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Thursday, November 29, 2018

Anthem among health insurers refusing to pay ER bills, doctors say

On Aug., 1, 2017, Brittany Cloyd of Frankfort, Kentucky, said she experienced pain "worse than childbirth." Her mother -- who had been to nursing school -- drove her to the nearest emergency room. Brittany thought her appendix had burst, but tests at the ER found she had ovarian cysts. She was given pain medication and told to follow up with her primary doctor.

Cloyd had an Anthem Blue Cross PPO health insurance plan and thought she would get charged just a co-pay for her ER visit. Instead, 15 days later she received a letter from health insurer Anthem. "Your condition does not meet the definition of emergency," read the letter. She was responsible for the total ER bill -- $12,596.

What Brittany endured is becoming more common in the health insurance industry, according to a Doctor Patient Rights Project (DPRP) study. It highlighted Anthem, which through its affiliated networks is the nation's largest private health insurer. The DPRP contends that Anthem has instituted an organized policy of denial designed to make its subscribers -- particularly those who are poor and reside in rural areas -- too afraid to go to an ER for fear of receiving a bill like Cloyd's, or more, for the visit.

More here

9 comments:

Anonymous said...

if you like your health plan you can keep it

Anonymous said...

I can attest the ovarian cyst pain is excruciating and would warrant an individual to seek immediate care. My episode occured one night while out with friends at a bar at 10PM and sadly there wasn't a doctors office open at that time. I was also admitted to the hospital.

BUT had I gone to my doctor, he would have told me to go to the hospital because he would not be able to diagnose whether it was my appendix or a cyst.

Laughingly I had a policy that if I went to an urgent care center and they deemed the problem not to be urgent care related they would refuse to pay the bill.

Basically at this point they want 14K for a policy and then not pay anything.

Anonymous said...

I foresee an onslaught of wrongful death suits in Anthem's future.

She fought it and won. Never take no for an answer

Anonymous said...

Let's look at this from the other side. Hundreds of millions of people go to the emergency room for a "cold." This clogs the flow of patients and costs hospitals billions. It really is a problem. The story should be about where to draw the line.

Anonymous said...

This is what you get when medical care is covered by greedy profit driven companies that care more about dividends to share holders and pay outs to senior staff than they do coverage for their clients.

It is completely criminal that Americans have to choose between financial ruin and their health care. All health care systems have flaws... but those countries with single payer systems pay less for health care, get more preventative care, catch diseases sooner making costs less, and have a higher quality of care. Did I mention no citizen has to choose financial ruin if they or a loved one gets sick?

Who do you want deciding your coverage? A profit motivated company that will drop you for any reason the moment you aren't profitable (i.e. the exact moment you need them)... OR a single payer system where the people running the system will also be bound to the same care?

I think that's an easy answer, don't you?

Anonymous said...

Obama, Pelosi and all Democrat Socialist Thanks for destroying US healthcare.

Anonymous said...

Receiving a letter from Anthem is horrifying for everyone. I fight this all the time. They are a horrible company...

Anonymous said...

"Not only can will you be able to keep your present doctor, your insurance will drop $2500.00 a year." Obama would never tell a lie...

Anonymous said...

I work for the Fire Department as a Nationally Registered Paramedic and I can tell you one thing. About 95% of the people transported by our ambulance can go by car. That is a significant amount of "patients" that should be driving themselves to see a doctor. Of those patients, they all should be making an appointment with their family physician and go see them. If they don't have a regular doctor then they should get one.

We transport about 9,000 patients to the hospital every year so that means 8,550 patients or more shouldn't be using the Emergency Room as their family doctor.

So, in reality, the Salisbury Fire Department should only be transporting around 450 patients to the Emergency Room per year.