Agreed. I think the biggest problem is that the providers themselves are as much in the dark as the customers when it comes to knowing what insurance will actua

Agreed. I think the biggest problem is that the providers themselves are as much in the dark as the customers when it comes to knowing what insurance will actually pay. So they submit some highball number and see what comes back. I think what is needed more than anything else is to require insurers to provide an API to providers that will give a legally binding coverage quote instantly, before services are provided, not months later. There will be some qualifiers to that, like the provider must indicate what conditions the patient is being treated for to qualify for the procedure, and if the patient doesn't actually have that condition, then whoever falsified the information (or was grossly negligent in diagnosing) is stuck with the bill. Once that is in place, then you can require the providers to give quotes beforehand.