ASHP

[Guest guest]

This may a bit off topic, but I know that there has been discussion of ASHP here

in the past. I am a reluctant provider. I decided to accept the low fee

schedule, because they promised a facilitated authorization process. i.e. they

did not require faxing tx notes. Now, I have recieved a letter requesting (with

the threat of terminating my affliation) treatment notes for three patients,

going back more than three years. I was told that this was a random audit to

make sure that I was collecting the necessary information. They have given me 1

wk to submit the notes. I'm indignant. I think I may call their bluff.

Has anyone else had this experience?

Thanks, Dean

 

 

[Guest guest]

Dear Dean,

 

I don't belong to ASHP, but I think their request is unreasonable. I belong

to several networks, including Cigna, and they do not routinely require

treatment notes at all. Only if they are trying to establish medical

necessity (usually because I used a questionable diagnosis code, like for

TMJ).

 

I think you should contact your rep (whoever recruited you, or find a

provider relations person) and ask them why they are harrassing you like

this.

 

Julie

 

 

-

" Dean Militello " <windwater5

 

Tuesday, January 20, 2004 8:58 PM

ASHP

 

 

> This may a bit off topic, but I know that there has been discussion of

ASHP here in the past. I am a reluctant provider. I decided to accept the

low fee schedule, because they promised a facilitated authorization process.

i.e. they did not require faxing tx notes. Now, I have recieved a letter

requesting (with the threat of terminating my affliation) treatment notes

for three patients, going back more than three years. I was told that this

was a random audit to make sure that I was collecting the necessary

information. They have given me 1 wk to submit the notes. I'm indignant. I

think I may call their bluff.

> Has anyone else had this experience?

> Thanks, Dean

>

[Guest guest]

On Jan 20, 2004, at 7:58 PM, Dean Militello wrote:

 

> This may a bit off topic, but I know that there has been discussion of

> ASHP here in the past. I am a reluctant provider.

 

The Reluctant Provider. Sounds like an Bravo channel reality series. :

)

 

> I decided to accept the low fee schedule, because they promised a

> facilitated authorization process. i.e. they did not require faxing tx

> notes. Now, I have recieved a letter requesting (with the threat of

> terminating my affliation) treatment notes for three patients, going

> back more than three years. I was told that this was a random audit to

> make sure that I was collecting the necessary information. They have

> given me 1 wk to submit the notes. I'm indignant. I think I may call

> their bluff.

> Has anyone else had this experience?

 

I received one of these requests recently too. Perhaps two months ago.

Like you, it was for patients I saw a few years ago.

 

I figure that if I were ASHP, I'd want to see some documentation

periodically as well. The real issue here is the scanty one week to

get it together. I would ask for more time if you need it. They gave

me something like a month. It wasn't a big hurry for me. Perhaps three

weeks.

 

The request also came in a 2nd day air package of some sort and

included another 2nd day air envelope to return the information that

they requested, so I found the whole process to be somewhat painless.

I have to admit though, that it did unerve me.

 

If you didn't get your request in a timely manner (such as a long

period of time between the date on the written request and the postmark

on the envelope), I think that you should ask for more time.

 

-al.

 

 

> Thanks, Dean

>

>