What is even the point of the "No Surprises Act" if there’s all of these loopholes to it and the patient still ends up screwed? [CA]

My husband had an ER visit three months ago at which time he was in so much pain he hadn't slept in 3 days and was literally pacing around the waiting room. Turned out he had a huge kidney stone which was blocking urine to his bladder, making him borderline septic, and his kidneys were literally shutting down. I've never seen the Hospital rush anyone back so fast. He ended up needing surgery. They pumped him full of morphine and antibiotics immediately and he was still in pain but doped to the gills. There was a bunch of paperwork he needed to sign, some they brought in at midnight for him to sign. He was obviously in no position to read it, let alone able to understand it in the state he was in.

We have an HMO, went to an in network hospital. We paid all of our copays immediately upon receiving them, nearly $1,000 when we have a Premium plan with as little copays as possible. Whatever, we were able to pay it and everything turned out okay.

Today, we get a bill from some random third party biller telling us that one of the treating physician (who we didn't even recognize the name and never even met!) was actually NOT in network, not employed by the hospital, and is billing us separately. I asked them how they can do this given the "No Surprises Act" and the rep says, "It was on line 6." So, my husband completely unknowingly gave consent to allow the "No Surprises Act" to be void on one of the thousand forms they had him sign, and it was "on line 6".

I called our insurance and they said that we can appeal the bill once the claim is submitted, but I am so angry and frustrated. How can they even do this? How is this legal? There were no outright discussions with us that one of the treating physicians, who, again, we never even met, wasn't in network or employed by the Hospital. My husband's kidneys were failing and he was in immense pain. How could he give consent for them to screw us like this in that condition?!

This is likely going to take months to sort through and fight, and I don't know that we'll even win the appeal given that my husband apparently signed something saying he waived his right to the "No Surprises Act." I just don't understand. This is so messed up and so not okay.

submitted by /u/aint_noeasywayout
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