Surprise billing is an unexpected event that requires significant financial resources. That’s hardly a unique economic phenomenon, and the usual solution is … insurance! The unique aspect of this event, however, is that it takes place in the context of an insurance contract. What could be modified? There are really two pieces: the surprise and the bill. The former can be ameliorated by giving patients clear, up-front knowledge that they will be treated by an out-of-network provider and perhaps providing an estimate of the likely charge. That would reduce the surprise element of the phenomenon.