Georgia agency creates code to track complaints about BCBS' new ED policy

State officials said they will monitor Anthem Blue Cross Blue Shield of Georgia's policy to no longer cover emergency department services it deems unnecessary for members with individual plans, according to WABE.

The Georgia Insurance Department said it will track the ED policy to ensure it "is not abused to the disadvantage of Georgia policyholders," according to the report.

Last month Anthem BCBS said it would implement a policy in July aimed at steering patients with nonemergent symptoms toward a primary care physician, urgent care provider or its LiveHealth telehealth app to limit costly ED visits. Under the policy, if a BCBS of Georgia member receives care for nonemergent symptoms, a medical director will use the prudent layperson standard to deem whether the service is necessary. The prudent layperson standard refers to someone who has an average knowledge of medicine and health.

Jay Florence, deputy state insurance commissioner, said in a statement to WABE the insurance department supports payers' efforts to curb "unnecessarily high premiums." However, he said the state agency is "tracking our phone calls and have created a specific code for complaints related to Blue Cross Blue Shield's new policy."

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