首先要搞懂自己的保险条例cover的范围，如果保险因故不能cover，或cover后还有医院和医生送来的balance bill, 这时就应该你自己去和medical provider谈判或dispute。
同一家保险公司，不同的保险计划对ER的批准和coverage都有不同的对待。譬如大的医疗保险公司如Anthem，持BlueCare卡的和持HealthKeepers卡的，这二者的ER待遇是明显不同的，持后者卡的进ER要及时报告，如果provider不在保险公司的network，即使cover，也只能按in network支付，provider可能按他们的charge将剩余额向你索要。请看下面这段说明：
An Anthem HealthKeepers member who receives emergency treatment (or someone on the member’s behalf) must notify us by calling the Anthem HealthKeepers 24-hour Nurse Advisor Line within 48 hours after receiving the care. Important note – If the provider or facility is not in the network, emergency care will be authorized for the highest level of benefits (the benefits that would be provided if the provider or facility were an in-network provider or facility). However, out-of-network providers and facilities may balance-bill their patients for the difference between our in-network benefits and their actual charges（见下面链接）
