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Using AI to negotiate a $195k hospital bill down to $33k
211–220 of 954 posts
Re: Using AI to negotiate a $195k hospital bill down to $33k
#212Earlier quoted context omitted.
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.
> The layout of a book of codes, for sure, but the information in it Are you talking about copyright here? It sounds more like design protection. Wouldn't the book be as copyrightable as any other non-fiction work?
Re: Using AI to negotiate a $195k hospital bill down to $33k
#213The problem is the insurance+hospital industrial complex. The insurance companies will negotiate this down on your behalf. They basically operate on fear of walking into a hospital and getting a 6-figure bill.
My SO had to take a medevac helicopter once: we got a $65k bill just for the 20-minute helicopter ride which suddenly became under $4k with insurance. The discount made me feel like I was getting a deal, so I gladly paid.
Re: Using AI to negotiate a $195k hospital bill down to $33k
#214Earlier 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…
Health Care Sharing Ministries (HCSMs) are an interesting loophole in healthcare regulations that excepts uninsured people that participate in an HCSM from paying the tax penalty.
HCSMs are membership organizations in which people with common religious or ethical beliefs share medical expenses with one another. They are not the same as traditional health insurance.
Because patients are considered "self-pay", they negotiate their own prices with providers and they are likely to get an 80% or more discount on "list price" for the service. They are reimbursed by the HCSM if the HCSM approves the reimbursement.
As of 2025, approximately 1.7 million Americans participate in Health Care Sharing Ministries (HCSMs), which amounts to about 0.5% of the U.S. population. In Colorado alone, HCSM enrollment (at least 68k) is equivalent to 30 percent of Obamacare enrollment.
Because HCSMs often exclude essential health services and are therefore more attractive to people who are relatively healthy, enrollment of this size, relative to marketplace enrollment, may increase premiums for marketplace plans.
I am not promoting HCSMs but I did research it when I lost my COBRA coverage a few years ago. I do find it an interesting alternative approach to paying for healthcare. We really do need to explore options in this country.
I can definitely see AI being applied in the HCSM context.
https://www.commonwealthfund.org/publications/fund-reports/2...
Re: Using AI to negotiate a $195k hospital bill down to $33k
#215These exorbital numbers are due to government and voters not willing to regulate the industry and rely on free market instead, correct?
Not really. The healthcare market is a very heavily regulated market, not an unregulated free market. The prices are not a result of there being a free market without regulation, but a product of what is and is not regulated. Both government and insurers take into account the "sticker price" of service in setting their reimbursement limits (they either have negotiated discounts from the sticker price, limit reimbursement based on the general charge to the public along with other factors, etc.)
As a result, the nominal general charge to the uninsured public is generally inflated, but also tend to be very easy to negotiate down.
Re: Using AI to negotiate a $195k hospital bill down to $33k
#216Earlier quoted context omitted.
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…
this looks like shopping in Moroccan bazaar with no price labels. But here you bargaining not for couple fruits but for your health and price range is in thousands. WTF :)
It’s worse than that. In a bazaar there are only 2 participants and they are looking out for their own interests. Most Americans don’t choose their own insurance their _employers_ do.
The insurance company has no reason to make the health recipient happy and the health recipient has little agency in pricing.
Re: Using AI to negotiate a $195k hospital bill down to $33k
#217This reads like an ad for Claude
Re: Using AI to negotiate a $195k hospital bill down to $33k
#218Earlier quoted context omitted.
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.
> The layout of a book of codes, for sure, but the information in it Are you talking about copyright here? It sounds more like design protection. Wouldn't the book be as copyrightable as any other non-fiction work?
The work I know of, I'm not in USA only have an interest in copyright laws in general, is Feist v Rural Telephone (1991) -- which appears to mirror codes for health procedures quite closely; but not exactly.
There's old but more recent law from Practice Management v AMA (1997) supporting that AMA's codes can't be copyrightable as they're part of legislation.
Berne's Art 2(8), to which USA are signed, related to non-copyright of facts.
I'm afraid I'm not appraised of the full situation, however.
Re: Using AI to negotiate a $195k hospital bill down to $33k
#219Earlier quoted context omitted.
My analogy is not with socialized healthcare but with the medicare scheme. Socialized healthcare works in lots of other countries due to a combination of rationing and (in the case of drug prices) prioritizing accessibility over R&D. > I suspect that it’s mainly doctors who need to be more responsive to cost incentives as they’re often the ones recommending unnecessary tests or treatments. Doctors would recommend few…
I edited my post to say Medicare shortly after your reply (sorry). But if there’s evidence that Medicare is especially profligate with unnecessary tests and treatments then you should give that evidence, rather than arguing by strained analogies.
I think that analogies are helpful for elucidating the point but in terms of concrete evidence, there are two gold standard studies that really reveal this issue. These studies are very hard to come by because it is typically difficult (for good reason) politically to experiment with people's healthcare, but we are lucky to have two: the RAND healthcare study and the Oregon medicaid lottery.
My understanding of both of those studies is that (particularly for pre-registered analyses), we saw that adding some sort of cost-sharing substantially reduced utilization of healthcare services (~30%) without any impact on health indicators even multiple decades down the line, with the possible exception of mental health indicators. Nowadays people try to p-hack their way out of these conclusions, but it is pretty strong high-N experimental evidence.
Re: Using AI to negotiate a $195k hospital bill down to $33k
#220While it's an interesting story, I doubt they needed Claude to work a hospital bill down to that amount. Hospital billing folks are acutely aware that the initial bill is outrageous and indefensible from their end. I've heard a ton of cases where folks basically "pay what they can" for the bill and that's good enough for both parties. I doubt the reasoning Claude provided was ultimately what got the hospital to knock…
I’m confused why - if this is indeed common practice - it’s not considered fraud on the part of the hospitals?
Where are the class action law suits?