Guest guest Posted June 6, 2005 Report Share Posted June 6, 2005 Hey group! This may have been discussed but I searched the archives to no avail....how does a practitioner begin to accept insurance? With whom do I need to file paperwork? Any responses are greatly appreciated. Thanks--> Lisa Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 6, 2005 Report Share Posted June 6, 2005 Dear Lisa From my personal experience First, you have to call to insurance co. to learn does they cover acupuncture or not. If they do - send them your bill with W-9 form. If they deny your claim they give the reason for that. Usually it is that you are not their provider. Then call again and ask how to be a provider, they should send you a bunch of forms for that or just ask about W-9 and include into data base.It is depends. Another way - join a network of providers for acupuncture like ASH network. yuri ovchinnikov, L.Ac --- ranchstyle wrote: > Hey group! This may have been discussed but I > searched the archives to no avail....how does a > practitioner begin to accept insurance? With whom > do I need to file paperwork? > Any responses are greatly appreciated. > Thanks--> > Lisa > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 7, 2005 Report Share Posted June 7, 2005 You should find a phone number on the back of the patient's insurance card. Call that number to check for coverage as well as confirm mailing address for the claims. Mike W. Bowser, L Ac >ranchstyle >Chinese Medicine >Chinese Traditional Medicine > preparing to accept insurance >Mon, 06 Jun 2005 18:27:55 +0000 > >Hey group! This may have been discussed but I searched the archives to no >avail....how does a practitioner begin to accept insurance? With whom do I >need to file paperwork? >Any responses are greatly appreciated. >Thanks--> >Lisa Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 7, 2005 Report Share Posted June 7, 2005 Joining networks is a good way to get set up to be a provider for many insurance companies at once. Here are the main ones that I am aware of: American Specialty Health Network (ASH) Alternare First Choice Network American Whole Health Good luck! Laura Chinese Medicine , " mike Bowser " <naturaldoc1@h...> wrote: > You should find a phone number on the back of the patient's insurance card. > Call that number to check for coverage as well as confirm mailing address > for the claims. > > > Mike W. Bowser, L Ac > > > > >ranchstyle@a... > >Chinese Medicine > >Chinese Traditional Medicine > > preparing to accept insurance > >Mon, 06 Jun 2005 18:27:55 +0000 > > > >Hey group! This may have been discussed but I searched the archives to no > >avail....how does a practitioner begin to accept insurance? With whom do I > >need to file paperwork? > >Any responses are greatly appreciated. > >Thanks--> > >Lisa Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 7, 2005 Report Share Posted June 7, 2005 ranchstyle wrote: > Hey group! This may have been discussed but I searched the archives > to no avail....how does a practitioner begin to accept insurance? > With whom do I need to file paperwork? Any responses are greatly > appreciated. Hi Lisa! First step, run, don't walk, to your US Representative's office and ask him/her to co-sponsor HR 818. This is the Hinchey bill to add acupuncture to Medicare. Without this only 40% of the insurance companies " cover " acupuncture to start with. It has been pending for TWELVE YEARS! It needs 100 co-sponsors to get out of committee. Next step, Acupuncture Today ran an article a while ago about the insurance codes, find that and take a look at it. Don't be surprised if you don't understand it, the whole topic is *intentionally* vague. Intentionally? Yes. The insurance companies don't want to pay you, they want to *pretend* to pay you. The contract your patient agrees to gives the patient the impression that acupuncture will be covered, it is a selling point, but in reality the insurance company will do all that they can short of being indicted for fraud in order to keep from paying. Once you know what the codes are you still need to submit insurance billing. You can get a third party to do this for $500 on up per month, you can hire a staff member to do it for whatever the wage rates are where you are or you can spend the whole month doing it yourself whenever you have a spare moment, during which time you will not be doing any other work. If your time is worth $50 per hour this adds up fast. It is just filling out a form with the right information on it in the right places. The contact number or billing address will be on the patient's insurance card or policy. No matter how you do it you will not