Charschan Chiropractic will no longer be participating with Cigna healthcare as of 11/1/2015
Due to actions by Cigna who will be requiring doctors to contract with American Specialty Health (ASH) to continue their participation by October 31st, we longer be contracted with Cigna PPO.
A few years ago, when Cigna decided to use ASH for a number of their plans, we joined temporarily, only to find out that as participating providers, we were working harder, being burdened with time consuming precertification forms, being paid improperly and in an untimely manner by ASH as required by law in NJ.
ASH has a history of poorly treating providers, and have been subject to a class action suit because of their methods of billing the plan, yet paying the doctors an unfair portion of that rate even though they were the ones working on the patient. Those who have high deductible plans are aware of their activities since they find that ASH had charged $79 to Cigna, and then paid $50 for the doctor to do what is necessary for their client for an average patient visit. We are aware of this because we have actually seen some of the evidence used against ASH in the class action case against them. The doctors accept this reduced fee and their excessive paperwork which is in many offices near or below their cost of performing the service.
Our patients are aware of the hard work it requires to help them, while being unaware of the hard work that goes on behind the scenes on their behalf. In any business, cash flow is essential as well as a fair reimbursement scheme. In our experience, this is a great business model for ASH but a horrible one for their participating doctors who work very hard to help their patients.
It is unfortunate that Cigna continues to use ASH, even as they are now being acquired by Anthem Health, a Blue Cross Blue Shield multi state insurance conglomerate.
We will continue to treat Cigna patients on an out of network basis and we are sorry for any inconveniences this may cause. This will allow us to continue to offer the high quality of care we have always offered, with our free rehabilitation suite.
While there are doctors of chiropractic who participate in ASH, the most experienced and established practices do avoid them due to their reimbursement schemes and policies.
Again, we are sorry for any inconvenience this may cause, however most PPO plans do offer out of network benefits with a reasonable deductible and some of the plans offer better out of network benefits than they do in their networks. Please call us with any concerns. We can review your out of network benefits with you and explain the differences to you.