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Surprise Billing & Out-of-Network Fees: What You Need to Know

Published on Sep 15, 2025 | 1:25 PM

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Imagine going to the ER in the middle of the night for sudden chest pain. You’re scared, you do everything right—show your insurance card, sign the paperwork, get treated. Then weeks later, you open a bill for thousands of dollars. The shocking part? You thought your insurance covered it. This is what’s known as “surprise billing.”

 

What Is Surprise Billing?

Surprise billing happens when you receive care from a provider or facility that’s outside of your insurance network—often without your knowledge. Even if the hospital itself is in-network, certain doctors, like anesthesiologists, radiologists, or ER physicians, may not be. Their services can generate hefty out-of-network fees you never expected.

Why Does It Happen?

  • Hidden Out-of-Network Providers: Hospitals may contract with specialists who aren’t on your plan.
  • Emergency Situations: You don’t have time to check networks when you’re rushed to the ER.
  • Limited Provider Access: In some areas, there may not be many in-network options.

The No Surprises Act

The good news is that laws have recently changed. The No Surprises Act, which took effect in January 2022, offers protection from most surprise bills by:

  • Prohibiting balance billing for emergency services at out-of-network facilities.
  • Preventing out-of-network charges for certain in-network hospital visits.
  • Giving patients an estimate of costs before elective services.

Still, not every situation is covered. Some outpatient services and elective procedures may still lead to out-of-network fees if patients aren’t careful.

 

How to Protect Yourself

  • Check your network: Always verify that both the facility and providers are in-network.
  • Request an estimate: Ask for a Good Faith Estimate before planned procedures.
  • Know your rights: If you get a surprise bill, you can dispute it under the No Surprises Act.
  • Consider telehealth: Many online providers are transparent about pricing upfront, reducing the risk of hidden costs.

How CallOnDoc Helps

At CallOnDoc, we believe healthcare should be affordable, transparent, and stress-free. That’s why:

  • You see flat pricing before your visit—no hidden fees, no surprise billing.
  • Prescriptions are sent directly to your preferred pharmacy, often with coupon support to lower costs.
  • You get nationwide access, meaning quality care without worrying about networks or out-of-pocket shocks.

Healthcare is complicated enough. Billing shouldn’t be the part that keeps you up at night. With the right knowledge and the right care partner, you can stay protected and focused on your health—not your wallet.

 

Because treatment should be as simple as a text.

Tap. Type. Treated. Start-to-finish in 15 minutes.

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Shelly House, FNP,

Shelly House, FNP, is a Family Nurse Practitioner and Call-On-Doc’s trusted medical education voice. With extensive experience in telehealth and patient-centered care, Ms. House is dedicated to making complex health topics simple and accessible. Through evidence-based content, provider collaboration, and a passion for empowering patients, her mission is to break down barriers to healthcare by delivering clear, compassionate, and practical medical guidance.

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