Specific Situations
Out-of-Network Bill at an In-Network Facility
Going to an in-network facility does not guarantee all providers are in-network. The No Surprises Act may protect you from surprise bills.
Updated August 17, 2026 · 6 min read
Quick answer
If you receive a bill from an out-of-network provider at an in-network facility, the No Surprises Act likely protects you. Your cost-sharing must be based on in-network rates. Contact your insurer to reprocess the claim.
How This Happens
Even at in-network hospitals, some providers (anesthesiologists, radiologists, pathologists, assistant surgeons) may be out-of-network. You chose an in-network facility but had no choice of these ancillary providers.
The No Surprises Act Protects You
The No Surprises Act prohibits out-of-network providers at in-network facilities from balance billing you for non-emergency services without your written consent. Your cost-sharing must be based on in-network rates.
What To Do
Contact your insurance company and explain the situation. Your insurer should reprocess the claim under in-network rates. If the provider continues to balance bill, report them to your state insurance department.
Frequently asked questions
Can I choose which ancillary providers are used at a hospital?
In most cases, no. The hospital assigns anesthesiologists, radiologists, and other ancillary providers. You have little or no choice.
What if I signed a consent form?
Providers must obtain consent at least 72 hours in advance. If the consent was not properly obtained, the balance bill may still be prohibited.
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