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Prudent Layperson Laws Improve Emergency Services Coverage; Not A Driver of Inappropriate Visits (Site not responding. Last check: 2007-10-13) |
 | | To correct this problem, 47 states have implemented a provision, known as a "prudent layperson" law, that requires the urgent nature of a patient's condition to be judged according to his symptoms that led him to seek emergency medical care, rather than by the patient's final diagnosis. |
 | | "State prudent layperson laws, as this study points out, may be effective in preventing denials of coverage for emergency services, but there are still significant pockets where health insurers haven't changed their practices," said Dr. J. |
 | | The study also describes the challenges insurers face in reviewing emergency department claims and determining whether the patient's reaction to symptoms is in fact "prudent." They noted that it was difficult to create an efficient automated review process based on patients' symptoms rather than the final diagnosis. |
| www.acep.org /webportal/Newsroom/NR/annals/2004/PrudentLaypersonLawsImproveEmergencyServicesCoverageNotADriverofInappropriateVisits.htm?SetText=big (813 words) |