be right. You will submit the bill and you will get back not a check but an " explanation of benefits " which is usually *anything*but* an explanation of why they *didn't* pay you. You could very well need a lawyer to explain it to you. The patient will also get a copy of this so the patient might ask you what it means. You go back and forth with this until either you or they get tired and you give up or they give up. This nonsense is with every single bill you submit. Welcome to fame and wealth in " accepting " insurance. Or you could do what my friend does. He takes the co-payment and doesn't even bother submitting the bill. Or you could do what I do, accept the co-payment, give the patient a " superbill " for what they pay you and tell them they can file it if they wish. On Medicare, I tell them that I will charge them whatever the co-payment would be if Medicare covered it and let them have the service for that. Regards, Pete Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 7, 2005 Report Share Posted June 7, 2005 heylaurag wrote: > Joining networks is a good way to get set up to be a provider for many > insurance companies at once. Here are the main ones that I am aware of: > > American Specialty Health Network (ASH) > Alternare > First Choice Network > American Whole Health Hi Laura! Are you a member of these networks? I got a proposal from a couple of them but they wanted money from me up front. They also wanted me to give them a cut of the action in the form of special rates or discount however it was expressed. I couldn't see where they were committing to send me any referrals. It looked like I would just be paying for nothing. Was I wrong? Regards, Pete Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 7, 2005 Report Share Posted June 7, 2005 Pete, This area has become a concern of recent times as these groups are not really HMO/insurance groups but instead are middlemen for such. They get a cut on both sides, from insr/HMO and also the practitioner. When joining a group there is never the claim to refer anyone to you but an op to list your services with them in their provider listing. I am concerned of some of their rules regarding the ability to audit your patient records at will. There does not really seem to be any medical reason for them to do so, so I turned them down. There is one group founded by L Ac in CA called Acu-care that you might also look into. Mike W. Bowser, L Ac >Pete Theisen <petet >Chinese Medicine >Chinese Medicine >Re: preparing to accept insurance >Tue, 07 Jun 2005 02:59:46 -0400 > >heylaurag wrote: > > Joining networks is a good way to get set up to be a provider for many > > insurance companies at once. Here are the main ones that I am aware of: > > > > American Specialty Health Network (ASH) > > Alternare > > First Choice Network > > American Whole Health > >Hi Laura! > >Are you a member of these networks? > >I got a proposal from a couple of them but they wanted money from me up >front. They also wanted me to give them a cut of the action in the form >of special rates or discount however it was expressed. > >I couldn't see where they were committing to send me any referrals. It >looked like I would just be paying for nothing. Was I wrong? > >Regards, > >Pete Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 7, 2005 Report Share Posted June 7, 2005 I am working to get credentialed through Tricare a provider through BlueCross BlueShield of Arizona and also the ACN (American Complementary Care Network). ACN is a provider through United Health Allies and requires no paper work and nothing to file. You simply provide patients with this insurance a 20% discount - that's it. I have no problem doing this as 20% is cheap for free patient referrals and greater internet presence. You need to contact the health insurance companies in your state and ask them if they provide coverage for acupuncture. If so, ask to have the paperwork to be credentialed sent to you. I originally didn't want to deal with insurance, but I figure to have a thriving practice I have to accept patients from more than one or two sources. Advertising is expensive. I'd gladly reduce my fees 20% for everyone if I didn't have to have the overhead of advertising and the time required to go out there and get new patients with talks and health fairs. The reality is that I need to do both. Christopher Vedeler L.Ac., C.Ht. Oasis Acupuncture http://www.oasisacupuncture.com 8233 N. Via Paseo del Norte Suite D-35 Scottsdale, AZ 85258 Phone: (480) 991-3650 Fax: (480) 247-4472 Chinese Medicine Chinese Medicine On Behalf Of ranchstyle Monday, June 06, 2005 11:28 AM Chinese Traditional Medicine preparing to