Compare hospital codes to Medicare before you negotiate
Claude helped price a hospital bill by Medicare rates so the patient could challenge the charges himself.
- What they did
- Matt Rosenberg asked the hospital for the coded UB-04 version of the bill, then had Claude turn each billing code into a spreadsheet using Medicare payment amounts. Claude first asked for details such as the insurance type, the place, and the year, then flagged lines that looked overstated, including charges that may have been split apart, a bypass procedure meant for inpatient-only use, and a ventilation item. Rosenberg ran the work through ChatGPT, checked key items himself for about 20 minutes, and drafted the letter without AI writing it for him.
- How it went
- Claude put the Medicare total at about $28,675 for a hospital bill of $195,628. The hospital replied with $36,356, and the matter ended around $32,500, or about $163,000 less than the original bill.
- Tips
- If the first spreadsheet comes back with zeroes on some lines, ask more questions and rerun the analysis. Use the output as a starting point for your own review, not as a substitute for legal advice.
Try it yourself with Claude
I’m pasting a hospital bill with billing codes and a total of [amount]. For each line, look up the Medicare payment rate for [insurance type], [location], and [year], then make a table showing the billed charge, the Medicare amount, and how far apart they are. Point out any lines that seem split apart, repeated, unusually priced, or worth a second look, and give me a short list of negotiation points I can use in a letter that I will write myself. After the analysis, stop and wait for my approval before doing anything that would send, submit, pay, or delete anything.
Fill in the [brackets]. Agents can make mistakes, so review anything before it is sent, paid or deleted.
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