In EMTALA, if a patient arrives with emergency symptoms and requests care but insurance denies payment, what is the physician's obligation?

• A. Document and discharge
• B. Do not treat until payer approves
• C. Refer to another facility without treatment
• D. Screen for emergency and treat until transfer

Answer: (D)

Under EMTALA, an emergency department must perform a medical screening to determine if an emergency medical condition exists and, if it does, provide stabilizing treatment regardless of the patient's ability to pay or insurance status. If the facility cannot stabilize the patient, it must arrange an appropriate transfer to a facility that can provide the necessary care, but only after stabilization. In this scenario, the physician should screen for the emergency and treat until the patient is stabilized or appropriately transferred. Payment denial does not negate this obligation.

Discharging without treatment, delaying care until payer approval, or referring someone elsewhere without providing stabilization would violate EMTALA.