September 27, 2017

Anthem could possibly charge patients for nonemergency emergency room visits in 2018

Human Resources is alerting benefits-eligible employees that this week Anthem Blue Cross Blue Shield will send letters regarding emergency room visits to patients who have used the ER for nonemergency needs within the last 12 months. The letter comes as a result of needing to remind patients to visit elsewhere for nonemergency needs.

Beginning Jan. 1, employees may be responsible for ER costs that are determined to be nonemergency. Plans aren’t changing, but more responsibility will be placed upon the individual to choose the most appropriate care option as to avoid possible ER costs under nonemergency circumstances.

In certain situations, the ER is the only option of choice, and Anthem acknowledges those instances. These instances are:

* Medical needs of members under the age of 14.
* ER visits directed by a doctor.
* ER visits between 8 p.m. Saturday and 8 a.m. Monday.
* When the closest urgent care is more than 15 miles from an employee’s home.

As a reminder, here are other options besides the ER for employees to consider for instances that wouldn’t require emergency services:

* Employee’s primary care physician.
* Retail health clinic.
* Urgent care.
* LiveHealth Online.

Additional information on choosing the right care at the right time is available via a June 2016 HR Connect article on that topic.

Questions about possible nonemergent ER charges can be directed to or 765-494-2222. 

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