ASHP

[Guest guest]

Hello all! I was just wondering if anyone has been accepting ASHP and

has been having a good experience? I have been dealing with them and

they are quite demanding. Please feel free to describe your experience

with me as I am re-evaluating whether or not to cancel my agreement

with them. Thank you,

 

Jamie

[Guest guest]

Hi Jean,

 

I have decided not to sign on with ASHP after a thorough evaluation this year.

After reviewing their brief list of what acupuncture would be approved for

(pain, musculoskeletal issues and nausea), I noticed that the different health

insurance companies that contract through them paid different amounts, and I

found it too confusing and not a very user-friendly system. I was attracted by

their online billing system and promises of quick payments, but that was the

only benefit I saw. Plus, I was mindful of the warnings of one of my practice

management teachers, Kevin McNamee, who showed how the fees that chiropractors

can bill insurance got driven down year after year, by insurance companies in

their efforts to make their programs more cost-effective to employers. He

argues that this is the reason chiropractors work the way they do - seeing so

many patients at once - not because they are greedy nor because that is their

preferred mode of working, but because it is

financially necessary, since their insurance payments are so low. I wouldn't

want this to happen with the acupuncture profession too, so this was part of my

decision as well.

 

 

 

jlshutt <jlshutt wrote: Hello all! I was just wondering if anyone has

been accepting ASHP and

has been having a good experience? I have been dealing with them and

they are quite demanding. Please feel free to describe your experience

with me as I am re-evaluating whether or not to cancel my agreement

with them. Thank you,

 

Jamie

 

 

 

Chinese Herbal Medicine offers various professional services, including a

practitioner's directory and a moderated discussion forum.

 

 

 

 

[Guest guest]

I've never gone with ASHP so forgive me these observations about many colleagues

and

friends who have.

What I keep hearing is that if you are new or wanting to crank up your patient

load, ASHP

may but not necessarily will, do that. However, once my friends have been doing

it long

enough they find it too burdensome (as you have described) and try to leave

ASHP.

 

Doug

 

 

 

 

, " jlshutt " <jlshutt wrote:

>

> Hello all! I was just wondering if anyone has been accepting ASHP and

> has been having a good experience? I have been dealing with them and

> they are quite demanding. Please feel free to describe your experience

> with me as I am re-evaluating whether or not to cancel my agreement

> with them. Thank you,

>

> Jamie

>

[Guest guest]

On 8/30/07, wrote:

>

> I've never gone with ASHP so forgive me these observations about many

> colleagues and

> friends who have.

>

 

 

 

 

 

Hi,

 

I'm a colleague and friend of Doug.

 

Its true, when you're just starting out, ASHP is a quick way to get some

bodies passing through the clinic. While there are a few hoops to jump

through for treatment course approvals, they do a good job of giving you a

hefty number of treatments to work with. It isn't a problem to make a case

for 2 or 3 treatments per week for a month.

 

On the other hand, as mentioned prior, their compensation rates are the

lowest in the business and once your practice is up to speed or your

business plan changes, you may need to drop the high-volume/low-price model

for something else. I did.

 

As for the issue of them lowering the " reasonable and customary " fees for

the entire industry, I would agree with that. They're the Walmart of

alternative medicine. However I always found their provider services to be

pretty good.

 

-al.

 

--

, DAOM

Pain is inevitable, suffering is optional.

 

 

 

[Guest guest]

Run away as fast as you can! ASHP requires a lot of paperwork, hardly gives

you what you ask for, and worse, puts you on a list where you're paid a

paltry amount for the quality work you've done.

 

Its best to develop a cash practice, forget about insurance.

 

My $0.02,

 

Robert Chu

chusauli

 

 

 

On 8/29/07, jlshutt <jlshutt wrote:

>

> Hello all! I was just wondering if anyone has been accepting ASHP and

> has been having a good experience? I have been dealing with them and

> they are quite demanding. Please feel free to describe your experience

> with me as I am re-evaluating whether or not to cancel my agreement

> with them. Thank you,

>

> Jamie

>

>

>

 

 

 

[Guest guest]

I agree.

