WILL YOU ACCEPT THE ASH LIMIT OF 6.5 VISITS PER PATIENT OR WILL YOU FIGHT?
Will you accept the BCBS ASH 6.5 visits per patient in 2011 or will you fight? The Arizona Chiropractic Society (ACS) hntends to fight. We are NOT going to lie down and roll over and accept this outrage.
Beginning January 1, 2011, all in- and out-of-network claims for the 1 million Arizonans with BCBS coverage will be processed by ASH. Five visits will be allowed and then you will have to get permission for more. ASH has stated their national average is 6.5 visits per patient and one therapy per visit with the adjustment. ACS' attorneys have concluded this is illegal under the Arizona insurance equality law which requires coverage for ALL medically necessary chiropractic care. We all know the notion that the average chiropractic patient only needs 6.5 visits is beyond a joke and borders on fraud.
Once ASH denies medically necessary care as expected in early 2011, complaints will be filed with the Arizona Department of Insurance (ADOI) for failure to cover all medically necessary chiropractic care. If ADOI does not force BCBS through ASH to cover all needed care, ACS will support a lawsuit against ADOI asking the courts to order ADOI to force BCBS to cover all medically necessary care, usually around 25 visits, not the absurd number of 6.5 visits, based on our insurance equality law. This will be a second ACS lawsuit for 2011, in addition to the copay/deductible lawsuit against ADOI which will be filed imminently. The entire ACS legal strategy is outlined in detail below and on the ACS website.
Will you accept the ASH limit of 6.5 visits per patient or will you fight? ASH and BCBS are trying to establish a new definition of medical necessity for chiropractic care in Arizona of only 6-7 visits per patient. The Arizona chiropractic community has long believed the proper number is in the 20-30 range and this is supported by every professional guideline from Mercy to ICA.
300 Arizona chiropractors have chosen to fight by belonging to ACS. Their dues support our essential lawsuits which our the only hope to create real change. 1500 Arizona chiropractors have chosen not to fight because they are not yet members of ACS, the only organization mounting a legal challenge to this outrage. Join the fight today by completing and sending in a membership application which you can find by clicking here: http://www.azchiropractors.org/documents/ACSMembershipApplicationStandard2010_
005.pdf. You can control whether 2011 will be a happy new year for you or not.
Financial support is needed from more than one fifth of the profession to win a legal battle against ASH, BCBS and ADOI for this second lawsuit. The 1500 Arizona DCs sitting on the sidelines will have to get involved or us to prevail unless you are willing to live under ASH rules and regulations for the rest of your career. The choice is yours: 6.5 visits per patients or 25 visits per patients. and 3-4 therapies/procedures per visits with an adjustment or 1 therapy per visit with an adjustment. Do nothing and you get the 6.5 visits and 1 therapy. Join ACS and fight and there is hope we can get back to real chiropractic like before.
Just how much are you going to take before you decide you just aren't going to take it anymore and you join the fight? We're waiting to see. The price tag for becoming part of the solution is only $100 per month in membership dues, even less if you are part-time or a new doctor. Here's the link again to a membership application. We're looking forward to seeing your application come into our fax machine. Don't hesitate to call withe any questions.
THE ACS FOUR POINT PLAN TO DEAL WITH ASH
ACS has developed a comprehensive Four Point Plan to deal with ASH. Click here to read the entire plan: