By now, you've almost certainly become familiar with the term "Surprise Billing." And you know it does NOT mean your 15-year-old bought a new iPhone and didn't tell you.

You went to the hospital, or God-forbid, brought your child there. You even took the time to check, and the hospital is IN your health insurance company network. The ER physician, or the radiologist, anesthesiologist, or another expensive somebody, however, is NOT. Still, you give the nice lady at the desk your insurance information, sign the form (the one that first, authorizes them to treat you, and second, constitutes your agreement to pay WHATEVER amount they charge), and then you go home.

Later—and later could be as long as a year or more—you get a bill from some "ER Physicians" group for an outlandish amount of money. They are the out-of-network provider working at your in-network hospital, and THIS is the "Surprise Bill." See—we told you the term was familiar. Your insurance company either, 1) kicked back the bill entirely, or 2) offered to pay what is customary for this type of treatment (by billing code) and so the provider has billed you what they couldn't collect from insurance. It's often the very scary "gross billed amount" that is super-inflated as a way to start negotiations with insurance companies over what will be the final, discounted amount.

Dr. Marty Makary's "Medpage Today" online journal chronicles one family's experience with Surprise Billing, $22K for 10 Stitches.

The good news: The No Surprises Act was passed by Congress at the end of 2020 and signed into law by President Trump. Regulations that implement this new law take effect this coming January 1.

The bad news:  if you split your head open today or tomorrow, you'll take the risk that there'll still be a surprise bill, not [fully] covered by your insurance. Or you could hold pressure on the wound, for about 2 months or so. Unfortunately, this is what our friendly neighborhood hospital, and the insurance company that gets first crack at every paycheck have left us with.

When the new rules take effect, there'll be arbitration for settling the amount between the provider and your insurance. It should get you out of the middle, but it could affect your premiums—like there's anything out there that doesn't affect your premiums!

One last thought:  After January 1, 2022, ONLY HOSPITALS will be affected by the new law, because that's where Surprise Bills overwhelmingly come from. What won't be fixed are all of those millions and millions of scheduled MRIs, CT-Scans, ortho, cardiology, ENT, physical therapy, major and minor surgeries and everything else you THINK your insurance will take care of. You'll still be covering your deductible. Do you know how much YOURS is? And when your specialist sends you down the block for an MRI, do you know how much it is? Do you know how much the other clinic you passed on the way charges (the one that, by the way, you never even knew was there)? The difference could be in the hundreds, or thousands.

This is what DOC$ is working to help you with. Comparative, searchable data on where people like you went, and what amount they spent.

Know The Cost of Healthcare BEFORE You Go In!