“Everyone knows a billed charge is bull shit. It’s like a sticker price on a new car. No one ever pays full billed charges unless they are brain dead. Leon has developed an AI tool that cuts through the bull shit” – Bill Rusteberg
By Leon Wisniewski
“I am pleased to present to you our AI Medical Bill Reviewer. Now people have the information they need to pay or dispute their medical bill at point of sale.”
Next week on July 4th will mark four years since I launched my website to sell the hospital price transparency data. Price transparency has been a journey for me, for sure.
The problem I thought I was setting out to solve wasn’t really the problem. It was only after years of studying people with the price transparency data available did I finally **understand** what the real problem was.
The consumer/patient is disengaged from the cost of the care, employers don’t want to change their benefits even if its overpriced, and intermediaries make money when the cost of care goes up. Furthermore, medical bills contain many different codes, are unstructured, and impossible to read. Then there’s hundreds of millions of pricing data rows and it’s virtually impossible for anybody, including me, to discover the true cost for care from a medical bill.
To change healthcare people have to be able to measure the amount they pay to their employer plan versus non-employer alternatives; and decide which one they want.
Thankfully there’s been an explosion of investment dollars in data centers, chips and ai in just the last two years that makes new programs available to solve business problems. To make the impossible possible. Without that my idea to fix healthcare does not materialize.
With that said I am pleased to present to you our AI Medical Bill Reviewer. It will read pictures of your medical bill, transform the image into a machine readable file, reprice to a lower commercial rate (or cash rate if its cheaper), then text and email you the repriced bill with the supporting data. Now people have the information they need to pay or dispute their medical bill at point of sale. Or when they get the bill a few weeks later. And ultimately measure the value of their employer plan versus non-employer alternatives. This is also an awesome utility for TPAs to manage their out-of-network bills.
We offer this service directly from our website with low cost subscriptions or a white label solution. Any organization, retirement advisor, employer, health share, church group etc can put their name and logo on the website and offer it to their members/employees. The prices for this service are included in the pamphlet below. As always, if I expect hospitals to post their prices then I have to post my prices. You deserve to make sure your dollar buys value from companies that open themselves up to competition. Welcome to the future of healthcare
The graph below illustrates the difference between billed charges and “real” charges.
The Re Line represents Billed Charges and the Green Line is cost of care hospitals attest to in their annual filings to CMS. This illustration is on a hospital in McAllen, Texas. The “real price” is somewhere between the Red Line and the Green Line, the price each hospital is known to accept from commercial payers.
Third party intermediaries make money off the spread. A lot of money. More money than you can shake a stick at. And most plan sponsors have no clue because it’s designed that way.