accept insurance Hey group! This may have been discussed but I searched the archives to no avail....how does a practitioner begin to accept insurance? With whom do I need to file paperwork? Any responses are greatly appreciated. Thanks--> Lisa http://babel.altavista.com/ and adjust accordingly. Messages are the property of the author. Any duplication outside the group requires prior permission from the author. _____ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 7, 2005 Report Share Posted June 7, 2005 Chris, A discount of services usually means that the company is a middleman and not really an insurance company. Please be careful with patient confidentiality as these groups have no right to audit your paitent files. The actual insurance company can if they so choose. Some of these groups may state that they have the right to audit, that is incorrect and you can opt out of that part of the contract by crossing this off your contract and signing it. If you contact them and explain they will most likely agree as well. Mike W. Bowser, L Ac > " Christopher Vedeler L.Ac. " <ckvedeler >Chinese Medicine ><Chinese Medicine > >RE: preparing to accept insurance >Tue, 7 Jun 2005 09:46:12 -0700 > >I am working to get credentialed through Tricare a provider through >BlueCross BlueShield of Arizona and also the ACN (American Complementary >Care Network). ACN is a provider through United Health Allies and >requires no paper work and nothing to file. You simply provide patients >with this insurance a 20% discount - that's it. I have no problem doing >this as 20% is cheap for free patient referrals and greater internet >presence. > >You need to contact the health insurance companies in your state and ask >them if they provide coverage for acupuncture. If so, ask to have the >paperwork to be credentialed sent to you. > >I originally didn't want to deal with insurance, but I figure to have a >thriving practice I have to accept patients from more than one or two >sources. Advertising is expensive. I'd gladly reduce my fees 20% for >everyone if I didn't have to have the overhead of advertising and the >time required to go out there and get new patients with talks and health >fairs. The reality is that I need to do both. > >Christopher Vedeler L.Ac., C.Ht. >Oasis Acupuncture >http://www.oasisacupuncture.com >8233 N. Via Paseo del Norte >Suite D-35 >Scottsdale, AZ 85258 >Phone: (480) 991-3650 >Fax: (480) 247-4472 > > >Chinese Medicine >Chinese Medicine On Behalf Of >ranchstyle >Monday, June 06, 2005 11:28 AM >Chinese Traditional Medicine >preparing to accept insurance > > >Hey group! This may have been discussed but I searched the archives to >no avail....how does a practitioner begin to accept insurance? With >whom do I need to file paperwork? >Any responses are greatly appreciated. >Thanks--> >Lisa > > > >http://babel.altavista.com/ > > > and >adjust accordingly. > >Messages are the property of the author. Any duplication outside the >group requires prior permission from the author. > >If you are a TCM academic and wish to discuss TCM with other academics, > > > > > _____ > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 8, 2005 Report Share Posted June 8, 2005 mike Bowser wrote: > Pete, > This area has become a concern of recent times as these groups are not > really HMO/insurance groups but instead are middlemen for such. They get a > cut on both sides, from insr/HMO and also the practitioner. When joining a > group there is never the claim to refer anyone to you but an op to list your > services with them in their provider listing. I am concerned of some of > their rules regarding the ability to audit your patient records at will. > There does not really seem to be any medical reason for them to do so, so I > turned them down. There is one group founded by L Ac in CA called Acu-care > that you might also look into. Hi Mike! Interesting take on it. The CA guy seems remote to me, being in Florida. Regards, Pete Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 8, 2005 Report Share Posted June 8, 2005 Pete, Be afraid, be very afraid. Sorry, just wanted to use that line. Some comapanies have and will be created for no other reason than to make money. They take goods and services from one group and market them to another, with an added cost of course. In the healthcare arena, it becomes harder to do this except when you get in on the insurance side. As most such groups are not insurance companies, they cannot perform duties of such. While it may be somewhat routine for an insurance carrier to ask for medical records to confirm that services were provided. This ability does not translate to these other