Wiki Bcbs ash???

[haraml7]

Is there any chiropractors contracted with the new florida blue network? The Ash program that has significantly decreases reimbursement.

After the 5 chiropractic visits are paid for by BCBS does the visits go towards coinsurance or deductible, or does BCBS not pay anything. As a "non covered" service.

Any answers would be helpful.
Thank you

 

[alystrappazon]

Sounds like your Doc is tier 1 with ASH if s/he is only getting 5 or 6 visits. If this is the case, then you would need to submit the Clinical Treatment Form with the clinical information the Chiropractor obtained from the visit with his treatment plan. This is an authorization request for more visits. The requests are reviewed by Chiropractors on the Utilization Review Team for ASH and determination is returned within a day or two. They will give you the number and timeframe they are authorizing or tell you that you don't meet medical necessity and the auth is denied. You would have the patient sign a non-covered services agreement specific for ASH and then the patient would be on cash until the new year when their benefits renew. Go back and double check your contract with BCBS and with ASH.

 

[glgallup08]

ash

is your doctor in the ASHN network? sounds like this goes to ASHN instead of BCBS, usually the HMOS and pos's are ASHN. ppo has chiropractic coverage. call and verify benefits