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Anthem Denials of Emergency Room CT Scans and MRIs; Patients Sent to Clinics

Anthem Denials of Emergency Room CT Scans and MRIs; Patients Sent to Clinics August 6, 2018. By Anne Wallace.
Washington, DC In July 2018, the American College of Emergency Physicians filed an insurance lawsuit against Anthem Blue Cross Blue Shield over the insurer’s new policy of denying emergency room coverage after the fact. As a subpart of the strategy, Anthem refuses claims for in-hospital CT scans and MRIs ordered in the course of emergency diagnosis and treatment. The lawsuit focuses on the harm the policy does to patients. But it also shines a light on the damage that Anthem’s plan does to hospitals and the wider healthcare system.
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Sen. McCaskill Probes Anthem Emergency Room Coverage Denials

Sen. McCaskill Probes Anthem Emergency Room Coverage Denials July 28, 2018. By Anne Wallace.
Washington, DC On July 17, 2018 Sen. Claire McCaskill’s office released a report detailing the results of an investigation into Anthem Blue Cross Blue Shield’s efforts to cut costs by denying emergency room coverage after the fact. Many of these insurance claim denials were eventually reversed. But Anthem may have succeeded in its overall goal of dissuading patients from seeking emergency care. A bad faith insurance lawsuit filed with California’s Department of Managed Health Care further shows how a combination of intimidation and delay can wear patients down. The good news, though, is that claimants who persist often win.
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Anthem Refuses to Cover Emergency Room Care After the Fact

Anthem Refuses to Cover Emergency Room Care After the Fact July 18, 2018. By Anne Wallace.
Sacramento, CA Anthem Blue Cross Blue Shield denies emergency room coverage for patients whose symptoms later prove to have been non-life threatening. This has been a long-standing practice, but it is now official policy in six states. Are California patients protected under California insurance law?
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