groups. In fact, I would venture to say that this would be a HIPAA violation unless the patient signs a consent to do so. Here in MN, our statutes actually contain verbage that makes us liable for unauthorized release of records except to certain groups. Middlemen are not included. Read the fine print as they say before you sign up for one of these groups. If you see the words audit of medical records, than run or call them to change the agreement if they are not an actual insurance company. Most likely they will comply with changes as they do not want to jeopardize themselves thru misrepresentation as an insurance carrier. Just food for thought. Later Mike W. Bowser, L Ac >Pete Theisen <petet >Chinese Medicine >Chinese Medicine >Re: preparing to accept insurance >Wed, 08 Jun 2005 05:40:43 -0400 > >mike Bowser wrote: > > Pete, > > This area has become a concern of recent times as these groups are not > > really HMO/insurance groups but instead are middlemen for such. They >get a > > cut on both sides, from insr/HMO and also the practitioner. When >joining a > > group there is never the claim to refer anyone to you but an op to list >your > > services with them in their provider listing. I am concerned of some of > > their rules regarding the ability to audit your patient records at will. > > There does not really seem to be any medical reason for them to do so, >so I > > turned them down. There is one group founded by L Ac in CA called >Acu-care > > that you might also look into. > >Hi Mike! > >Interesting take on it. The CA guy seems remote to me, being in Florida. > >Regards, > >Pete Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 9, 2005 Report Share Posted June 9, 2005 mike Bowser wrote: > Pete, > Be afraid, be very afraid. Sorry, just wanted to use that line. Some > comapanies have and will be created for no other reason than to make money. > They take goods and services from one group and market them to another, with > an added cost of course. > > In the healthcare arena, it becomes harder to do this except when you get in > on the insurance side. As most such groups are not insurance companies, > they cannot perform duties of such. While it may be somewhat routine for an > insurance carrier to ask for medical records to confirm that services were > provided. This ability does not translate to these other groups. > > In fact, I would venture to say that this would be a HIPAA violation unless > the patient signs a consent to do so. Here in MN, our statutes actually > contain verbage that makes us liable for unauthorized release of records > except to certain groups. Middlemen are not included. Read the fine print > as they say before you sign up for one of these groups. If you see the > words audit of medical records, than run or call them to change the > agreement if they are not an actual insurance company. Most likely they > will comply with changes as they do not want to jeopardize themselves thru > misrepresentation as an insurance carrier. Just food for thought. Later Hi Mike! Yes, I just filed the solicitation. Regards, Pete Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 10, 2005 Report Share Posted June 10, 2005 Hi Pete--yeah, they do charge us to apply, and then take a portion of our income. Its hard to know if its worth it, but I'd have to say that it probably has helped me be successful getting started. Every once in a great while I get a referral from them. Laura Chinese Medicine , Pete Theisen <petet@a...> wrote: > heylaurag wrote: > > Joining networks is a good way to get set up to be a provider for many > > insurance companies at once. Here are the main ones that I am aware of: > > > > American Specialty Health Network (ASH) > > Alternare > > First Choice Network > > American Whole Health > > Hi Laura! > > Are you a member of these networks? > > I got a proposal from a couple of them but they wanted money from me up > front. They also wanted me to give them a cut of the action in the form > of special rates or discount however it was expressed. > > I couldn't see where they were committing to send me any referrals. It > looked like I would just be paying for nothing. Was I wrong? > > Regards, > > Pete Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 10, 2005 Report Share Posted June 10, 2005 On this thread: I would never join any network that required money from me. The bigger, more serious networks won't ask for this. - Matthew Bauer - heylaurag Chinese Medicine Thursday, June 09, 2005 5:26 PM Re: preparing to accept insurance Hi Pete--yeah, they do charge us to apply, and then take a portion of our income. Its hard to know if its worth it, but I'd have to say that it probably has helped me be successful getting started. Every once in a great while I get a referral from them. Laura Chinese Medicine , Pete Theisen <petet@a...