[benmorris]

We've had 2 children in the last 4 years and this concept was foreign to me. Our 2nd child we were billed for an out of network anesthesiologist at an in network hospital. Several thousand dollars in total, I called the insurance after reading online a bit about it. Eventually they said they would "resubmit" the claim for reconsideration. A few weeks later we got an EOB showing we didn't have to pay any of it. The whole experience we shocking to me, I can't imagine dealing with this sort of thing on a regular basis.

Even worse is receiving bills from various providers up to a year later. How are these people still in business?

[redler]

Anesthesiology is a particularly pathological case, so to speak. You don't choose your anesthesiologist; it's the medical equivalent of a (very important and highly-paid) back-office function. So you've chosen an in-network hospital and an in-network surgeon? Surprise! You may also discover, months later, that your chart was read, while you were sleeping, by an out-of-network physician on call. Surprise!

The American system is literally (literally literally) unsustainable.

[wonderwonder]

How could they go out of business? Any time they need money they can just go through patient records and charge for anything they feel like with very little statute of limitations. Its a license to print money at the expense of those that can least afford it.

[fma]

Yep...I got an email last week for something for my daughter's birth...which 2 years ago. It was charged to an insurance I no longer have. I met deductible that year so everything was covered and it says I'm paying $0. They could lie about the some missing cost and I wouldn't know where to begin disputing it. If I don't successfully dispute it, it goes to collections and hurts my credit. Is my time worth disputing a $500 bill (it I had to pay it?).

It's a lose lose situation.

[village-idiot]

Regulatory capture.