Series finale of KMOX's investigation of the Condition of Urgent Care

Urgent care
Photo credit (Megan Lynch, KMOX)
By NewsRadio 1120 KMOX

ST. LOUIS (KMOX) - The business of urgent care is booming nationwide, with hundreds of new centers opening every year. 

The question is whether those facilities are really giving patients what they want and need. 

KMOX's Megan Lynch concludes this week's investigation into the Condition of Urgent Care.

As KMOX News has reported, some experts are concerned that cost is pushing people with life-threatening emergencies to urgent care centers. 

As part of our look at the Condition of Urgent Care, Megan Lynch tells us about one company that may refuse to pay your entire ER bill if you make the wrong choice.

Here is the full statement from Anthem:

Anthem’s goal is to ensure access to high quality, affordable health care, and one of the ways to help achieve that goal is to encourage consumers to receive care in the most appropriate setting. Anthem’s Emergency Department Review (“ED Review”) aims to reduce the trend in recent years of inappropriate use of EDs for non-emergencies. If a consumer reasonably believes that he or she is experiencing an emergency medical condition, then they should always call 911 or go to the ED. But for non-emergency health care needs, EDs are often a time-consuming place to receive care and in many instances 10 times higher in cost than urgent care.
If a consumer chooses to receive care for non-emergency conditions at the ED when a more appropriate setting is available, Anthem will request more information (including additional medical records) from the hospital and a statement from the consumer as to why they went to the ED. An Anthem medical director will review the additional information using the prudent layperson standard, and the claim might be denied as not a covered service. In the event a consumer’s claim is denied, they have the right to appeal. 
 Anthem has made, and will continue to make, enhancements to ED Review to help consumers receive the right care at the right place and time.
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