Matt Rosenberg
@mattrosenberg.bsky.social
Marketing guy, former sitcom writer, pizza maker, proprietor of www.maphousewellfleet.com, politically engaged. Comments are my own wise-assery and political pov and do not reflect on any organization I am part of besides the human community.
Weren’t you guys the hackers that promised to expose every rotten thing about Trump (and other rotten things). Are you just a social account now? Where are the revelations?
November 16, 2025 at 7:51 AM
Weren’t you guys the hackers that promised to expose every rotten thing about Trump (and other rotten things). Are you just a social account now? Where are the revelations?
At least we have that.
November 16, 2025 at 7:48 AM
At least we have that.
Seriously, some people are way too cynical. Also, if you're a Brit, please don't vote for Farange and his brethren--if they privatize NHS, you'll soon be in this sort of mess. Single payer is the only way American health care can be saved, don't screw up yours. Ours is NOT better in any way.
November 11, 2025 at 8:10 PM
Seriously, some people are way too cynical. Also, if you're a Brit, please don't vote for Farange and his brethren--if they privatize NHS, you'll soon be in this sort of mess. Single payer is the only way American health care can be saved, don't screw up yours. Ours is NOT better in any way.
Thank you for reading this. I hope it helps someone fight back. I posted this to Threads last week and it went quite surprisingly viral. From those comments I want to say up front that I am a writer and a marketer but I have no AI clients and this was my actual experience, not a campaign for AI.
November 11, 2025 at 8:10 PM
Thank you for reading this. I hope it helps someone fight back. I posted this to Threads last week and it went quite surprisingly viral. From those comments I want to say up front that I am a writer and a marketer but I have no AI clients and this was my actual experience, not a campaign for AI.
I had access to tools that helped me land on that number, but the moral issue is clear. Nobody should pay more out of pocket than Medicare would pay. No one.Let’s not let them get away with this anymore.
November 11, 2025 at 8:10 PM
I had access to tools that helped me land on that number, but the moral issue is clear. Nobody should pay more out of pocket than Medicare would pay. No one.Let’s not let them get away with this anymore.
Ultimately, my big takeaway is that individuals on self-pay shouldn’t pay any more than an insurance company would pay—and which a hospital would accept as profitable business—than the largest medical payer in the country.
November 11, 2025 at 8:10 PM
Ultimately, my big takeaway is that individuals on self-pay shouldn’t pay any more than an insurance company would pay—and which a hospital would accept as profitable business—than the largest medical payer in the country.
I’ve done a lot of this kind writing. Claude helped with facts and math, but you need to calibrate the language.
November 11, 2025 at 8:10 PM
I’ve done a lot of this kind writing. Claude helped with facts and math, but you need to calibrate the language.
Hospitals know they are the criminals they are and if you properly call them on it they will back down. That doesn’t mean yelling, that means writing a letter a lawyer might write, with the correct cadence and tone and threats.
November 11, 2025 at 8:10 PM
Hospitals know they are the criminals they are and if you properly call them on it they will back down. That doesn’t mean yelling, that means writing a letter a lawyer might write, with the correct cadence and tone and threats.
Yes, AI assistants can hallucinate and give you garbage. So I didn’t rely on it. I spot checked by looking up its big findings myself and found it was right. I also had ChatGPT, to which I subscribed for one month just to do this, read the letter and fact check it. No notes.
November 11, 2025 at 8:10 PM
Yes, AI assistants can hallucinate and give you garbage. So I didn’t rely on it. I spot checked by looking up its big findings myself and found it was right. I also had ChatGPT, to which I subscribed for one month just to do this, read the letter and fact check it. No notes.
So we are now right in the middle and the hospital accepted. Here are the morals I draw from this experience. If you have the money and they want it, you have more power than you might think. An invoice isn’t an entitlement. Fight with knowledge. My $20 subscription to Claude paid for itself.
November 11, 2025 at 8:10 PM
So we are now right in the middle and the hospital accepted. Here are the morals I draw from this experience. If you have the money and they want it, you have more power than you might think. An invoice isn’t an entitlement. Fight with knowledge. My $20 subscription to Claude paid for itself.
I presented this to my sister-in-law and suggested we split the difference. She had been afraid of being sent to collections and asked why we wouldn’t just take their counter-offer. I said, that’s four thousand more dollars you’ll have and they didn’t earn it.
November 11, 2025 at 8:10 PM
I presented this to my sister-in-law and suggested we split the difference. She had been afraid of being sent to collections and asked why we wouldn’t just take their counter-offer. I said, that’s four thousand more dollars you’ll have and they didn’t earn it.
We said we weren’t looking for charity, we were negotiating price and we had caught them in a bad place that they couldn’t defend in court or in public. Don’t make threats you aren’t willing to follow through on. We were. And it worked. They came back and asked for $37k.
