You’re watching your son play outside in a beautiful summer day. He’s running, playing with the family dog. Suddenly he falls, crying out as he lands on the ground. You run to him and find that he can’t put any weight on his ankle and it hurts to move. What do you do? If you’re like most people you go to the emergency room.
Recently, Blue Cross Blue Shield sent letters to customers in Georgia, Missouri, and possibly other states letting them know that it won’t reimburse for some emergency room visits that it decides aren’t emergencies. If you arrive at the ER and learn that your son only sprained his ankle, instead of it being broken, that is one of the circumstances listed where Blue Cross Blue Shield says they won’t reimburse. You’ll have to pay for the entire visit out of pocket simply because you didn’t diagnose your son’s injury and decide to go to the urgent care instead.
Blue Cross Blue Shield claims that this isn’t designed to deny care. However, it clearly is designed to control costs. Most of us are not doctors. We did not go to medical school. And yet over and over again insurance companies are pushing medical care, medical decisions onto patients and their loved ones in the name of cost containment.
It’s obvious really. What would you do if you got a letter in the mail saying that the emergency room visit may not be covered? You wouldn’t go unless you really had to, and that’s going to save the insurance company money. It’s also has the potential to impact your health. Who’s looking out for the patient now?
Be a part of the solution and share this to let others know. The more we spread the word, the more we’ll fight back against these practices.
For over 25 years, Dr. Nordella has served patients in the Santa Clarita and the San Fernando Valley and has a long history of confronting the Anthem Blue Cross’ business practices which focus on profit instead of facilitating access to quality healthcare and treatment for patients. After a 10-year litigation history with Anthem, Dr. Nordella was successful in receiving a favorable judgment--something the LA Times stated had not been done by a solo practitioner in over 25 years. He is currently the Medical Director at Porter Ranch Quality Care in Porter Ranch, California.