> wrote: > heylaurag wrote: > > Joining networks is a good way to get set up to be a provider for many > > insurance companies at once. Here are the main ones that I am aware of: > > > > American Specialty Health Network (ASH) > > Alternare > > First Choice Network > > American Whole Health > > Hi Laura! > > Are you a member of these networks? > > I got a proposal from a couple of them but they wanted money from me up > front. They also wanted me to give them a cut of the action in the form > of special rates or discount however it was expressed. > > I couldn't see where they were committing to send me any referrals. It > looked like I would just be paying for nothing. Was I wrong? > > Regards, > > Pete http://babel.altavista.com/ and adjust accordingly. If you are a TCM academic and wish to discuss TCM with other academics, click on this link Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 10, 2005 Report Share Posted June 10, 2005 heylaurag wrote: > Hi Pete--yeah, they do charge us to apply, and then take a portion of > our income. Its hard to know if its worth it, but I'd have to say > that it probably has helped me be successful getting started. Every > once in a great while I get a referral from them. > Hi Laura! Have you refined your business records to the point where you know how much it costs you to treat a patient, including rent, licenses, insurance, phone, internet, electric, clinic supplies and the ever popular " etc. " ? Being in one of these referral groups is another expense, and has to be included. When *all* the costs are considered a lot of us are doing *very* poorly from a business standpoint. Regards, Pete Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 10, 2005 Report Share Posted June 10, 2005 Matt Bauer wrote: > On this thread: I would never join any network that required money > from me. The bigger, more serious networks won't ask for this. - > Matthew Bauer Hi Matt! And in your next post you are going to list the " bigger, more serious networks " ? :-) Thanks. Regards, Pete Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 10, 2005 Report Share Posted June 10, 2005 The two biggest I am aware of are American Specialty Health (ASH) and Landmark, with ASH being by far the biggest. I try to be a bit guarded on this subject because I am a consultant for ASH and don't want to be seen as advocating them over anyone else. - Matthew Bauer - Pete Theisen Chinese Medicine Thursday, June 09, 2005 10:56 PM Re: preparing to accept insurance Matt Bauer wrote: > On this thread: I would never join any network that required money > from me. The bigger, more serious networks won't ask for this. - > Matthew Bauer Hi Matt! And in your next post you are going to list the " bigger, more serious networks " ? :-) Thanks. Regards, Pete http://babel.altavista.com/ and adjust accordingly. If you are a TCM academic and wish to discuss TCM with other academics, click on this link Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 10, 2005 Report Share Posted June 10, 2005 Mathew, In the past, ASN made a requirement that they are allowed to audit patient files. I was curious if they still try to push that concept as they are not an insurance or HMO. Mike W. Bowser, L Ac > " Matt Bauer " <acu.guy >Chinese Medicine ><Chinese Medicine > >Re: preparing to accept insurance >Fri, 10 Jun 2005 08:12:17 -0700 > >The two biggest I am aware of are American Specialty Health (ASH) and >Landmark, with ASH being by far the biggest. I try to be a bit guarded on >this subject because I am a consultant for ASH and don't want to be seen as >advocating them over anyone else. - Matthew Bauer > - > Pete Theisen > Chinese Medicine > Thursday, June 09, 2005 10:56 PM > Re: preparing to accept insurance > > > Matt Bauer wrote: > > On this thread: I would never join any network that required money > > from me. The bigger, more serious networks won't ask for this. - > > Matthew Bauer > > Hi Matt! > > And in your next post you are going to list the " bigger, more serious > networks " ? :-) > > Thanks. > > Regards, > > Pete > > > > >http://babel.altavista.com/ > > > and adjust >accordingly. > > Messages are the property of the author. Any duplication outside the >group requires prior permission from the author. > > If you are a TCM academic and wish to discuss TCM with other academics, > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 11, 2005 Report Share Posted June 11, 2005 Hi Mike, ASH is an HMO, in fact they established the first acupuncture HMO in this