This scene can happen anywhere. You are not feeling well and go to a hospital that you specifically signed up for because it’s your hospital of choice and your primary care physician fully participates with the insurance. You register in the emergency center, they take your insurance information and the entire “episode of care” begins, or as we now call it in our electronic world, your “encounter” starts.
You are discharged. Encounter complete. Three weeks later, you open your mail and find an enormous bill. You’re reminded of the old “Gomer Pyle-U.S.M.C.” episodes and Gomer smirking to Sergeant Carter, “Surprise, surprise, surprise.” The insurance you signed up for, with great thought and diligence, covered far less than you thought because not everyone who treated you was within your insurer’s network.
Some call it “balance billing,” some call it “out of network payment” – unfortunately, the term being used most often...