Oh my, where to start?
I don't live in America, Nicole. I'm an Australia citizen.
Some years ago, after having a hysterectomy, and with top cover, I went to my insurance provider to check on the huge after-surgery costs.
I asked for a breakdown of the expenses and noted a name in theatre that I'd not come across, complete with a bill from him.
I asked who he was and was told he was observing on the day.
I responded that I did not give permission for his observing, and politely asked that his time be extracted from my bill.
And it was!
That one incident made me double-wary!