General Discussion

A substantial number of anesthesiologists are out-of-network even when the hospital in which you are having surgery is in-network, so this may be a way of trying to rein in costs associated with the higher costs of care by an anesthesiologist.

When I was 5 months pregnant I had an emergency appendectomy. Insurance completely denied the claim by the anesthesiologist because they were out of network. They were eventually required to cover the costs - because the closest in-network anesthesiologist was 50 miles away. Not a good look to require a 5-month pregnant woman needing emergency surgery to research and find the only in-network anesthesiologist (and then to drive 50 miles to have surgery. (The anesthesia was complex, since they tried to operate with only an epidural to save my daughter from in-utero exposure to anesthesia. Unfortunately, they had to switch to anesthesia since there was too much pain associated with the surgery.)

I'm sure I'm not the only one who has successfully argued to get out-of-network anesthesia covered as in-network care, since most people are completely unaware that anesthesiologists are often not employed by the hospitals in which they work.

I'm not suggesting it is appropriate - just that there are reasons unique to anesthesiologists for special rules - and to some extent these rules are similar to the time limits insurance imposes, at least indirectly, on regular office visits (where payment is based on the time each kind of visit is allotted - and if the visit runs over (or the doctor chooses to schedule longer visits) there is no additional payment.