Hacker News Board Hacker News, browsed like a classic message board
Live data from Hacker News

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

threads.com

Post reply on HN
Print view View original

141–150 of 954 posts

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

#141

Post by [deleted] »

lotsofpulp wrote: post #98
sixothree wrote: post #67

Earlier quoted context omitted.

When people talk about government inefficiency, I always think of how prevalent these kinds of shenanigans really are. I think they are more costly than inefficient government.

Having to settle because court cases take too long to resolve is due to inefficient government. Not only does the actual court case and appeals process take years, but even after you “win”, the collection process takes years after it has already been determined who owes what. See Alex Jones for a ridiculous example. He should have been homeless and shirtless a long time ago.

[deleted]

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

#142

Post by noir_lord »

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 two prescriptions per month, total cost to me is £114 a year (about 150 bucks).

Folks over in the US are getting hosed, twice the per capita with a worse outcome and it costs you a fortune on top personally.

That healthcare is tied to employment is just the insane cherry on top (I’m aware of the historical reasons why that happened but should have been fixed not long after).

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

#143

Post by gpm »

pbhjpbhj wrote: post #138
ecosystem wrote: post #74

The American Medical Association owns copyright to all the codes and their descriptions. They have an extremely restrictive and expensive licensing options and they strictly forbid training models with the codes. This month, the practice was called out ( https://www.help.senate.gov/rep/newsroom/press/chair-cassidy... ) so the Overton window may be opening. The AMA (a nonprofit!) clears ~$300M/year revenue from the co…

A code is not an artistic expression and so can't be copyrightable. The layout of a book of codes, for sure, but the information in it... might be protectable with other IPR but not copyright. Does not stop people threatening you though. This is my opinion only, not legal advice, and does not relate to my employment.

Judging by Judge Alsup's ruling even if the codes were copyrighted it would most likely not be copyright infringement to train on them either, and as such even if they are copyrightable and they do own copyright on them it remains beyond their abilities to forbid training on them. (Also opinion, also not legal advice, I'm also not a lawyer and sort of doubt the person I'm responding to is).

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

#144

Post by potato3732842 »

mjr00 wrote: post #42
ibash wrote: post #12

Earlier quoted context omitted.

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.

Yeah, US hospital billing is based on the idea that the patient has insurance and won't really care about what their insurer gets charged. (The wider implications of this are left to the reader.) For the uninsured this sort of thing is actually really common. Had an online friend who had to get emergency treatment and they sent him a bill for $20k. His response was, "lol I'm uninsured and don't give a fuck about my c…

I know a couple that avoided marriage so she could negotiate the childbirth bill on the basis that she was an uninsured single mom who didn't own property, etc, etc.

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

#146

Post by itissid »

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 author mentioned in a reply in threads that most of the fees was Facility Fees. That might be just wrapped up in a code for cardiology sure, but its just profit chasing hospitals because that practice can wildly inflate the cost and billing and that can be fought.

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

#147

Post by nradov »

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,…

Yes, it is a huge mess. For patients who do have health insurance it's worth checking your health plan's online cost estimator tool before any elective treatments. Most payers are now legally required to offer an estimator to members under federal cost transparency rules. It can be confusing to know what to search for but at least worth a try for something like an MRI.

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

#148

Post by Workaccount2 »

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,…

Last time I had blood work done, my doctor and I decided on a set of cholesterol related markers beyond your typical cholesterol assay.

It took me a week and hours of phone calls to figure out what would be covered, and how much the non-covered tests would cost. The doctor pointed at the lab, the lab pointed at insurance, insurance pointed at the doctor.

Finally it was the lab that was able to produce numbers.

And when I was finally billed those numbers were still incorrect! (and thankfully cheaper)

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

#149

Post by philipbjorge »

> We asked for a bill with the standard CPT codes. No reply. Asked again. “Oh, we meant to send it. We upgraded our computers five months ago and nothing works.” Uh-huh. Finally got the CPT codes.

I work in healthcare RCM. I have no trouble believing the staff here that nothing in their system works.

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

#150

Post by onionisafruit »

pbhjpbhj wrote: post #138
ecosystem wrote: post #74

The American Medical Association owns copyright to all the codes and their descriptions. They have an extremely restrictive and expensive licensing options and they strictly forbid training models with the codes. This month, the practice was called out ( https://www.help.senate.gov/rep/newsroom/press/chair-cassidy... ) so the Overton window may be opening. The AMA (a nonprofit!) clears ~$300M/year revenue from the co…

A code is not an artistic expression and so can't be copyrightable. The layout of a book of codes, for sure, but the information in it... might be protectable with other IPR but not copyright. Does not stop people threatening you though. This is my opinion only, not legal advice, and does not relate to my employment.

And yet people are collectively paying $300M licensing these non-copyrightable codes? With that kind of money somebody must have looked into not paying for licensing
Post reply on HN