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I had a minor procedure a few months ago. Hospital, surgeon, etc, are all 'in-network' the anesthesiologist, however, is not. And there is only one 'group' for anesthesiologists in our town.

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I didn't even know that an out-of-network provider was involved in my surgery until after it was over. A couple of weeks after the surgery, my insurance company sent me an unexpected check for $3,000. I called and asked them about it. They said, "It's to pay the surgical assistant. They're out of network, so we can't pay them directly." I had no idea that a surgical assistant was even there. (I hadn't yet received the bill.) The insurance company told me that since I had already been anesthetized and couldn't ask the surgical assistant if they were in-network, I didn't have to pay anything out of pocket for the surgical assistant.

Anesthesiologists are never in-network, it's usually the most expensive part of having surgery in the US.

Another major annoyance -- if you have surgery, the hospital usually gets their money from you right away. However, you're going to spend the next 18 months receiving random bills from various different firms representing nurses, doctors, lab technicians, etc. related to your procedure, many of which come down to "stuff we decided to do while you were unconscious."

That has been exactly my experience with a very minor event a few years ago. The bills kept coming at random intervals for about 18 months, some for a few tens of dollars, one or two for hundreds, others for literally $0. I just had no visibility into it and honestly would only be half surprised if now, 8 years later, I received a bill for $17 for procedure AU8-QB-12 from department CO9-s4 (and the bill would mention that my insurance paid the other $872)

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