Emergency Room for Non-Emergent Problem

Shawn Gretz, 
Ridiculously Nice Vice President of Sales

Blue Cross and Blue Shield (BCBS) is no longer paying for the boy who cried wolf in four states. You know the old wives’ tale – A bored boy tending sheep cried “Wolf!” to get attention. He did it a second time, and again the village people came to help him. The third time the boy cried “Wolf!” and the boy was ignored but this time the wolf was real and his flock of sheep was eaten. The moral of the story… BCBS doesn’t want patients utilizing the emergency room when a primary care doctor will do!

BCBS in New York, Georgia, Kentucky, and Missouri will be no longer paying for non-emergent use of emergency departments. It is an interesting stick that BCBS is using to try to drive the patient to cheaper options for healthcare.

What does that mean for Americollect clients? I am afraid to say that it is going to mean more bad debts and confusion for patients if you work in those four states. I also feel that this provision is one that could potentially spread to other insurance companies and divisions of BCBS before long.

What can you do? I believe now is the time to start training all registration staff in the emergency department to have the discussion with patients that have non-emergent problems as they leave the ED. Educate them on the options they have for service that would be in their best interest, or they risk paying the charges themselves if the service isn’t covered in the future.

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