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American Specialty Health Network is Lobbying for Chiropractic

ASHN Wants Inclusion in the Affordable Care Act

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by: DrTirpak posted: May 21, 2013

ASHN Representing Chiropractic on the Hill

American Specialty Health’s (ASH) Vice President of Public Affairs R. Lloyd Friesen, DC took part in meetings with 3 senators last week promoting chiropractic. Under the Umbrella of The National Association of Specialty Health Organizations (NASHO) Dr. Friesen along with representatives from other Chiropractic health specialty organizations were lobbying a white paper promoting the inclusion of Chiropractic care and Chiropractic management organization in the Affordable Care Act around DC. Other participants included the executives from ChiroCare of Minnesota, Palladian Health and the CHP Group.

The National Association of Specialty Health Organizations (NASHO) serves as a national organization and lobbyist for numerous health specialty companies. Health specialty organizations or Chiropractic Networks are more commonly known to Chiropractors as the companies that contract with major insurance providers to manage Chiropractic benefits. They make money by cutting reimbursements and visits for Chiropractic care from contracted insurance plans.

The white paper that NASHO’s Chiropractic Council created highlights the benefits of Chiropractic care, the high satisfaction rate, the cost reduction compared to medical treatment as it pertains to low back pain and a VA study on Chiropractic and neck pain. The white paper also suggests primary care co-pays rather than specialty rates, Chiropractors as point of entry, and inclusion in the medical home for musculoskeletal care.

A few claims in NASHO’s White Paper that may not be well received by Chiropractors currently battling with a health specialty organization over payments. The paper states the benefits of health specialty organizations or Chiropractic networks (as they call themselves) include “gain preferred access to patients covered by plans and insurers, adding volume to the chiropractic practice.” They suggest that the Chiropractic networks also offer Chiropractic Continuing Education in care management and best practices. Various times in the paper they refer to cost-effective rates, medical necessity and no over utilization. This translates into practice as lower reimbursement than the terms of the plan, lower ceilings on visits and billable procedures and arbitrary cut offs of treatment.

Throughout the paper the American Chiropractic Association is referenced, amusing considering that ACA announced a class action suit last year against American Specialty Health Networks’ practices against Doctors of Chiropractic participating in CIGNA insurance plans across the county. The quality of representation of the Chiropractic profession by this lobby organization and Chiropractic networks should be questioned when other references in the paper include WebMD and NASHO’s own website.

What is you experiece with ASHN and other Specialty Health Organizations? Any tips for other Chiropractors?

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Comments

I never signed on to Cigna or ASH. It does not mater what your assessments are as they give you 1/2 to 1/3 of the treatments you ask for. My Cigna patients pay cash at each visit and get reimbursed. I'd rather have a some empty times than due all that paperwork they require.
by: Dr.Warren Baskin
Agreed. One only needs to go to yelp to see this very same complaint repeated a hundred times. After five visits (not yearly, but lifetime), they make it impossible to get paid, and if you do, it's six to nine months and a pittance. No matter how jacked up a patient presents and how much you've helped, some faceless signee will review whatever they send and say it wasn't necessary. Doesn't everyone get it? ASH is PAID to deny claims by Cigna and bow Blue Cross self funded and small group plans. It violates California Insurance Code (law) 10133.b, but it's not an arrestable offense. One think I've found that worked was having the patient sit with their HR person, call Cigna, and insist that claims be paid. Ultimately it's the insured's responsibility and they'll listen if they think they'll loose an entire company over it. Has worked like a charm so far. Cigna/ASH know that the Dr. really has no legal recourse since they're not the policy holder.
by: Dirk Rockland
American Specialty is a complete sham. They exist solely to enrich their own pockets as the expense of people who are denied the terms and benefits of the insurance policies they have paid for. The only any to rid the earth of these vermin, is for everyone person denied treatment under the terms of their insurance policy is to complain loudly and often to the HR department at their place of employment. if enough employers complain then CIGNA and Blue Cross will have no choice but to withdraw from their contacts with ASHN.
by: Marco, DC
They are a scam, I will be dropping out of network tomorrow. They can't give straight answers on why claims are not paid. Always a new reason and nobody can help get it worked out. Better off having the few patients that actually have this BS insurance just pay cash.
by: Rory Marrello
ASHN does not help anybody but their bottom line! The patients suffer while Dr.'s try and figure out how to claims paid through ASHN while they are making money off DC's backs! Ridiculous!!!
by: Jeff

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