Now you get to guess your own diagnosis in a game of "will I die or go bankrupt."
UnitedHealthcare delayed the policy's rollout, but experts worry about chilling effect.
In a 2018 analysis published in JAMA Open Network, researchers found that up to 90 percent of the symptoms that prompted an adult to go to the emergency room overlapped with symptoms of non-urgent conditions, which may be denied coverage in the future. But those same symptoms could also be linked to life-threatening conditions.
Maria Raven, chief of emergency medicine at the University of California, San Francisco—noted how problematic it is to retroactively evaluate emergency medical care. “My colleagues and I examined whether a patient’s symptoms at presentation to the ED could be labeled reliably as a non-emergency based on the discharge diagnosis—the diagnosis that Anthem is currently using to determine medical necessity,” she wrote. “We found it was impossible.”