Blue Cross and Blue Shield of Texas is delaying the rollout of a controversial change to how it will evaluate emergency room claims for members holding HMO policies.

The new process was set to take effect June 4 but will now be delayed for 60 days, according to the Texas Department of Insurance, which has been in discussions with the health insurer and continues to have questions about how consumers would be able to appeal denied claims.

“When you’re facing an unknown situation at 2 o’clock in the morning, you need to be able to act quickly,” said Stephanie Goodman, a spokeswoman for the Texas Department of Insurance.

“And that’s our interest...." she said, "making sure that someone isn’t later caught by a surprise bill for something they legitimately believed was an emergency."

In April, The Dallas Morning News first reported about the change in process that could leave more than 500,000 Blue Cross members on the hook for 100 percent of the emergency room bill.

If they visit an out-of-network emergency room and the insurer’s subsequent evaluation of the claim determines that the medical problem wasn’t life-threatening or serious enough to warrant an ER visit, the claim could be denied.

The plan outraged consumer groups, medical professional organizations and others who worried that such a process would force consumers to self-diagnose, when the average person does not have the medical expertise needed to do so.

On Tuesday, Blue Cross of Texas president Dr. Dan McCoy and other representatives of Blue Cross Blue Shield of Texas met with Texas Commissioner of Insurance Kent Sullivan in Austin.

The health insurer agreed to a 60-day delay, during which it will provide additional information requested by the Department of Insurance "while continuing to educate our members on the importance of appropriately using emergency services," the company said in a statement.

"We anticipate this thoughtful, multi-step review process will be implemented on August 6, 2018 to provide protection for our members from inappropriate billing, egregious charges and fraud, waste and abuse by out-of-network emergency departments," the statement read.

While pleased about the delay, both the Texas Medical Association and Consumers Union said a delay is only a first step.

"We expect to see changes that explicitly acknowledge Texas' legal protections for patients seeking emergency care," said Dr. Douglas Curran, president of the Texas Medical Association. "We do not believe patients should be expected to self-diagnose to determine whether their symptoms are serious enough to warrant an emergency department visit," he said.

Likewise, Betsy Imholz, director of special projects for Consumers Union, said making the appeals process clearer isn't enough. She pointed to a survey her nonprofit consumer advocacy group found that showed roughly 85 percent of consumers never file complaints and don't understand where to turn with medical billing concerns.

While careful messaging is important, even with that, she said, the policy could end up causing harm if it means patients delay care due to financial fears.

On Thursday, the Texas Department of Insurance sent a letter requesting more details about the policy, how the claims would be handled, and how the appeals process would work to ensure consumers’ rights are protected.

Read the TDI's letter here:

"The answers determine the appeals rights for the consumer," Goodman said. "We want to absolutely be as clear on the front end of this as we can, looking at every process in great detail knowing exactly how it works."

The letter also inquired why members who do not have health maintenance organization plans also received emails about the new policy and how the insurer communicated with members who don't have email.

Dr. Paul Hain, the North Texas market president for Blue Cross, said that communications had been sent to all customers, reminding them about the SmartER website.

It was set up, Hain said, to help patients decide when to visit an emergency room "to ensure that members are not taken advantage of by out-of-network, usually freestanding emergency rooms, and their unconscionable charges."

Follow me on Twitter @sabriyarice