Blue Cross Blue Shield is making some big changes that could affect half a million Texans.
If you have an HMO plan with the insurance company, you should be aware that Blue Cross Blue Shield will no longer pay for an out-of-network ER visit if it is not serious or life-threatening.
Claims will be evaluated by a medical director to determine the reason a patient chose to go to the ER, and whether treatment could have been handled by a clinic or family physician.
Critics claim the program forces patients to make untrained diagnoses and potentially skip treatment if they fear medical bills will not be paid.
Blue Cross Blue Shield won't pay some out-of-network ER visits in Texas