 

 

On Aug 30, 2007, at 2:25 PM, Robert Chu wrote:

 

> Run away as fast as you can! ASHP requires a lot of paperwork,

> hardly gives

> you what you ask for, and worse, puts you on a list where you're

> paid a

> paltry amount for the quality work you've done.

>

> Its best to develop a cash practice, forget about insurance.

>

> My $0.02,

>

> Robert Chu

> chusauli

>

> On 8/29/07, jlshutt <jlshutt wrote:

> >

> > Hello all! I was just wondering if anyone has been accepting ASHP

> and

> > has been having a good experience? I have been dealing with them and

> > they are quite demanding. Please feel free to describe your

> experience

> > with me as I am re-evaluating whether or not to cancel my agreement

> > with them. Thank you,

> >

> > Jamie

> >

> >

> >

>

>

[Guest guest]

I was contracted with ASHP for about 3 years and didn't renew this

year. The red tape was too much. Every 5 treatments or so, both you

and your patients have to send in paperwork requesting more

treatments. Also if you count all the non-billable hours spent

tracking claims, writing authorization requests, and resubmitting

claims that were kicked back unpaid, the whopping $40 per treatment

now drops to about $25.

 

 

-Danny Johnson L.Ac.

 

 

 

 

 

 

 

[Guest guest]

Thank you for all of your feedback I will steer away. These people have been a

headache from the get go. I appreciate your time in this matter and have been

teeter tottering this issue for a while. Thanks again!

 

Jamie

 

 

Danny Johnson <danny wrote:

I was contracted with ASHP for about 3 years and didn't renew this

year. The red tape was too much. Every 5 treatments or so, both you

and your patients have to send in paperwork requesting more

treatments. Also if you count all the non-billable hours spent

tracking claims, writing authorization requests, and resubmitting

claims that were kicked back unpaid, the whopping $40 per treatment

now drops to about $25.

 

-Danny Johnson L.Ac.

 

 

[Guest guest]

I've had both, and cash is waaaay better. But - big but - if you are

in an area with insurance coverage, you're going to have a heck, no, a

big heck of a time starting a cash practice from scratch competing

against all the other acupuncturists who take insurance. Blue Shield

in the Seattle area has been closed to acupuncture for years. If

someone called and thinks you are the best acupuncturist on the

planet, they'll drop you in a NY minute if you don't accept their Blue

Shield insurance.

 

In Seattle, insurance was easily 95% of my business. Here in

Missouri, 100% is cash. I would never want to go back since at the

end of the day it's just one stop at the cash machine for a deposit

and no receivables. Also, I don't have no shows. When people get

their treatments for 'free', they aren't that vested into their

treatment plan as when they have to lay the cash on the table.

 

Geoff

 

, " "

<zrosenbe wrote:

>

> I agree.

>

>

[Guest guest]

Hi Jamie and everyone,

 

I went through the application process with ASHP (lots of paperwork) to become

a provider and here is what I have to say. They asked me if I did direct moxa

and since I was trained in Japanese acupuncture and that is part of our

treatment method I said yes. Then the asked me to write an essay about my

understanding of the technique and requested any research articles

substantiating the technique (apparently they are concerned about their patients

getting burned). I complied with their request. Then they told me that I would

have to change my malpractice insurance to not require my patients to sign an

arbitration agreement with the American Acupuncture Council (AAC). I like that

type because let's say that a patient of mine conjures up a law suit (God

forbid); if I didn't have arbitration then my insurance company could legally

settle out of court with the patient. This could go against my license and

could even jeopardize my license to practice. To me this would be

a bad thing!

 

In addition, ASHP would only reimburse me $40 per patient visit and would not

allow me to charge any co-pay. To me that is price fixing and it doesn't come

close to covering my fee.

