Naturally they would not wake you up mid-procedure for payment, nor ask you for payment later. What anthem wanted to do was put a cap on the number of billable hours per procedure, and have anesthesiologists accept payment based on that cap as "payment in full", meaning they would not expect additional payment for the extra time they spent after a procedure went long, either from the patient or the insurerer. This would have resulted in anesthesiologists making less money (as well as having less opportunity for fraud), which is why they didn't like it.
But it was presented in popular media as if the insurance company was trying to shift the cost of overlong procedures onto the patient, rather than onto the anesthesiologists. Thankfully there was a public outcry and the anesthesiologists won, well-deservedly so considering they must be barely scraping by on a median income of $470,000/year.
> What anthem wanted to do was put a cap on the number of billable hours per procedure, and have anesthesiologists accept payment based on that cap as "payment in full", meaning they would not expect additional payment for the extra time they spent after a procedure went long, either from the patient or the insurerer.
The policy even had a path for the anesthesiologist to justify the overrun so that portion could be covered too. No doubt Anthem would scrutinize the justification closely and reject cases where they detect abuse, and the incentives are for Anthem to be too strict, but there was nothing wrong with the policy on its face. These sorts of things are absolutely necessary in order to drive healthcare costs, which are absolutely obscene, down.
But it was presented in popular media as if the insurance company was trying to shift the cost of overlong procedures onto the patient, rather than onto the anesthesiologists. Thankfully there was a public outcry and the anesthesiologists won, well-deservedly so considering they must be barely scraping by on a median income of $470,000/year.