Here are items that cause violations
Here are items that cause violations
Violations of Emergency Medical Treatment and Active Labor Act (EMTALA) occur frequently, although relatively few are ever reported and investigated, according to Todd Taylor, MD, FACEP, an attending ED physician at Good Samaritan Regional Medical Center in Phoenix.
"They generally occur when some event occurs that interrupts the usual process for evaluating patients in the ED," he explains.
Taylor recommends watching out for these common "red flag" scenarios:
• Managed care requests input into how the patient will be managed. For instance, managed care makes a request to "triage" the patient to a primary care doctor’s office or demands prior authorization for elements normally considered part of the medical screening exam.
• The patient requests assurances that his or her insurance will cover particular services and then refuses to consent to evaluation if assurances are not provided.
• Simple or what appear to be obvious nonemergency complaints are dealt with at triage by a person not designated as a "qualified medical provider."
• Physicians alter their usual medical screening exam due to notification of denial of payment by the health plan.
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