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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

#741

Post by robertritz »

sidewndr46 wrote: post #59
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…

having hired an expert in this field, I can tell you they aren't really that sophisticated. I found myself with an absolute mountain of cash after an accident as part of a settlement. My medical insurance won't pay claims until I've exhausted that cash. The claims I had were much higher than even the mountain of cash. The lawyer I hired use a pretty effective strategy: he contacted all of the claims against me and to…

He literally did a prisoner's dilemma on them. Love it.

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

#743

Post by trollbridge »

frikskit wrote: post #726
georgeecollins wrote: post #676

Earlier quoted context omitted.

OK, but by that logic lots more USA citizens should be moving to the UK, Ireland, Spain than the other way around. That's just not the case, at least until very recently. I could see that the appeal of Ireland can be increasing and Poland sounds cool. I'm not saying that the USA is great, it has tons of problems.

Net migration US/Ireland is positive to Ireland. UK numbers yes, though maybe gloomy weather plays a role? Just kidding. That said, Brits are slightly more likely to move to Spain than US despite it being a tiny country in comparison and not necessarily easier to move to after Brexit. Spain, not sure. It’s tricky to compare since non immigrant Spanish speaking population in US is probably significantly lower than Spa…

America has around 42 million fluent Spanish speakers (based on # that speak Spanish at home).

Spain’s entire population is 48 million.

I have never met an American that migrated to Spain.

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

#744

Post by trollbridge »

frikskit wrote: post #722
LastTrain wrote: post #672

Earlier quoted context omitted.

Your wand would also need to erase the reason people speak (or don’t speak) the languages they do, otherwise what you said would already be true for the UK, Australia, etc.

Would it? People don’t exclusively learn English to migrate to the US. What language do you think Germans and Spaniards use to do commerce with each other? There needs to be a common language, there’s no bandwidth to learn all languages, so due to historical and modern reasons, English prevailed. Re Australia, Australians have highly preferential options to move to US which is not reciprocated.

Same for NZ, Canada, UK…

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

#745

Post by sowbug »

mr_toad wrote: post #566
onionisafruit wrote: post #150

Earlier quoted context omitted.

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

I’m sure it’s crossed the mind of many people in the industry. But it’s a comprehensive taxonomy of all diseases, medical conditions, causes, procedures and treatments. Starting from scratch would be much more expensive than just paying the licensing.

Here in California, Senate Bill 478 bans many junk fees, such as the mandatory "service fee" to buy a concert ticket. It's a stretch, but I could see an argument that if hospitals use a billing system that's incomprehensible without licensing an expensive codex, then the hospital is on the hook to provide the codex to you.

Fight fire with fire.

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

#746

Post by amarant »

gonzobonzo wrote: post #715
Aurornis wrote: post #438

Earlier quoted context omitted.

> 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…

> For those who don't attend the prestigious universities with large endowments, average in-state state-run University tuition is under $10K, though again a large percentage of students receive some form of aids or grants to bring that number down even further. This is an extremely important point that keeps getting ignored. People keep comparing _public_ schools in Europe to _private_ schools in America. To further…

>People keep comparing _public_ schools in Europe to _private_ schools in America

Not necessarily the case. In Sweden private schools are paid for by the government, assuming they have been approved by the CSN (central agency for study-support(rough translation))

I don't know how that works in the rest of Europe, because I've never studied outside of Sweden. But in Sweden it doesn't really matter if the school is private or public. The only instance you have to pay yourself is if the school isn't sufficiently good to pass muster.

Also, again in Sweden at least, but possibly other parts of Europe as well, the tuition isn't effectively $0. The government will pay any student enrolled in higher education a monthly support. Back in my day it was 10k SEK per month (roughly 1000usd), no strings attached. Not sure how it currently stands but I imagine it hasn't changed much.

This money is meant to ease the burden on students, so that they can put more focus on studies.

"Working your way through collage" over here means you'll have a 20% job to pay for your cost of living minus the 10k SEK mentioned above.

The difference in cost of study is quite real, even taking your comment into account

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

#747

Post by maxerickson »

tptacek wrote: post #660
maxerickson wrote: post #597

Earlier quoted context omitted.

A lot of people with FSAs will have insurance that disqualifies having an HSA. I have the paranoid idea that they designed FSAs in such a goofy way for budget scoring and it drives me nuts.

The preceding comment was discussing HDHPs, which depend on HSAs.

You think it's obvious that "lesuorac" was scoping their comment to people that have an FSA with an HDHP?

Doesn't read that way to me.

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

#748

Post by tptacek »

maxerickson wrote: post #747
tptacek wrote: post #660

Earlier quoted context omitted.

The preceding comment was discussing HDHPs, which depend on HSAs.

You think it's obvious that "lesuorac" was scoping their comment to people that have an FSA with an HDHP? Doesn't read that way to me.

It's obvious in that they specifically referred both to HSAs (not FSAs), and to HDHPs, which depend on HSAs, not FSAs. FSAs are not a kind of HSA.

So, yeah. Little bit.

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

#749

Post by CivBase »

kwanbix wrote: post #363
georgeecollins wrote: post #278

Earlier quoted context omitted.

I think the reason is that people know it is a problem but ideologically they really disagree about what to do about it. The impasse creates an opportunity for profit driven actors to fight reforms. Also, democracies do dumb things sometimes. See Brexit. But also, sometimes people from other countries-- I am thinking parts of Europe-- underestimate how well paid people in the US often are. They compare the averages,…

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. Health care is expensive as fck.

University isn't near as big of a problem. That's not something the blindsides you like health care expenses. Nobody is making you spend $300k on university. Got my engineering degree at a public university for ~$100k in total and had it paid off 5 years after graduation. But a $195k hospital bill is something I'd never be prepared for. Nobody chooses to go to a hospital.

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

#750

Post by trollbridge »

stronglikedan wrote: post #573
egorfine wrote: post #253

Earlier quoted context omitted.

[flagged]

Yes, but we also want universal healthcare. What we don't want is only universal healthcare with death panels like the UK and Canada has. Give us universal health care where we can also get insurance if we want, and we'll vote it in. That's never what comes up though. I firmly believe we could gut medicare/medicaid and the savings from the bureaucratic administration costs alone could pay for universal healthcare.

Note that Massachusetts and San Francisco have universal healthcare. Mass. is also home to one of the best healthcare systems and children’s hospital in the word.
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