I’m not sure who of you have read last week’s blog in regards to Blue Cross and Blue Shield of Georgia stating they would not reimburse for a particular diagnosis from an emergency room visit.

Let’s look at a clinical scenario: a 13-year-old boy plays in his front yard and suffers an inversion injury (twisted) to his ankle causing much pain and swelling with discoloration. He cannot bear weight. The parents are now in a quandary because they know if they take into the emergency room and the x-ray is negative for fracture he will be diagnosed as a strain/sprain treated with ice, elevation, decreased weight bearing, and Advil for pain. If the final diagnosis is a strain/ sprain the parents will be responsible for the full emergency room charges which are quite costly (another problem). If they do not take their child to the emergency room and tell him to suck it up and he has a fracture which extends into a growth plate classified as a Salter fracture, healing may not occur properly and the child could bear a permanent problem.

I can think of thousands of scenarios that could bear the same potential negative outcome and many only worse.

So what will it take for the people to pay attention and say enough is enough? The Insurance industry could not be more bold and brash in regards to their behavior, destroying the physician patient relationship. Where are the political lawmakers? Where are the plaintiff attorneys that love to litigate the insurance industry? Where are the people to stand and fight?

You can kill the beast, stop feeding him! They love fun money and money alone. They have no ethics, no morals. And the question that is always asked is “how you sleep at night?”. I imagine they sleep just fine!

When will it stop? Only when you, the people, stop it!

Jeffrey Nordella M.D.
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Jeffrey Nordella M.D.

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.
Jeffrey Nordella M.D.
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