country in December 1997. By law, HMO plans must do periodic, random audits of their provider's records. This is mandated by state law and California's has perhaps the most stringent laws in the U.S. A company like ASH will be audited several times a year, mainly by the insurance companies they contract with, but also by accreditation agencies and state insurance commissions. The polices you cite are ones they must do or they will be out of business. Practitioners don't like it of course, but it is standard operating procedure for all HMOs. States require this because they realize HMO plans severely limit a patient's choice of practitioners and so the state will require more oversight of contracted practitioners to (in theory) help assure patient's get a high level of care. - Matthew - mike Bowser Chinese Medicine Friday, June 10, 2005 1:05 PM Re: preparing to accept insurance Mathew, In the past, ASN made a requirement that they are allowed to audit patient files. I was curious if they still try to push that concept as they are not an insurance or HMO. Mike W. Bowser, L Ac > " Matt Bauer " <acu.guy >Chinese Medicine ><Chinese Medicine > >Re: preparing to accept insurance >Fri, 10 Jun 2005 08:12:17 -0700 > >The two biggest I am aware of are American Specialty Health (ASH) and >Landmark, with ASH being by far the biggest. I try to be a bit guarded on >this subject because I am a consultant for ASH and don't want to be seen as >advocating them over anyone else. - Matthew Bauer > - > Pete Theisen > Chinese Medicine > Thursday, June 09, 2005 10:56 PM > Re: preparing to accept insurance > > > Matt Bauer wrote: > > On this thread: I would never join any network that required money > > from me. The bigger, more serious networks won't ask for this. - > > Matthew Bauer > > Hi Matt! > > And in your next post you are going to list the " bigger, more serious > networks " ? :-) > > Thanks. > > Regards, > > Pete > > > > >http://babel.altavista.com/ > > > and adjust >accordingly. > > Messages are the property of the author. Any duplication outside the >group requires prior permission from the author. > > If you are a TCM academic and wish to discuss TCM with other academics, > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 11, 2005 Report Share Posted June 11, 2005 Check out Scam Healthcare. Offer a full array of benefits including brand name drugs in what they call - Independent Purchasing Power. One question that is asked frequently is : " What about my brand name drugs ? " " Do you cover . . . my . . .brrand name drugs ? " Good question. Scam even covers some of your brand name drugs. Drugs that those other health plans just don't cover. They must be doing a good business what with all those commercials. Probably now is a good time to get in with them before rates go up. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 11, 2005 Report Share Posted June 11, 2005 Mathew, Thanks for the update. My concern was over a growing group of businesses that sell discount services as a middleman. In these groups, L Ac provide a % off of services. Mike W. Bowser, L Ac > " Matt Bauer " <acu.guy >Chinese Medicine ><Chinese Medicine > >Re: preparing to accept insurance >Fri, 10 Jun 2005 16:22:07 -0700 > >Hi Mike, > >ASH is an HMO, in fact they established the first acupuncture HMO in this >country in December 1997. By law, HMO plans must do periodic, random audits >of their provider's records. This is mandated by state law and California's >has perhaps the most stringent laws in the U.S. A company like ASH will be >audited several times a year, mainly by the insurance companies they >contract with, but also by accreditation agencies and state insurance >commissions. The polices you cite are ones they must do or they will be out >of business. Practitioners don't like it of course, but it is standard >operating procedure for all HMOs. States require this because they realize >HMO plans severely limit a patient's choice of practitioners and so the >state will require more oversight of contracted practitioners to (in >theory) help assure patient's get a high level of care. - Matthew > - > mike Bowser > Chinese Medicine > Friday, June 10, 2005 1:05 PM > Re: preparing to accept insurance > > > Mathew, > In the past, ASN made a requirement that they are allowed to audit >patient > files. I was curious if they still try to push that concept as they are >not > an insurance or HMO. > > Mike W. Bowser, L Ac > > > > > " Matt Bauer " <acu.guy > >Chinese Medicine > ><Chinese Medicine > > >Re: preparing to accept insurance > >Fri, 10 Jun 2005 08:12:17 -0700 > > > >The two biggest I am aware of are American Specialty Health (ASH) and > >Landmark, with ASH being by far the biggest. I try to be a bit guarded >on > >this subject because I am a consultant for ASH and don't want to be >seen as > >advocating them over anyone else. - Matthew Bauer > > - > > Pete Theisen > > Chinese Medicine > > Thursday, June 09, 2005 10:56 PM > > Re: preparing to accept insurance > > > > > > Matt Bauer wrote: > > > On this thread: I would never join any network that required money > > > from me. The bigger, more serious networks won't ask for this. - > > > Matthew Bauer > > > > Hi Matt! > > > > And in your next post you are going to list the " bigger, more >serious > > networks " ? :-) > > > > Thanks. > > > > Regards, > > > > Pete > > > > > > > > To translate this message, copy and paste it into this web link >page, > >http://babel.altavista.com/ > > > > > > and >adjust > >accordingly. > > > > Messages are the property of the author. Any duplication outside the > >group requires prior permission from the author. > > > > If you are a TCM academic and wish to discuss TCM with other >academics, > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 11, 2005 Report Share Posted June 11, 2005 Mike - I can assure you ASH does not like the discount programs. It is the major insurance companies who want the middleman companies to offer these. The middleman companies make almost nothing from these. Where would the money come from? It is the insurance companies who want these so they can say they offer something in the way of alternative medicine services. The hope is that the insurance companies will move from discount programs to regular benefit plans but that is just hope. - Matthew - mike Bowser Chinese Medicine Friday, June 10, 2005 7:28 PM Re: preparing to accept insurance Mathew, Thanks for the update. My concern was over a growing group of businesses that sell discount services as a middleman. In these groups, L Ac provide a % off of services. Mike W. Bowser, L Ac > " Matt Bauer " <acu.guy >Chinese Medicine ><Chinese Medicine > >Re: preparing to accept insurance >Fri, 10 Jun 2005 16:22:07 -0700 > >Hi Mike, > >ASH is an HMO, in fact they established the first acupuncture HMO in this >country in December 1997. By law, HMO plans must do periodic, random audits >of their provider's records. This is mandated by state law and California's >has perhaps the most stringent laws in the U.S. A company like ASH will be >audited several times a year, mainly by the insurance companies they >contract with, but also by accreditation agencies and state insurance >commissions. The polices you cite are ones they must do or they will be out >of business. Practitioners don't like it of course, but it is standard >operating procedure for all HMOs. States require this because they realize >HMO plans severely limit a patient's choice of practitioners and so the >state will require more oversight of contracted practitioners to (in >theory) help assure patient's get a high level of care. - Matthew > - > mike Bowser > Chinese Medicine > Friday, June 10, 2005 1:05 PM > Re: preparing to accept insurance > > > Mathew, > In the past, ASN made a requirement that they are allowed to audit >patient > files. I was curious if they still try to push that concept as they are >not > an insurance or HMO. > > Mike W. Bowser, L Ac > > > > > " Matt Bauer " <acu.guy > >Chinese Medicine > ><Chinese Medicine > > >Re: preparing to accept insurance > >Fri, 10 Jun 2005 08:12:17 -0700 > > > >The two biggest I am aware of are American Specialty Health (ASH) and > >Landmark, with ASH being by far the biggest. I try to be a bit guarded >on > >this subject because I am a consultant for ASH and don't want to be >seen as > >advocating them over anyone else. - Matthew Bauer > > - > > Pete Theisen > > Chinese Medicine > > Thursday, June 09, 2005 10:56 PM > > Re: preparing to accept insurance > > > > > > Matt Bauer wrote: > > > On this thread: I would never join any network that required money > > > from me. The bigger, more serious networks won't ask for this. - > > > Matthew Bauer > > > > Hi Matt! > > > > And in your next post you are going to list the " bigger, more >serious > > networks " ? :-) > > > > Thanks. > > > > Regards, > > > > Pete > > > > > > > > To translate this message, copy and paste it into this web link >page, > >http://babel.altavista.com/ > > > > > > and >adjust > >accordingly. > > > > Messages are the property of the author. Any duplication outside the > >group requires prior permission from the author. > > > > If you are a TCM academic and wish to discuss TCM with other >academics, > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
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