Ohio insurer stopping payments for non-emergency ER visits

When Laura Killoran experienced chest pains last July, she went to the emergency room at St. Elizabeth Hospital.  But when Killoran got her explanation of benefits from Anthem, her health insurer, it said she owed about $1,488.  Anthem finally paid after a four-month appeal. But the company said it's trying to minimize rising healthcare costs by charging those who go to the ER for a non-emergency. Now that Anthem has extended its new ER policy to Ohio, local hospitals aren't sure what to expect.  "It's really too early to speculate on the impact that policies like this are going to have on our patients here at Mercy Health," Mercy Health Cincinnati Chief Clinical Officer Dr. Erin Fries said.  In Kentucky, Anthem also denied cases like a patient bleeding from a surgical incision, a patient with shortness of breath and a patient who was sent to the ER by a doctor, according to data from the Kentucky Department of Insurance. Most of the denials were eventually reversed by Anthem or the state.  Dr. Michael Argus, a board certified emergency physician with U.S. Acute Care Solutions, reviewed the data from Kentucky. He said the same set of symptoms in a different patient could mean a life-threatening condition. "In the end, you know, this is just ... cruel," he said.  Killoran believes one reason her denial was overturned was because she had support from St. Elizabeth's. The state department of insurance can also help.  Anthem provided 9 On Your Side with a statement which read, in part:  "Emergency rooms treat life and limb threatening situations, and if a consumer feels he or she has an emergency they should always call 911 or go to the ER. But for non-emergency ailments, ERs are an expensive and time-consuming place to receive care. Primary care physicians are often the best and least costly option for the treatment of any non-emergency medical concerns, with urgent care, telemedicine, retail clinics available to assist consumers in after-hours situations."