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Director, Medical Director, U. S. Congress discussed on Sean Hannity

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Giant anthem is muddying the waters even more for some known as the emergency department review the company's program launched in twenty seventeen with the intent of reducing unnecessary visits to the nation's emergency rooms in and of itself the idea isn't such a bad thing since emergency departments are sometimes ill use a twenty ten report found thirty eight billion dollars per year in wasteful spending thanks to emergency department over here however instances policy if a person goes to the emergency department with symptoms or condition that turns out to not be life threatening they could wind up holding the bag for a whole lot of money we spoke with Christina gains communications director for anthem incorporated by email she said if the consumer chooses to receive care for non emergency conditions at the emergency department when a more appropriate settings available in them will request more information including additional medical records from the hospital and a statement from the consumer as to why they went to the emergency department then in the medical director will review the additional information using the prudent layperson standard ends the claim might be denied as not a covered service in the event of consumers claims denied they have the right to appeal much of the controversy surrounding this program lies with that prudent layperson standard gains mentioned the standard was enacted by the U. S. Congress back in nineteen ninety seven with forty seven states opting to work it in state laws well it was done at a layer of protection for health care consumers so they can see care without working up a huge emergency department bill we also spoke by email with Dr David Farsi president of.

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