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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

#891

Post by jobs_throwaway »

xtracto wrote: post #412
jobs_throwaway wrote: post #302

Earlier quoted context omitted.

> US health care which is probably one of the worst in the world Not really. If you have money, the US system is one of the best. It just really, really sucks if you don't have money.

What % of the US population would you think have to pay to get that "best" care? Would a household making $250,000 have enough to pay for that best care? That would mean 2% [1] of US household. Other comment in the thread mentioned earning "6 figures" and not being able to pay. A health system that is affordable to 2% of the population is definitely not working. [1] https://www.factcheck.org/2008/04/americans-making-…

That source is from 2008. Now (https://dqydj.com/household-income-percentile-calculator/) its at 11%. And its not a binary. Anyone making six figures (nearly half of households) should be able to easily afford the best care. I'm sure there are people with spending problems who are exceptions to this.

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

#892

Post by tonymet »

vjvjvjvjghv wrote: post #492
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,…

The stuff you are describing is what bothers me the most. There is a lot of talk about how we should have a free market system. But there is no real market for patients. Most people can't pick an insurance plan for themselves because the employer picks. Then it's extremely hard to get an estimate for anything. And even if you get an estimate, it's most likely wrong. Then the billing is totally opaque. Insurance and p…

That’s true. The ideal case of elective MRI or planned surgery (like a hip surgery) are the exception. In most cases you have to make a decision on the spot. In our case we were basically told to move forward within 3 weeks or mortality would be much more likely.

Moving to another provider is like starting over with paperwork, records , diagnostics tests, building relationships . We already did one transfer due to insurance requirements and lost about 90 critical days that we can never get back. Images were lost preventing a proper diagnosis.

I’m not against free market medicine in principle but the current billing, records and regulations make it impossible with our setup.

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

#893

Post by alemanek »

georgeecollins wrote: post #630
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…

If this were true, the number of Americans I have known who moved to Europe would be roughly equal to the number of Europeans I have known who have moved to the US. That's not data, that's anecdote. But what is the European country where more people go there from the US than come to the US from there?

All the benefits OP lists are at or below mandated minimums for Western EU countries. It’s trivial to lookup and confirm for yourself.

In software the money difference you still end up ahead of where you would be on an equivalent salary in the EU. Also last time I was considering a move to the EU job market was weaker than the US. Also you still need to get all the necessary work visas which aren’t automatic. Even as a dual citizen I can’t just show up to work at a company in the EU.

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

#894

Post by tonymet »

kamaal wrote: post #780
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,…

>>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. Here in India when my dad underwent bypass surgery, I checked the bills the breakdown is insane. This how a charge goes, Nurse comes to see you, so she wears a pair of gloves, that gloves is billed. And often something like 10x the p…

It’s funny that USA is supposed to be an advanced economy but all of those billing issues happen here. Nearly every procedure is preceded with a pointless “consultation” that is ~$1500 for 15 minutes convo with a doctor. It’s worse than an email basically “how are you feeling , what can i help you with – oh that’s normal we can’t do anything about that”. And all the same absurdity billing for gloves, baby aspirin .

We were laughing at some of the bills. Blood draw $500 . 10 minutes of work and a few dollars in disposables. Billed at $3k / hour.

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

#895

Post by tonymet »

sevenseacat wrote: post #857
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,…

As a non-American, I can't even comprehend this level of shitfuckery. At all.

I’ll borrow that. Here’s a serious “shitfuckery” convo we had. I asked my wife to guess the cost of one drug for 12 weeks. I guessed $150k , she balked and said I was crazy, and guessed $30k. Actual price : $300k

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

#896

Post by jack_tripper »

danlugo92 wrote: post #860
jack_tripper wrote: post #505

Earlier quoted context omitted.

I don't think that contradicts what I said previously but feels more of an off-topic tangent. And of course when you earn US wages you can afford to get private care in Europe out of pocket given how lower wages in Europe are in comparison to US, which is why plenty of locals like low income people and pensioners can't afford private healthcare.

> which is why plenty of locals like low income people and pensioners can't afford private healthcare. False equivalence fallacy. As those locals have free access to public healthcare which is not only cheap but also actually on par with US healthcare standars if not higher in certain places. > when you earn US wages you can afford to get private care You're implying private care is expensive, sure, but what 99.99% o…

> but what 99.99% of people do in Europe is get private /insurance/

Source for the 99,99% claim?

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

#897

Post by keybored »

georgeecollins wrote: post #630
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…

If this were true, the number of Americans I have known who moved to Europe would be roughly equal to the number of Europeans I have known who have moved to the US. That's not data, that's anecdote. But what is the European country where more people go there from the US than come to the US from there?

> If this were true, the number of Americans I have known who

People only live in one unvarnished (more or less) reality at a time. Americans live in America and get told stuff about “Europe”; Europeans live in Europe (or their respective countries if we want to get anal about it) and get told stuff about America. Only a very very small number of people get to live in multiple places and for long enough stretches of time to be able to compare them pretty fairly.

In what kind of dream reality do people come to have such perfect (I’m being hyperbolic) information about other places that they then are able to base their move-or-not decisions on? This is just not reality. People know what their own place is like. They “know” other places through propaganda, mostly.

But Americans are so propagandized that you have to teach them about their own propaganda.

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

#898

Post by terminalshort »

mcherm wrote: post #839
terminalshort wrote: post #818

Earlier quoted context omitted.

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…

I am in 100% agreement with you about dental insurance, but that's a completely separate system.

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

#899

Post by keybored »

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,…

People discover that they are healthy until one day (when they live long enough) that they are not.

> 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.

The world does not move in a positive direction at the direction and discretion of “great technical minds”. They are too busy being narrowly technically brilliant that they fail to see what a sufficiently generalist and curious 15-year-old could figure out what is the root cause. Which this post demonstrates.

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

#900

Post by IG_Semmelweiss »

bilekas wrote: post #830
IG_Semmelweiss wrote: post #811

Earlier quoted context omitted.

This is why insurance plans have out of pocket maximums. To prevent this exact issue. We can say whether those maximums are still too high (some really are), but the mechanism is there. The real issue is that most people don't have a rainy day fund to deal with such emergencies. And that they are too expensive anyway. There are 2 concepts you should always keep in mind. 1. Always avoid the hospital unless you are lit…

> Hospitals may sue you, depending on the state, but that carriers reputational risk I'm sorry but if I need a hospital, my first thought isnt, "well how is their reputation". I don't understand why people defend the insurance system in the US when you're already paying taxes. If it's not the responsibility of the government who you pay to take care of their people in an emergency then what are taxes for. It's like p…

What we have is not insurance.

What we have is all-you-can-eat ferrari care

Insurance is what i have when i drive my car , or get water damage insurance for my house.

The monster we have today is not insurance. Instead, it is the frankenstein born out of the womb of bureaucrats and politicians influenced by money. Decades of tinkering politicians without a clue, messing around with the relationship between the doctor and patient, responding to voting patterns of the electorate, led us to today.

Unless you blow it up, (and it will blow up, just like it happened in sweden) there's no solution, except paying more for ferrari all-you-can eat.

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