Patients are becoming increasingly aware of out-of-network billing practices, and they don't like what they see, according to an article in the Los Angeles Times.

The paper reports that, when teacher Lynne Nielsen found out an ASC had charged her insurer $87,500 for a "routine, 20-minute knee operation that normally costs about $3,000," she called on the California attorney general's office to investigate the "insane" out-of-network markup. (Blue Shield of California covered $84,800 of the bill.) According the article, the AG has opened an inquiry.

The Times writes, "surgery centers seek out well-insured patients …, sometimes by waiving their copays and deductibles, and then bill their insurers exorbitant amounts for out-of-network care." The result, according to critics cited by the paper is rocketing insurance premiums for businesses and patients and some insurers "have begun to challenge these bills." Aetna Inc. and UnitedHealth Group Inc. in particular are said to have pursued action.

In Ms. Neilsen's case, Blue Shield and the surgery center, Advanced Surgical Partners, have agreed to a lower payment amount, the Times reports.

Stephanie Wasek