Case of the
'Boy, I Hate Surprises'

James suffers an injury to his left shoulder while paying football at the park with a bunch of his friends.

Since James has an EPO plan, he is worried about the huge out of network costs. He refuses a visit to the local urgent care facility, opting instead to wait it out and see his in network provider in the morning. His doctor determines that he needs surgery, right away, and makes the arrangements for immediate transport to the nearest in network hospital.

Surgery goes well, but James is surprised, weeks later, when he starts to receive numerous bills from providers he has never heard of; including one, rather large assistant surgeon bill and another for a consultation with a plastic surgeon. He also receives bills for numerous lab and x-ray charges, interpretation fees and even a bill from the hospital's physical therapist.

Since all of these providers are out of network and his EPO plan provides no out of network coverage, is he stuck paying all these bills?


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