<prompt> Human: My wife had breast surgery. The location, surgeon, and everything else was in-network. Except this one anesthesiologist. He is billing us direct for the amount not covered. We have gone through insurance twice. We werent told he was out of network. Should we have asked every single nurse and doctor in the place?Options now? What to do next time?Update: Call just now. Cigna already processed an In Network Exception we had called once before to send it back throughDr. Just hasnt cashed the checks.Thank you all for the help. You were all mostly right and together completely correct in my course of action.  <response>: Check with your state regulator. You may live in one of the 15 or so states that have legislated protections for people who incur unavoidable out-of-network charges. California, Florida and New York, for example, have extended those protections beyond the ER to all hospital stays. Even states without such protections may have resources to help you resolve the problem. Keep in mind, its not always obvious which state office handles these complaints. In New York, for instance, its the Department of Financial Services. To find out who you should contact, go to the Consumers Union complaint tool and type in your state. Youll find the appropriate agency and any nonprofit volunteer organization available that can also help.Contact the provider who sent the bill. Now its time to call the provider directly. Ask to speak to the person in the office that handles billing. Inform him or her of your surprise charges, why you think they are unfair and any protections in your state that youve learned about. Ask the provider to reduce your bill to the amount that would be covered if the provider were in your network. When pressed, providers will often lower the bill.Source: 