The Institutes

Patients Could Get ER Bills as Insurer Moves to Deny Claims it Deems Non-Emergent

 Thursday, June 10, 2021

 Naples Daily News

Insurance giant UnitedHealthcare is cracking down on unnecessary emergency room visits with a new policy starting July 1 that the American Hospital Association says will jeopardize patients’ health and threaten them with financial penalties.

The American College of Emergency Physicians said it fears the change will cause patients to avoid using emergency rooms because they will be responsible for their hospital bills when UnitedHealthcare rejects them.

UnitedHealthcare this month told its network hospitals in 34 states including Florida that it will assess emergency room claims to determine if visits were indeed medical emergencies.

Claims that are determined not to be tied to emergencies will be subject to no coverage or limited coverage based on the patient’s insurance plan, according to the insurer’s notice sent to hospitals.

As many as 1 in 10 claims could be rejected, said Tracey Lempner, spokeswoman for the Minnesota-based insurer.
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