My wife had a medical condition at the beginning of April and I took her to the nearest ER, which is out-of-network because at that point I just needed someone to examine her. There, she was diagnosed with a hemorrhagic stroke. The neurosurgeon present said it was a lot of bleeding in the brain and he heavily recommended us to get a surgery to removed as much blood from the brain as possible so we opted to do that. The surgery happened the same night as the ER visit and then she was admitted to the ICU afterwards. We recently got our Explanation of Benefits from our provider and while the ER visit was counted as in-network, the surgery itself was billed as surgery and not as ER. As a result, the patient responsibility of anesthesia and surgery totaled to about $23,000. By my understanding, No Surprises Act should cover surgeries performed during the ER visit. I have just filed a dispute of these charges and contacted the social worker of the hospital which the ER visit was done at to try to get additional documents supporting my case. In the meantime, if I can get more information on what I should be doing and looking out for, that will be extremely helpful. Thank you in advance.
Update: Her insurance is through her employer and is Blue Shield of California.