Last summer, Anthem’s Blue Cross Blue Shield of Georgia changed its emergency room policy to stop covering trips to the ER it deems unnecessary. As the insurer has been expanding the policy in other states, a group of ER doctors has launched a video campaign against the policy.
In a pair of video ads released by the American College of Emergency Physicians, patients are deliberating whether or not they should go to the ER.
In one of the videos, a man at the gym struggles with chest pains and grabs a defibrillator. A woman urges him to go to the ER, but he hesitates and says he has to try the device first.
“I have Anthem insurance and if I go to the ER with chest pain and then it just turns out to be injured ribs or something, then Anthem could deny my claim, and I’d get stuck with the entire ER bill,” the man in the video says.
John Rogers, a Macon doctor and president-elect of the American College of Emergency Physicians, said the insurer’s policy can prompt patients to question their symptoms.
“Basically, they’re asking patients to decide or to diagnose themselves before they come to the emergency department, which is our job,” Rogers said.
Anthem said in a statement that it’s “avoidable ER program to reduce the trend in recent years of inappropriate use of ERs for non-emergencies as the costs of treating non-emergency ailments in the ER has an impact on the cost of healthcare for consumers, employers and the health care system as a whole.”
The company said if it denies a claim for an ER visit, patients have the right to appeal. The insurer said it’s made a number of changes to the original policy to “ensure that [the] program is implemented effectively across our participating markets.”
The company said it won’t deny a patient’s claim if in certain circumstances, including if a patient lives more than 15 miles from an urgent care center, or was directed to the ER by a provider.
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