That sounds weird. If he really thought kidney stones then why not order an ultrasound? Also why not go to the ER? Your insurance has to cover it.. I guess it would depend on your coinsurance/copay though..
Not necessarily. If it turns out it wasn't an emergency after all (just appeared to be), or if the insurance company decides that the remedy wasn't medically necessary (but the doctor treating you at the ER did), some states allow insurance companies to deny claims. They are slowly trying to unravel all of the protections created by the ACA, and they are succeeding.
>His company uses Anthem, one of the country’s largest health insurance plans. In recent years, Anthem has begun denying coverage for emergency room visits that it deems “inappropriate” because they aren’t, in the insurance plan’s view, true emergencies.
>The problem: These denials are made after patients visit the ER, sometimes based on the diagnosis after seeing a doctor, not on the symptoms that sent them, like in Cloyd’s case.
https://www.vox.com/policy-and-politics/2018/1/29/16906558/a...
>His company uses Anthem, one of the country’s largest health insurance plans. In recent years, Anthem has begun denying coverage for emergency room visits that it deems “inappropriate” because they aren’t, in the insurance plan’s view, true emergencies.
>The problem: These denials are made after patients visit the ER, sometimes based on the diagnosis after seeing a doctor, not on the symptoms that sent them, like in Cloyd’s case.