November 11, 2025 at 8:10 PM
We said we weren’t looking for charity, we were negotiating price and we had caught them in a bad place that they couldn’t defend in court or in public. Don’t make threats you aren’t willing to follow through on. We were. And it worked. They came back and asked for $37k.
With Claude’s help, I wrote a letter explaining their billing violations and threatening legal action, bad PR, and appearances before legislative committees if they didn’t take what Claude calculated Medicare would have reimbursed them.
November 11, 2025 at 8:10 PM
With Claude’s help, I wrote a letter explaining their billing violations and threatening legal action, bad PR, and appearances before legislative committees if they didn’t take what Claude calculated Medicare would have reimbursed them.
The hospital wanted to discount the bill based on charity because they are obligated to provide charity to keep their tax exempt status. Bills are a fiction so the hospital can write off accounts and look like they are somehow doing right by people, this is an effed system. So we didn’t play.
November 11, 2025 at 8:10 PM
The hospital wanted to discount the bill based on charity because they are obligated to provide charity to keep their tax exempt status. Bills are a fiction so the hospital can write off accounts and look like they are somehow doing right by people, this is an effed system. So we didn’t play.
We told the hospital they had billed an unconscionable amount. They suggested we apply for charity assistance. But here’s the thing: my sister-in-law is not a charity case. He left a million dollar life insurance collection. She could have paid.
November 11, 2025 at 8:10 PM
We told the hospital they had billed an unconscionable amount. They suggested we apply for charity assistance. But here’s the thing: my sister-in-law is not a charity case. He left a million dollar life insurance collection. She could have paid.
A third was ventilator services, which Medicare says you can’t bill for on the same day as a critical care issue. Supplies were billed between 500% and 2,300% of Medicare reimbursement. The hospital made up its own rules, its own prices, and figured it could grab money from unsophisticated people.
November 11, 2025 at 8:10 PM
A third was ventilator services, which Medicare says you can’t bill for on the same day as a critical care issue. Supplies were billed between 500% and 2,300% of Medicare reimbursement. The hospital made up its own rules, its own prices, and figured it could grab money from unsophisticated people.
So, if they did that thing then they would have had to re-bill everything else under inpatient rules and if they didn’t then why was it on the bill?
November 11, 2025 at 8:10 PM
So, if they did that thing then they would have had to re-bill everything else under inpatient rules and if they didn’t then why was it on the bill?
That was over a hundred grand of cost that Medicare would have reimbursed zero dollars for. Another was a code that was inpatient only and because it was an emergency he had never been admitted.
November 11, 2025 at 8:10 PM
That was over a hundred grand of cost that Medicare would have reimbursed zero dollars for. Another was a code that was inpatient only and because it was an emergency he had never been admitted.
Like going to a restaurant and being charged for the experience of eating a pizza and then getting separate bills for the dough, the sauce, and each pepperoni.
November 11, 2025 at 8:10 PM
Like going to a restaurant and being charged for the experience of eating a pizza and then getting separate bills for the dough, the sauce, and each pepperoni.
Claude figured out that the biggest rule for Medicare was that one of the codes meant all other procedures and supplies during the encounter were unbillable. So the hospital had billed us for the master procedure and then again for every component of it.
November 11, 2025 at 8:10 PM
Claude figured out that the biggest rule for Medicare was that one of the codes meant all other procedures and supplies during the encounter were unbillable. So the hospital had billed us for the master procedure and then again for every component of it.
Looking up codes wasn’t helpful. There are rules to each code. And this is where it got interesting. I fed the itemized bill and codes to Claude (AI).
November 11, 2025 at 8:10 PM
Looking up codes wasn’t helpful. There are rules to each code. And this is where it got interesting. I fed the itemized bill and codes to Claude (AI).
No reply. “Oh, we meant to send it. We upgraded our computers 5 months ago and nothing works.” Uh-huh. Finally got the CPT codes. It’s not like medical care is just a menu of things they do with a cost for each. Four $31 low-dose aspirin. I take that 81mg aspirin. A bottle of a thousand cost $8.
November 11, 2025 at 8:10 PM
No reply. “Oh, we meant to send it. We upgraded our computers 5 months ago and nothing works.” Uh-huh. Finally got the CPT codes. It’s not like medical care is just a menu of things they do with a cost for each. Four $31 low-dose aspirin. I take that 81mg aspirin. A bottle of a thousand cost $8.
I helped my sister-in-law negotiate these down but they weren’t back breakers. Then the hospital bill came: $195k. This is a story about that. We asked for a bill with the standard CPT codes.
November 11, 2025 at 8:10 PM
I helped my sister-in-law negotiate these down but they weren’t back breakers. Then the hospital bill came: $195k. This is a story about that. We asked for a bill with the standard CPT codes.