Hypothetical question
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.