Anthem Blue Cross Blue Shield in Missouri recently notified emergency service providers that they would deny coverage for services already provided when Anthem decides the services were not for a true emergency. The reason is that they are trying to reduce inappropriate use of the emergency department. But, will some individuals delay or not seek important and life-saving care when they may really need it?
The Missouri Hospital Association, Missouri State Medical Association, Missouri Association of Osteopathic Physicians and Missouri College of Emergency Physicians believe this is unfair to individuals who have health insurance through Anthem, and puts patients at risk. Federal and state laws require coverage for emergency services for any symptom that leads a person possessing average knowledge of health and medicine to believe immediate care is required. Anthem’s policy expects patients to diagnose their own condition and make a clinical decision that could be the difference between life and death.
We need your help. MOCEP has worked with the groups listed above to create a webpage for providers and patients to share their stories. We encourage you to submit your stories, and if you hear from a patient that an ED visit was denied, please encourage them to submit their story. It is important that we gather this data to provide fair coverage for our patients.