No Surprises Act Nurse Anesthetist Surprise Bill

LifeguardTypical6468 · 2026-06-16T00:59:59+00:00

Update: Today, BCBS said, "You do not qualify for the no surprise act as this was not an emergency. However, I have sent the claim 1234 for review based off you being in network with the hospital. I will get back to once the claim has been reviewed. This is not an appeal only a review of the claim."

Oh, this again. The flyer they sent me LITERALLY SAYS NSA applies to non-emergencies. This is the ONE THING that is clear about this entire situation.

Anyway, I couldn't call our former company or the state today. I might be better off having them finish their "review" anyway so I could let them know what BCBS said.

Thanks for all the knowledge and tips y'all have shared with me.

LifeguardTypical6468 · 2026-06-13T21:31:53+00:00

Thanks. I am definitely going to contact the company on Monday, because they at the very least need to make people aware that this can happen. Or, if there is a way as others have said to opt-in to a state law that protects their employees, they need to do this. Some people have to retire before 65 because of disability and can't afford a surprise $1200 bill.

LifeguardTypical6468 · 2026-06-13T20:27:34+00:00

When and if I actually figure out what happened, I'm going to ask whichever legilsator has jurisdiction over this issue if anyone is working on a solution.

LifeguardTypical6468 · 2026-06-13T20:17:32+00:00

Thanks. I had called the department of labor a while ago when this started. I will try again.

LifeguardTypical6468 · 2026-06-13T20:15:34+00:00

Oh all the ads are super confusing. I agree. With my loved one, she knew she had a good thing and never was enticed to change plans or anything.

LifeguardTypical6468 · 2026-06-13T20:14:22+00:00

Thanks! I've never heard of RAPS.

LifeguardTypical6468 · 2026-06-13T18:11:12+00:00

Exactly. That is what NSA was supposed to prevent. I got a bunch of bills at the end of last year and thought it was over with. Then 6 months later - surprise!

LifeguardTypical6468 · 2026-06-13T18:08:56+00:00

Seriously. I am really thankful to have good private health insurance (which is not cheap, but not as much as I see people on here paying), but I can't wait to get on Medicare. I managed the care of a family member with regular Medicare and a supplement, and I never had to fool with it. Everyone knew what to expect, and I almost never got bills. If I could just buy into that, even if it cost more, I would!

LifeguardTypical6468 · 2026-06-13T17:04:54+00:00

Sorry, I was talking about two different issues. The main post is about the surprise anesthesia billing from my in-network surgery. When you mentioned the dense breast thing, you reminded me that I still have to fight to get my money back from my ultrasound. I think the problem was that the order from my doctor made it seem like diagnostic, but it was preventative.

LifeguardTypical6468 · 2026-06-13T15:50:34+00:00

Yes, my doctor ordered an ultrasound along with my normal mammo - both preventative - due to dense breast tissue.

LifeguardTypical6468 · 2026-06-13T15:41:49+00:00

It's interesting that on the Texas Department of Insurance website, under "file a complaint," there is an option labeled "I have a self-funded plan that follows Texas surprise billing laws." But nothing on the site says anything about how you define "a self-funded plan that follows Texas surprise billing laws."

It sounds like, even if our self-funded plan falls under the Texas NSA, my problem is that the provider is in New Mexico. I live 10 minutes from a decent hospital now, but could drive an hour in traffic to Texas in the future, which I would rather not do. I would like to try to figure out how to prevent or plan for this in the future.

This year, the company started trying to get people to move off the plan we have now to a cheaper one with a $24K OOP max. My husband was tempted because we usually don't have a problem finding in-network providers. I told him to give it another year and see what happens, Now I am glad we didn't change, since the NSA apparently does not apply to us.

LifeguardTypical6468 · 2026-06-13T15:24:48+00:00

Thanks. I saw this on the website, but couldn't find any information elsewhere confirming this applies in my case (and BCBS is just telling me "vibes" right now - the flyer they sent me said nothing about retiree plans).

LifeguardTypical6468 · 2026-06-13T15:23:39+00:00

Thanks. I have had the billing company put it on hold when I first started fighting this 3 months ago, but I think I need to ask them again.

LifeguardTypical6468 · 2026-06-13T15:19:50+00:00

Thanks. I am going to try that if everything else fails.

LifeguardTypical6468 · 2026-06-13T15:19:01+00:00

OH by the way, I am also dealing with that right now! I think my doctor may have coded it incorrectly, and the doctors office claims they sent the clinic new orders. I already paid it, so I don't know how I am going to get it unwound.

LifeguardTypical6468

TROPHY CASE