Patients outraged by Anthem ER visit policy change - CBS46 News

Patients outraged by Anthem ER visit policy change

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(Source: WGCL) (Source: WGCL)

This week The American College of Emergency Physicians put out a series of videos criticizing Anthem Healthcare for scaling back it's emergency room coverage.

Anthem, the group that offers Blue Cross Blue Shield of Georgia, has announced it will not pay for emergency room visits that it deems unnecessary.

The news has sent ER doctors and hospitals into deep concern that patients would stay home trying to self-diagnose and save money.

ER physicians like Michael Lipscomb who is a member of ACEP say patients shouldn't try to decide at home if they need care in fear of the cost.

"To delay medical care when you feel or perceive that you have a serious emergency or potential serious emergency is really dangerous," says Lipscomb. "Some of the video illustrate some of the patients I saw over the weekend. Patients with the exact same symptoms and one patient has a life-threatening medical problem, and one patient doesn't, and that's reality. That's why you seek medical care."

CBS46 reached out to Anthem. They stood by their policy saying in a statement:

If a consumer feels he or she has an emergency they should always call 911 or go to the ER. Bur for non-emergency healthcare needs, ERs are often a time-consuming place to receive care and in many instances 10 times higher in cost than urgent care.

Lipscomb says emergency room abuse is not as common as people think. 

"The research is pretty clear. It's between five and six percent of patients who are coming to the emergency department probably shouldn't be there. That means more than 90 percent of people in the emergency department are there for the right reason."

The American College of Emergency Physicians, as well as the American Hospitals Association and the American College of Radiology all, sent a joint letter to Anthem admonishing their policy.

You can appeal an insurance denial from Anthem.

A spokesperson says they are enhancing the ER policy and applying new procedures to previously denied claims. They will overturn denials if the new procedures would have resulted in an approval.

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