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Interesting idea, but I imagine it suffers from similar issues to writing legal opinions: by signing your name to it, you're swearing that it's all true. Given AI's propensity for making things up, you need to check everything.
I wouldn't be surprised if 'knowingly filing a false appeal' is a reason to boot you off the plan in the first place.
It's still a lot easier to review and understand something you weren't able to write than to also write that same thing without knowing how to write it.
I wouldn’t be surprised if ‘knowingly filing a false appeal’ is a reason to boot you off the plan in the first place.
For that to be an issue you would have to "know" it was false.
You signed it, verifying that you knew what it entailed. That's what the comment was pointing out.
Usually when signing things off like this, it's affirming that you believe all statements to be true. They would have to prove you willingly lied, not that you were simply wrong, which is very difficult to prove legally.
That said, IANAL.
Pictured: average Lemmy user.
I wish the average Lemmy user was writing open source tools that help people fight mega corps. That would be amazing!
might try that tbh, what're your ideas?
I’m not sure what you can do. But she wrote a cool tool that generates appeal letters automatically. Just find what is bothering you and work on it.
Same thing but to automatically send emails to your local political representative. Bonus points if I don't even have to know who it is
Too thin
It’s free for users, though she might eventually charge for added services like faxing appeals.
She should sell the home addresses of health insurance executives.
And golf clubs. She should definitely sell golf clubs.
Unrelated fact, but on the topic of golf clubs, they are pretty slender. I think they may bend if you hit a large object with them.
That's why Casey Jones traded the golf club for a hockey stick in the first movie. At which point he opened a can of whoop ass all over the foot clan thugs.
Gave it a go. Seems like it has potential. I'm still working through an appeal. My wife ended up in the ER in May and was directly admitted to the hospital for emergency surgery. Ten days afterwards we received a letter from the insurance company saying they had decided it wasn't medically necessary so they wouldn't be paying the $67k bill.
It has been a journey trying to get the appeal together. I had hoped the hospital would at least assist with a letter from one of the many physicians that attended her, but nope. We got laughed at by the surgeons office and told condescendingly "Yeah, that's not how any of this works. "
My biggest concern from the AI generated appeals are being able to confirm the statements it is making isn't just a LLM hallucination. As a lay person, much of the things necessary to make an argument are paywalled out of reach. For example, the insurance company cited the "2023 InterQual criteria for Surgical Conditions" as the reason why they are denying it. The AI appeal that was generated states that per the 2023 InterQual criteria for surgical conditions that hospitalization was medically necessary.
The only way it seems you can actually get access to InterQual is as a medical provider / payer.
In an ideal ~~world~~ country, we would have a different system, but we don’t live in an ideal ~~world~~ country, so what I’m shooting for here is incremental progress and making the ~~world~~ country suck a little less,”.
It’s a good article. Don’t let that American exceptionalism creep into it.
...This is just a network switch/router.
You sound like one of them fancy book reading types you get the fuck out! Lol
We love some good news to start the day
Yeah, honestly the appeal is a standard step in the bottom surgery process in the states. I know one lady who had to explain to her insurer why removal of the penis was a necessary step in her vaginoplasty.
You go human
Hehe her dog is a donut hole with a PhD.
I think the PhD may be honorary in Timbit's case. Though I suppose if she has a doctorate as well, she may have used him as a rubber duck, and therefore given him credit on her Doctorate Thesis, thereby granting him a doctorate as well? I dunno if that would work.
Gender affirming surgery can be the opposite of health care, supporting what neuro-diversity thinks it needs is often harmful to that individual. For example, you wouldn't prescribe unlimited sleep for someone with narcolepsy.
The states has bad healthcare but this is a misleading article, and not necessarily in support of patient health.
Maybe take that transphobic take to a community that doesn't have LGBTQ+ resources as a pinned thread.
Could you please point out how their statement was transphobic? Basically, what they said is just that "gender affirming surgery can sometimes be harmful to health", and surely that's just a true statement, not even an opinion, really.
They are saying gender affirming healthcare is often harmful when the medical literature available says the exact opposite. What motivation do you think they have for misrepresenting available medical knowledge?
Here's your reminder about gender affirming treatments like testosterone pills and jawline surgery and hair transplants: Elon got all three
And i think he eats bulking powders enough for Arnold, but forgot the training.
Okay, i happen to actually have narcolepsy & be gender nc, and have a trans partner, i feel like i can speak with some authority on this.
Gender affirming surgery can be the opposite of health care
Every surgery can be, but gender affirming care is one of the least regretted surgeries in existence. By opening this way, you frame the argument as different for trans healthcare. Its not.
We're also not children. Dont infantilize trans people. We have the same right to make choices others don't understand, just like cis folks can.
And narcolepsy is a chronic inability to get delta wave sleep. Extra sleep is absolutely treatment. I can see what your getting at, but you're choosing examples you don't understand and misinforming people.
An opinion that ignores all actual research.
Gender affirming surgery helps 99% of people who receive it! So sure, technically, there's a tiny minority who regret it. More people regret Lasik and boob jobs, should we ban those too? Many people regret a night out drinking, how about we ban that too. Drinking causes way more harm than giving estrogen or testosterone pills to folks.
On the other hand, I like that my friends have the freedom to express themselves any way they want. They aren't hurting anyone so let's let them be free to wear whatever clothes they want and take whatever hormones they want.
So join the side of American freedom and let's stop policing what clothes people wear or what name they use.
What does one need im order to get a prescription for unlimited sleep? I gotta get on that