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But most people in most western countries tend to be insured by default through some national system if they have a legal job, or, if their system is private like in the US, then heath insurance is mandatory for everyone, unlike in the US.
US is kind of a "wild west" where people can live and work, sometimes illegally, and not be insured if they don't want to. Weird system.
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.
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 credit score, so, fuck you basically." The bill was revised to $500, which he paid just to not have that debt on his record.
Earlier quoted context omitted.
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.
I suppose a saving grace there is that Medicare is incentivized to help people or at least not incentivized to provide the minimum amount of value for maximum profit.
You could probably tell them to eat dirt,the receiver of services can't be collected against as he's no longer physically here.
Getting the money from his estate would probably take years, if possible at all. I am not a lawyer, so I might be completely wrong, but suing a widow for 200k would be a nightmare for any hospital.
Anyway, maybe one day we'll join the civilized world and not bankrupt families for the crime of being suck.
While 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…
Just tell the hospital you don't have much money but will pay what you can with cash. I got a $2k bill down to $200 like that. The system is totally absurd.
But the raw numbers like $200k for this poor gentleman’s heart attack or $500k aren’t the most alarming. It’s the Terry-Gilliam-level of absurdity of the billing process. Absolutely no one will tell you how much things are, and when you ask, they sass you that it is a ridiculous question. Even though one of my providers just recently started offering estimates, those are off by 100-200% , and completely missing for about half of what has been ordered.
We are both very strong accountants, and despite trying to do audits of these services, it’s impossible. There are 3-4 levels of referred services, bundled codes, nested codes, complication / technical / professional codes , exceptional status codes . Providers overbill, double bill. On accident and on purpose. When we call to get it corrected there is no way to make corrections.
You’ll be asked to take a diagnostic not knowing whether it will cost $10 or $15000 . Even if you try to be responsible and call the provider (who isn’t your doctor, clinic, or hospital ) – they won’t be able to tell you.
The point I’m trying to make isn’t to make you sympathetic. It’s to reinforce in all of the great technical minds here that healthcare billing is the most complicated spaghetti code cluster flock of a system that you’ve ever imagined. It’s far worse than any piece of software you’ve ever seen. And we all just accept the bills and pay them.
Supply and demand and finding a better vendor doesn’t work. There are some rare exceptions like elective MRIs – but those aren’t the norm. Nearly every service is something time sensitive or your disease will get significantly worse. Moreover, signing up a new provider has $1000+ in billing and a few hours in paperwork to make the transfer. is it worth saving $500 for one MRI when $250k worth of services are unaccountable?
The only thing I’m sure of is that there has to be tremendous amounts of incidental and deliberate corruption . Auditing a single patient’s billing is impossible – so a population’s worth is a goldmine .
I've just ignored any medical bill I don't agree with or think was fair ($10k+ worth in the last 10 years). At least in new york state there has been no downside for me. It never went on my credit score and I bought a house a few years ago.