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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

#471

Post by tptacek »

Aurornis wrote: post #454
basisword wrote: post #384

Earlier quoted context omitted.

>> University is expensive as fck. While healthcare is brought up all the time this is usually ignored. The idea of parents saving a 'college fund' for their child is something I only know from movies. It's such a strange idea that access to education would be something you either need to be able to afford or need to get a 'scholarship' for (another strange concept).

> something I only know from movies. It's such a strange idea that access to education would be something you either need to be able to afford or need to get a 'scholarship' for (another strange concept). Like most things learned from movies, you're not getting the full picture. Most US universities charge on a sliding scale based on family earnings. For larger universities, tuition can actually be free depending on…

And, in fact, the median amount of college debt for adults who don't hold degrees is sharply lower than the overall median (it's around $10k). It's not nothing, but it's also not a life-changing amount of debt.

(By way of policy bona fides: I'd strongly support forgiving student debt for all for-profit schools, but would oppose forgiveness for degree-holders from universities, which would be a sharply regressive policy).

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

#472

Post by tsoukase »

Health care is an extremely sensitive, personal, diverse and vital part of our life. It cannot be exploited in the USA like you are in a casino, because health is a roulette. It makes us Europeans our jaw to drop. It plays no role how much you earn. It is inhuman, cruel, mocking and severely impacting the society. Developing countries surely have better systems, I don't know about underdeveloped ones.

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

#473

Post by throwforfeds »

Aurornis wrote: post #438
kwanbix wrote: post #363

Earlier quoted context omitted.

As a non-american (from South America) who lived in both USA an Europe: Yes, in USA you get much more money, like you said 2x~5x, but then: University is expensive as fck. Health care is expensive as fck. You have 5 days of paid sick leave per year in most companies. You have 10 days of paid holidays per year in most companies. In contrast, in Europe: University was cheap or free. Healthcare is cheap and universal. I…

> University is expensive as fck. One thing that's hard to understand from the outside is that almost nobody actually pays those mind-blowing $60K/year tuition prices. US universities charge on a sliding scale based on the applicants' families' ability to pay. For an extreme example: Harvard's tuition is nominally $60K per year, but for families earning $200K or less it's $0. Many prestigious universities follow simi…

Yes, but Americans have an incredible amount of student loan debt too. Something like $1.7 trillion. If you can get into one of the best schools in the world that has a huge endowment, then sure, you'll get grants and whatnot. It may even be free, in the case of Harvard. But then there's a long tail of schools that are honestly not that great, charging only slightly less than the top schools per year, with smaller aid packages, and kids sign up for crazy loans because they think they have to.

Personally I think the government should get out of the business of these loans, fully fund state schools to make them all free, and let the private schools and the private banking market deal with the rest of it. We were going down that path in CA until Reagan killed it when he was governor. [1]

[1] https://newuniversity.org/2023/02/13/ronald-reagans-legacy-t...

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

#474

Post by Izikiel43 »

pessimizer wrote: post #85
cm2012 wrote: post #13

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.

Hot off the presses: Judge Scraps Rule Eliminating Medical Debt on Credit Reports https://www.nytimes.com/2025/07/17/business/medical-debt-cre...

Unless you live in WA:

> Senate Bill 5480, sponsored by Sen. Marcus Riccelli (D-Spokane), will protect Washington consumers by prohibiting collection agencies from reporting medical debt to credit agencies.

https://senatedemocrats.wa.gov/riccelli/2025/04/22/governor-...

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

#475

Post by ajkjk »

egorfine wrote: post #253
chrisgeleven wrote: post #245

I fought insurance over this past summer after they declined covering a life saving surgery for my 6-year-old child at the last minute. We were in despair that my child's life was at risk each day we waited because of insurance incompetence. ChatGPT literally guided me through the whole external appeal process, who to contact outside of normal channels to ask for help / apply pressure, researched questions I had, hel…

[flagged]

We fucking hate it don't worry

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

#476

Post by alistairSH »

stivatron wrote: post #145

how the hell is that possible. Why isn't someone taking economical advantage of offering lower prices. Costs can't be that high.

Because there's no incentive to stop extorting the uninsured. That's all this is.

Medicaid and Medicare pay fixed fees set by the government.

Insurance companies negotiate "reasonable" fees for services.

As I have insurance, my medical bill usually looks something like...

Procedure A...... Amt Billed: $2000.......Paid by insurer: $100.... Amt Owed: $25

Where $25 is my co-pay and $100 is the fee the insurance company negotiated as "reasonable". For in-network care, the contracts disallow "balance billing" (trying to collect the $1900 in make-believe charges). For out-of-network (no negotiated rates), the hospital often will balance bill (except where prohibited by law).

It's a completely ridiculous system in which "non-profit" hospitals make billions (and write off those imaginary "losses") and insurance companies (who have to pay our ~80% of revenue on care) are happy to have inflated numbers all over the place because 20% of 100 billion is more than 20% of 10 billion.

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

#477

Post by goodluckchuck »

egorfine wrote: post #253
chrisgeleven wrote: post #245

I fought insurance over this past summer after they declined covering a life saving surgery for my 6-year-old child at the last minute. We were in despair that my child's life was at risk each day we waited because of insurance incompetence. ChatGPT literally guided me through the whole external appeal process, who to contact outside of normal channels to ask for help / apply pressure, researched questions I had, hel…

[flagged]

I think you’re just believing whatever the author says, and not considering the fact that reasonable people can disagree and be wrong and make mistakes. For all we know the procedure was entirely unnecessary and they agreed because he pushed for it. Also, what’s the alternative? The only system where you can go get procedures that authorities think unnecessary is a free market where you self-pay. A government-run system could equally decide that the procedure isn’t recommended.

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

#478

Post by dekhn »

chinathrow wrote: post #456
dekhn wrote: post #451

Earlier quoted context omitted.

I don't know, I don't run an ambulance company- what should the cost be (either to me, my insurance company, or to the government)? Can't be cheap to fully staff an ambulance with EMTs.

What's "short" in your context? 20min?

Yes, but I'm talking about the costs of actually running a 24/7 emergency vehicle operation- even completely idle, the emergency vehicle has significant costs that they need to cover.

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

#479

Post by blitz_skull »

egorfine wrote: post #253
chrisgeleven wrote: post #245

I fought insurance over this past summer after they declined covering a life saving surgery for my 6-year-old child at the last minute. We were in despair that my child's life was at risk each day we waited because of insurance incompetence. ChatGPT literally guided me through the whole external appeal process, who to contact outside of normal channels to ask for help / apply pressure, researched questions I had, hel…

[flagged]

This frame assumes several things:

1. Americans are not displeased with the situation. Ironically, I think this is one place most Americans agree there is a problem. The solution is the hard part because:

2. This presumes a drop-in solution where no one loses. This is where the fight is.

3. This presumes that democracies do what is logical or beneficial for the vast majority, which is a very naive view of democracy.

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

#480

Post by broguinn »

BurningFrog wrote: post #189
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…

It's important to understand that a "nonprofit" can be just as greedy as any other organization. It can't pay out profits to shareholders, but it can hire its owners as employees and pay them any number of millions.

Doesn't the AMA serve the medical industry? They don't have to make profits themselves. If a byzantine coding process raises medical treatment costs, they'll do it. Just like how they intentionally cap med school admissions to keep doctors in demand and inflate their salaries.
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