Anthem Overturned Most Appealed ER Claims It Had Denied

“Health insurer Anthem’s policy of denying reimbursement for emergency department visits later deemed not enough of an emergency sparked outrage and lawsuits from healthcare providers and lawmakers when it was rolled out to several states in 2017 and more this year,” Modern Healthcare reports.

“They feared that hospitals and ED doctors would be delivering care without getting paid and that patients would be saddled with massive medical bills that could deter them from seeking care in an emergency in the future.”

“It turns out that Anthem’s policy did lead to a big spike in coverage denials among ED patients in Georgia, Kentucky and Missouri last year, according to a report by Sen. Claire McCaskill (D-Mo.). But Anthem ended up overturning the majority of denied claims that patients appealed.”

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