871–880 of 954 posts
Earlier quoted context omitted.
On what basis are you refusing to pay? Services were rendered...
Refusing? ... you misunderstand. I'm from a country where we have a national insurance scheme. And I'm incredibly glad about that.
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…
Reading between the lines, it seems like this is a threat made to bring AMA in line with the administration's policies around medically supporting transgender people. I would expect that if (when) the AMA folds on the matter, concerns around the codes will be somehow forgotten
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…
So what you're saying is the AMA is openly hostile to Americans.
the AMA is their homie and is sponsored by them
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> I'm curious, where do you live that denies a child a life saving surgery just because insurance won't cover it? Because in the US there's laws against that. Maybe I'm just too skeptical, but a) This is a very new account with exactly 1 other posting 3 months ago, and b) They don't refer to their child with any sort of gender. They even used slightly awkward sentence construction just to avoid gender. Few parents th…
Or they value privacy? Especially regarding their children? Many people nondescriptly don’t gender themselves in online discussions.
Could be, but they made only a single other posting and are effectively not even pseudo-anonymous, but completely anonymous.
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Routine stuff is never denied in the US either. I've never had one thing denied ever and I even have a weird condition that requires expensive testing to diagnose and even more expensive treatment (narcolepsy). The insurance companies will throw up annoying bureaucracy like prior authorizations, and made me switch medication to generic when it came out (reasonable) and then back from the generic to another brand name…
Odd that your experience would be so different from mine. I routinely experience denials. To give an example, about 60 to 80% of the time, when I visit the dentist for a regular cleaning the charge is denied and I have to submit additional paperwork to convince them to pay it. I can't think of any more simple and basic procedure than that. I have no idea why your experience with healthcare in the US is so much better…
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Do you think countries with even the most coveted universal healthcare just approve everything blindly? Should everyone (anyone?) receive monoclonal antibodies, gene therapies, biologic medications? What criteria should be used to make these determinations?
> Do you think countries with even the most coveted universal healthcare just approve everything blindly? Yes. Everything that they are trained and able to do here, is covered by the national insurance, at least where I live. We never even have to explicitly ask them to approve anything, it's all automatic. You don't see the bill. You might have to pay the difference for "nonessential upgrades", like a plastic cast i…
Earlier quoted context omitted.
Do you think countries with even the most coveted universal healthcare just approve everything blindly? Should everyone (anyone?) receive monoclonal antibodies, gene therapies, biologic medications? What criteria should be used to make these determinations?
> Should everyone (anyone?) receive monoclonal antibodies, gene therapies, biologic medications? What criteria should be used to make these determinations? Yes, if that's an indicated and effective treatment. Do you think people should just be left to die if they can't pony up the dough in the hospital? Oh, your card's declined, no oncology ward for you?
What if they have a 99% likelihood of death, are unlimited funds expended in this case?
What if there's a shortage on drugs - who should get the limited supply available?
Which country with public health options pays for biologic medications or similar patient-tailored solutions?
So close, yet so, so far! If a corporation commits fraud against you, and you literally ask if the corporation has committed fraud against you, and you proceed to voluntarily send that corporation THIRTY-THREE THOUSAND DOLLARS anyway, are you not a willing co-conspirator in the fraud?
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.
A hospital is vastly more complex. They have huge costs (for things they must have) that can’t be recovered 1:1 with services.