My Emergency My Choice has and always will protect the Prudent Layperson Standard, however there are many other hurdles and practices that insurers have used to put profits over patients that don’t appear to go explicitly against the standard. Protecting patient’s rights is more than just about protecting the Prudent Layperson Standard by the letter of the law. It’s about ensuring patients have the right to make their own emergency healthcare choices to the greatest extent possible.
So, how is My Emergency My Choice helping now, and what will we do moving forward to protect patient’s rights?
Protecting the Prudent Layperson Standard is most critical to protecting patient’s rights in emergency medicine. We can not allow insurers to directly attack and avoid this standard as they have, and continue to do. Just because the most recent and egregious example from United Healthcare has been delayed doesn’t mean this is their last attempt. For now this standard has been upheld on the national level, but as it has become evident time and time again, insurers will do anything they can to attempt to circumvent and break apart this standard.
Surprise medical bills are unacceptable…period. There is no reason for a patient to be met with an outrageous bill when they have insurance that is legally REQUIRED to cover emergency care.
The No Surprises Act passed by Congress last year, helps defend the Prudent Layperson Standard by requiring insurers to cover emergency services independently of the final diagnosis. Before this protection, many insurers would automatically deny claims based upon diagnosis codes presented after treatment rather than the presenting symptoms which triggered the emergency visit. Emergency Physicians and facilities are legally bound to treat every patient who enters the ER as if their condition could be life-threatening. So, we will continue to fight to ensure that insurance companies cover patients in the same way.
One topic that is not discussed enough are the tactics insurers use to “influence” their customers to make medical decisions that are not in their own best interests. Patients regularly receive communications from insurers telling them to avoid certain types of care in an emergency. This practice is known as “patient steering” and can lead patients to make healthcare decisions which increase insurance company profits at the cost of their own personal health. We are dedicated to help clarify and explain these practices, arming patients with the facts about their rights when seeking emergency care.
Please join us next week where we deconstruct the cryptic documents known as EOBs and explain how they differ from a bill. My Emergency My Choice will continue to clarify and demystify these policies to help keep patients up to date and armed for when an emergency does strike.
We believe patients should always be put over profits. As you know, it’s your emergency, you have a choice.