Private members-only forum

Surprise $14,000 bill after surgery - hospital used out-of-network anesthesiologist without telling me

Started by ImmigrationAttyMJ_32 · Feb 21, 2024 · 1 replies
For informational purposes only. Healthcare billing laws vary by state and individual circumstances. The No Surprises Act has specific requirements and exceptions.
IM
ImmigrationAttyMJ_32 OP

Had knee surgery last month at an in-network hospital with an in-network surgeon. Everything was pre-approved by insurance. Got home, thought I was done.

Then yesterday I get a bill for $14,200 from some anesthesiology group I've never heard of. Turns out they were out-of-network. I had NO choice in this - I was literally unconscious when they provided services!

My insurance says I'm responsible for the balance after they paid their "usual and customary" amount of $1,800. The anesthesiologist billed $16,000 total.

How is this legal? I'm in California if that matters. I specifically chose an in-network hospital to avoid this exact situation.

NA
not_a_bot_i_swear_12 Attorney

Excellent outcome! This is exactly how the law is supposed to work. Keep that letter forever - scan it and save it in multiple places smh.

For others reading this: the No Surprises Act is one of the most significant consumer protection laws in healthcare in decades. Know your rights!