy might have spent their life savings paying this bill unnecessarily As OP says: "I had access to tools that helped me land on that number, but the moral issue is clear"

The direction is clear though; enable healthcare consumers using generative AI to appeal their bills, and scale up. If it breaks insurance companies and healthcare billing departments, well, we could fix this, right? It is a choice not to, healthcare consumers will act accordingly as rational actors in a suboptimal system. Working systems are rarely changed; failing systems at least have the opportunity for change to occur.

https://fighthealthinsurance.com/ was previously posted about a year ago, but I see no traction. There is no moat, just build and distribute, right?

Show HN: Make your health insurance company cry too Fight Health Insurance - https://news.ycombinator.com/item?id=41356832 - August 2024

(broadly speaking, my thesis is generative AI can be weaponized to break down bureaucracy designed to extract from the human, from cost efficiency and power asymmetry perspectives)

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

#12

Post by ibash »

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…

The thing is the prices are all made up anyway. The hospital hallucinates prices, so they don’t blink an eye when an llm does the same.

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

#15

Post by atonse »

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…

Totally agree that even this buggy expert can empower patients.

But you better believe that hospitals all over the place are also using AI to find ways around Medicare/Insurance rules to maximize their profit too.

The rules are probably going to get WAY more complex because they will rely less on a few humans, and more on very powerful AIs.

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

#16

Post by xnorswap »

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.

It seems pretty messed up when a $30k bill is written up like a big win.

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

#17

Post by timenotwasted »

It does feel like AI has really started to level the playing field for some of these industries that are black boxes. Close family members have fed medical data to Claude and ChatGPT and had much more useful interactions with care providers than previously possible. Was it possible to sort this out before? Sure, but not without a lot of research, now it is become much more accessible and that is a great thing.

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

#18

Post by potato3732842 »

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…

Exactly. You can do this with anything where the racket is based around the layman not being able to take in the amount of arcane subject matter info they'd need to argue their case, not just medical.

Tons of institutions that specialize in screwing people are built this way because it's pretty hard to "overtly" build an institution to screw people.

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

#19

Post by ToucanLoucan »

atonse wrote: post #15
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…

Totally agree that even this buggy expert can empower patients. But you better believe that hospitals all over the place are also using AI to find ways around Medicare/Insurance rules to maximize their profit too. The rules are probably going to get WAY more complex because they will rely less on a few humans, and more on very powerful AIs.

So what you're saying is we've injected a whole smorgasbord of electrical dumbasses into a system already rife with corruption, greed and exploitation that provides services no person can do without and is frustrating to use at every juncture.

Yaaaaaaaaaaaaaaaay.

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

#20

Post by meowface »

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.

I think there's more than just regulatory capture at play here, unfortunately. America is an odd place.

I think a public option is the only feasible path forward.

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