Check a hospital bill against what Medicare would pay
- Level Intermediate
- Setup1–3 hrs (estimated)
- Evidence Strong evidence
- CostNot stated in source
- No-codeNo
What they did
A writer gave Claude the coded hospital claim (UB-04) for his late brother-in-law's $195,628 ER bill and asked it to build a spreadsheet of Medicare rates per code. Claude flagged bundled items billed separately, a bypass charge for a procedure that never happened, and a ventilation charge Medicare does not allow.
How it went
Claude estimated Medicare would have paid about $28,675. He cross-checked the work with ChatGPT and Medicare's own rules, wrote a six-page dispute letter, and settled at about $32,500, roughly $163,000 less than the bill.
Worth knowing
- Ask for the itemized bill and the UB-04 claim form first; the summary bill is too vague to analyze.
- He checked Claude's numbers with a second AI and the Medicare rules before sending anything. Large language models can make up codes and rates.
- He wrote and negotiated the letter himself. The article warns against using AI as your lawyer.
Prompt
Core command is original; setup is cleaned from the source.
Make a spreadsheet with these CPT codes and research what Medicare pays for each one in [state, year]. Flag anything that needs further research, and explain any code where Medicare bundles the payment into another procedure.
Recommended
Try it in Grok Bot
Originally done with Claude; this prompt works in Grok Bot.
- Copy the prompt (button below).
- Open Grok Bot chat and paste it. Replace any [bracketed] placeholders.
- Connect the listed tools (Spreadsheet) as connectors when Grok Bot asks.
- If the task repeats, ask: "Make this a daily routine."
Alternatives: the same prompt works in Claude, ChatGPT Agent, OpenClaw.
Set it up
Tools: Spreadsheet · Stack: Claude + Spreadsheet
- Read the original source for full context (Business Insider — Claude analyzed the bill; a human wrote and negotiated the letter).
- Get the itemized bill and UB-04 claim form (summary bills are too vague).
- Connect a Spreadsheet tool, paste the prompt, and replace [state, year] and your CPT codes.
- Cross-check rates before you send anything. You write and negotiate the dispute letter — the agent assists.
Setup tailored for honesty with source #166; verify every rate yourself.
Evidence
Ask for the itemized bill and the UB-04 claim form first; the summary bill is too vague to analyze. He checked Claude's numbers with a second AI and the Medicare rules before sending anything. Large language models can make up codes and rates. He wrote and negotiated the letter himself. The article warns against using AI as your lawyer
Source: Web · 2026-02-13 · Verified by us: not yet · Report broken or outdated