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We Want You to Know About Our Emergency Room Program in Ohio

February 14, 2018

Recently we launched a program in Ohio to help address the rising trend of emergency room use for non-emergency health concerns. This program encourages people to use primary care doctors, urgent and retail clinics, and telehealth options instead of the ER. We’ve used this program in other states and have applied the latest learnings and enhancements in Ohio.

  1. We expanded our list of “always-approve” exceptions. That means if one of those conditions is present, we will pay the claim according to the terms of your health plan.
  2. If medical records are not provided, we will ask for them from the treating provider and include them in our review.

It is important that we continue to address this trend because it is impacting the cost of health care for consumers, employers and the health care system as a whole. At Anthem, we believe that getting care in the most appropriate setting is an important part of making health care simpler, more affordable and more accessible.

As always, nothing is more important than your safety. If you are experiencing a health emergency, you should always call 911 or go to the ER.