<prompt> Human: Backstory: My wife had an epidural birthing our son. All of our bills were fairly nominal but today we received a bill from the anesthesiologist for 4500, stating that insurance only paid 456 of it, with a message that said they dont participate in our insurance but that they make additional payment if we call.Bill no personal info: This was unexpected and seems borderline egregious for a 90 second stop in to poke her back, but I digress.Id like to know the best route to minimize the cost of this bill if possible. What verbiage do I need to use and do I need to work with the Anesthesiologist or Insurance first. If anyone had advice or an order of operation to avoid such an expense my wife and I would appreciate you.  <response>: The doctors office deals with this regularly, which is why they put the note on the bottom of the bill. Call your insurance company and tell them you went to a participating facility and had no in-network option for an anesthesiologist because the only one there was out-of-network. You will probably have to file an appeal of the way they handled the initial bill. Whether theyll make a payment to bring the cost down to what it would have been in-network probably depends somewhat on your insurance policy. If you read through the policy itself, they may mention this situation and how its handled. 