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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

#231

Post by mgkimsal »

kasey_junk wrote: post #216
vincnetas wrote: post #174

Earlier quoted context omitted.

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.

> Most Americans don’t choose their own insurance their _employers_ do.

I don't have an employer, but I still only have one company selling health insurance in my county, so... that's all I can buy.

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

#232

Post by keernan »

I assume the law will only award a medical provider in a fee collection dispute for fees that are reasonable and within what the provider usually charges and receives in the normal course of business.

Every EOB I receive shows medical charges many multiples of what insurance actually pays (and the provider actually accepts). IMO that is not only prima facie evidence of fraud, but - since every provider does the same thing - of collusion on fees amongst and within the medical industry - worthy of anti-trust investigations (I have no anti-trust experience).

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

#233

Post by dangus »

bloat wrote: post #201

Why is the man's wife worried about being sent to collections? She owes nothing to the hospital, the dead man's estate owes money. Let the hospital line up with the other creditors. She shouldn't be paying her late husband's hospital bills out of her own funds.

I don’t think she likely had to pay a dime and wouldn’t have faced any consequence besides a few months of annoying calls. Her credit score wouldn’t have even been impacted.

I think given this story they totally messed up.

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

#234

Post by JohnMakin »

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,…

I feel a great deal of sympathy for you. A medical event wiped out my meager life savings - I’m a tad younger but I worked my whole life for much of it just to go “poof” because of exactly what you are describing. I don’t feel I have a hope at retiring anymore and it makes me really depressed.

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

#235

Post by astrange »

xp84 wrote: post #178
Aloisius wrote: post #158

Earlier quoted context omitted.

> one way for insurance companies to make more money is to have inflated health care prices to justify increasing premiums This only makes sense if they have no competitors since another insurance company would just steal their customers by having lower rates. The truth is though, healthcare providers are ultimately responsible for prices.

> since another insurance company would just steal their customers by having lower LOL. Meanwhile, in real-life America, there are only four or five major carriers that control the market, and none of them are incentivized to do this "competition" thing you speak of by engaging in damaging price wars. Why would they when continuing to be part of the problem makes them more and more profits each year? See also: milita…

The military encourages them to buy each other because it's much easier to regulate an industry with fewer companies in it.

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

#236

Post by JCM9 »

patja wrote: post #97
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.

We are self-employed in the US and buy our own high deductible plan on our state's marketplace. One of my family members needed a fairly routine planned surgery, so I went through the effort to try to determine in advance how much I would be billed. What a waste of time. My favorite was the hospital who told me the fee for a one night stay would be 73k. But, good news! Your insurance has a contracted discount that br…

The “full” prices are basically just made up. If this was like the insurance company negotiates a 15% discount than OK. But the reality is crazy stuff like the “full price” is $7,623 but “your insurance company paid” $34.12. It’s totally bonkers and should be illegal.

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

#237

Post by jimbokun »

Zambyte wrote: post #163
pbhjpbhj wrote: post #138

Earlier 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.

Software I write at work is not artistic expression yet is covered by copyright. This isn't a counter argument, just pointing out how absurd copyright is.

Your software is definitely artistic expression. You signed over the rights to those expressions to your employer.

(IANAL)

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

#238

Post by Capricorn2481 »

Workaccount2 wrote: post #177
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

Because 92% of Americans have health insurance, and 22% have totally free everything covered health insurance. Of the uninsured, most either are eligible but don't apply, have insurance through work but forgo it, or are not US citizens. All said and done, you end up with a very small sliver of people who are legitimately uninsured, which means the problem mostly exists as scary stories rather than people actually exp…

Wildly false. This thread is full of people sharing stories of being supposedly "insured" and getting fucked anyway. The complete lack of transparency around what your insurance covers, something you can't be expected to verify while in the middle of a dire medical crisis, can lead to a life destroying bill.

Nobody should have to be wondering what company an ambulance works for. It's crazy. The whole world thinks it's crazy.

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

#239

Post by BeetleB »

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,…

> 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, supposedly). Even with insurance it will be at least $50k/yr out of pocket

I can see them being out of network this year, but can't you change insurance in the following year to one where it will be in network?

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

#240

Post by kenjackson »

CGMthrowaway wrote: post #91
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…

>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. What exactly do you think negotiating is? Real negotiation in business transactions is more ofte…

People want so badly that AI won't be useful that I feel like they will diminish everything they do. I also get that they probably feel like it's all hype, but there are plenty of examples of real value that AI brings to the table.
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