Is it an Emergency or not, Patients must decide?

Now I have heard it all.  Patients receiving bills for ER visits that were ruled Non-emergency by their insurance company.  Yes, Anthem Blue has denied thousands of claims after review of treatment for ailments determined not a serious health risk.

So, if you think you are having a heart attack and it turns out to be indigestion look for the bill or at least a fight to get benefits.  This is all being done to defray costs associated with the overuse and misuse of the emergency room hospital care. If the insurance company deems your care as “minor” you may be getting a bill for your ER visit.

This policy is meant to reduce the use of the emergency department because it is one of the most expensive places to receive medical care.   Most people would not want to sit in the ER for 5 hours if they had a simple sprain or chest cold; it is the chest pain, back sprain, abdominal pain or suspected broken bone that brings many people to the ER.

I have visited the ER with my children in the past because the doctor’s office and the urgent care were closed.  My daughter at age 16, came home early from work with a bad pain in the middle of her abdomen. Though most people would have dismissed it as menstrual or the flu, I immediately suspected appendicitis because it runs in the family.  She was in acute pain as time went by in the ER, but I could not get her seen sooner. We came in at 7:00 pm and she was diagnosed at 2:00 am and entered surgery stat for the removal of her appendix.

It is not right for a patient who isn’t sure whether it is truly an emergency or not to postpone immediate care because they may not have any coverage.

It would be wise to check with your health insurance coverage to see what their policy is on emergency room visits.


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