Have you ever gone to a hospital or had a procedure done and when you get home and open the bills that you thought were all covered by your insurance ... only to get a big surprise? The term is "balance billing" and it's when folks outside of your insurance network are involved in your health care. Even though your hospital may be in-network, the doctors, labs and others may not be and you'll be billed at their normal rates.
I've experienced this problem myself when the anesthesiologist turned out not to be in my network, even though I'd called to check ahead of time for an elective procedure. Even my insurance company admitted there's no way to be sure even when you try to be careful.
At 23 Texas hospitals that contract with the state's three largest PPO plans there are NO emergency room doctors who are in those plans' networks. Talk about being at the mercy of the medical system!
Texas is one of the states trying to eliminate this Catch-22 of medical billing but the medical industry is fighting it as always. Doctors and others seem to feel they have a God-given right to earn more money every year regardless of the economy or what's going on with other industries. They think they really can walk on water.
The BIG question is how much medical spending is going to destroy the American economy? It's already nearly 18% of our GDP and many doctors expected health care to be nationalized when it reached 5% (which was a long, long time ago). What are we going to do and when?