Chatbots haven’t totally nailed fighting medical bills

Not every news story pitching some “game-changing” or “dystopian” AI tech is worth your time.

But this week, a couple stories stuck out to us about navigating somewhat more mundane uses of AI in health care, and we wanted to share our takeaways.

First: what you should know about those AI scribes in the exam room.

And then, a new look into how well popular chatbots work fighting medical bills — and which tools are best.

In the exam room, you have a say about the scribe

While on the exam table chatting with your doc, you might not be thinking about the possible third set of ears in the room — the AI scribe.

But according to this recent KFF Health News story, “Can I opt out of having my doctor take notes with AI?”, nearly a third of physicians are now using these notetakers to record patient visits.

And it sounds like there can be some real benefits — like getting to look your doctor in the eye as you talk, instead of talking to the back of their head while they type away. But, there are also concerns, like how that data from your conversation will be used by the third-party operator.

Your doctor is supposed to ask for consent to use a robot scribe. But according to the KFF story, laws governing exactly how they ask — whether having you sign something or not — vary state by state.

So if you want to be absolutely sure they don’t use one, you might want to ask at the outset.

And as with everything generated by AI: It hallucinates sometimes. If you opt to let that scribe go ahead and type away, it might be worth checking your health records after the appointment to make sure the doctor’s notes are accurate. (I know — one more to-do. Ugh.)

When using chatbots to fight medical bills, be aware of the pitfalls

It’s not news to First Aid Kit readers that folks are experimenting with chatbots and other AI tools to fight bills and appeal insurance denials.

Add to that (unofficial) data set the stories in this new report from The New York Times (gift link).

According to experts and patients interviewed by The Times, some of the most popular AI tools like ChapGPT and Claude regularly miss the mark on medical bill advice — and miss important avenues for fighting back. Especially the one we talk about the most: charity care — aka financial assistance that as many as 60% of us likely qualify for.

Dollar For founder (and friend of our show) Jared Walker is quoted in the story, saying that when he asked ChatGPT a hospital billing query, it downplayed charity care.

There are also privacy risks. Chatbots aren’t covered under HIPAA. That means, according to The Times, that what you tell a chatbot could be used all kinds of ways — including in court. (Like, in say, a custody battle.)

Our big takeaway from all of the above: Always check if you qualify for charity care.

And if you’re going to use a chatbot to help you fight back against your provider or insurer, leave personal information, like your name and social security number, out of your prompts.

Non-bot options

Instead of a ChatGPT or Claude, consider using a free AI-tool specifically designed for dealing with medical bills, like the model Holden Karau made for her project Fight Health Insurance.

Or, check out the Marshall Allen Project, an AI trained on the reporting of the late journalist Marshall Allen, author of Never Pay the First Bill.

Or, go full analog. We have guides on appealing insurance denials or fighting huge medical bills.

Check ‘em out, and maybe you’ll find you already have the tools to fight back without needing a robot’s assistance!

If you use any of these tools to fight back against a big bill, we want to hear how it goes.

A postscript to last week’s newsletter: I had a call with Katherine, the listener from Georgia who wrote in about the text she got from her provider with a click-to-pay link.

Turns out, the bill was legit, but she still paid with a check in the mail. “Because then, at least I have some receipt of what I did,” she said. Right on!

We’ll be back with a new episode next week. Till then!

— Claire