It’s a common problem.
A patient with insurance is admitted to an in-network hospital. Weeks later, the patient gets a bill for thousands of dollars from an out-of-network doctor they never met.
It could be from an anesthesiologist, radiologist, or other provider involved in the patient's care. The doctor sent the bill because they don't accept the patient's insurance.
Anthony Wright, executive director of the non-profit group Health Access California, said in these situations, doctors and insurance companies need to take the lead.
“There should be a way to figure out what is the appropriate compensation," Wright said. "But the wrong thing to do is to simply shift those costs and charges onto consumers.”
California patients are already protected from surprise bills in emergency rooms. But a new Assembly bill proposed by Rob Bonta would expand those protections.
The bill would allow enrollees who visit non-participating providers for covered services to pay the same cost had they gone to a participating provider.
Thirteen states have some form of protection against surprise bills from out-of-network providers.
