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Mon Dec 31, 2018, 06:29 AM

Why an insurance policy change has some ER doctors worried in Mississippi

A physicians group is raising concerns about a planned Blue Cross & Blue Shield of Mississippi policy change it says could lead to less care being covered when a patient comes into the emergency room.

The Mississippi chapter of the American College of Emergency Physicians said it's worried about a change where the insurer will review ER bills so "level of care" charges more closely align with the patient's diagnosis and not their symptoms.

The group is concerned the policy set to take effect next year means tests and treatments related to the "ruling out" process would no longer be covered. But Mississippi's insurance commissioner said the move is meant only to stop hospitals from over-billing related to the severity and complexity of an ER visit.

"A patient experiencing chest pain who fears that he or she may be experiencing a heart attack should be covered for his or her visit, even if the condition turns out to be a non-urgent medical condition, such as a hiatal hernia," the ER doctors wrote in a recently distributed letter, which has not been sent to the insurance company.

Read more: https://www.clarionledger.com/story/news/politics/2018/12/28/blue-cross-blue-shield-insurance-change-limit-coverage-ms-er-mississippi/2387867002/

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Reply Why an insurance policy change has some ER doctors worried in Mississippi (Original post)
TexasTowelie Dec 2018 OP
Ilsa Dec 2018 #1

Response to TexasTowelie (Original post)

Mon Dec 31, 2018, 06:50 AM

1. Looks like BCBS is testing this change in MS.

It's a disgusting attempt to save money by having people self-diagnose whether they need emergency care. It's not what ERs are for, it's not what insurance is for.

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