To avoid legal issues that could arising out of the concept of price fixing,

let's take a look at a typical (hypothetical) insurance bill:

 

Typical Initial Patient Visit with same day treatment Typical Follow-up

Visit with treatment

99203-25 Initial E/M Low Severity $100

99203-25 Initial E/M Low Severity $100

95831 MMT, Extremity/Trunk $40

97813 Electro Acupuncture $55

95851 ROM, 1 section $50

97024 Infrared (TDP lamp) $30

97813 Electro Acupuncture $55

97140 Myofacial Release $55

97024 Infrared (TDP lamp) $30

Total $140

97140 Myofacial Release $55

Total $330

 

These values are based on the Relative Value Unit (RVU) established by the

American Medical Association.

RVU = W+PE+M

Relative Value Unit (RVU)

Work performed by the physician (W)

Practice expense or overhead of physician (PE)

Physicians malpractice expense (M)

 

My 2007 RVU Conversion Factor (CF) = $37.8975

RVU x Conversion Factor = Reimbursement (How much is charged)

 

See the following link:

http://www.acupuncturetoday.com/online/martincptcodes.html

 

Granted, that most insurance companies don't presently pay the full amount

that is billed.

But, the amount they do pay is substantially a lot more than $40 per patient

visit.

 

Here is a hypothetical reduced fee for the uninsured and underly insured

patient.

Initial visit $120 Follow-up $75 Senior citizen/Student/financial

hardship $45

 

Under the ASHP the practitioner wouldn't even be reimbursed for the reduced

minimum $45 fee! That's not going to pay my bills. Now, even if they were

willing to undergo this substantial cut in pay and do what the chiropractors do

" rack 'em and crack 'em " or in this case stick 'em and kick 'em ... off the

table that is', which I'm not and never will be, there is a lot of additional

paperwork that ASHP requires which I feel is unrelated to normal documentation

of patient care & progress. It would seem as though ASHP wants to use me to

collect a bunch of statistical information on patient care for some reason. All

this translates into additional (uncompensated) time that that would have to be

spent filling in their paperwork.

 

Marilyn Allen president of the AAC taught my Business ethics & practices class

suggested that ASHP is undermining the acupuncture profession and recommended

against subscribing. I also have three (3) colleagues from the PCOM doctoral

program who were once ASHP members and have since elected not to re-

because if dissatisfaction with the fee compensation.

 

A former congressional candidate informed me that ~32% of all healthcare costs

are absorbed by the middle man companies like ASHP. When you realize that the

money is coming out of yours & my pockets, (the people who are actually doing

the work to treat the patients, I think that is outrageous! And, when you see

how much the HMO's are paying their top executives you will probably be

appalled. Bear in mind that the executive's job is to make the company

profitable meaning that they are trying to cut down on medical expenses while

maximizing profitability.

http://www.familiesusa.org/resources/newsroom/press-releases/1998-press-releases\

/press-release-families-usa-study-examines-executive-compensation-in-managed-car\

e.html

 

By subscribing to organizations like ASHP you are undermining your own

profession by making it possible for other insurance carriers to reduce the fees

that they compensate for acupuncture services. Why should they pay more when

there are acupuncturists who are willing to work for $40 a treatment? You may

think that $330 may be excessive but when you think about all the knowledge and

training (as a primary healthcare physician there is a lot of responsibility

that you don't miss a red flag condition, etc.), outstanding student loans,

overhead like office rent, receptionist, marketing costs, malpractice insurance,

etc. it adds up pretty quick and hypothetically they only pay let's say $120 but

that is triple what ASHP pays.

 

I definitely took a pass on ASHP!

 

Good luck to you with your decision,

Steve

 

< wrote:

Hi Jean,

 

I have decided not to sign on with ASHP after a thorough evaluation this year.

After reviewing their brief list of what acupuncture would be approved for

(pain, musculoskeletal issues and nausea), I noticed that the different health

insurance companies that contract through them paid different amounts, and I

found it too confusing and not a very user-friendly system. I was attracted by

their online billing system and promises of quick payments, but that was the

only benefit I saw. Plus, I was mindful of the warnings of one of my practice

management teachers, Kevin McNamee, who showed how the fees that chiropractors

can bill insurance got driven down year after year, by insurance companies in

their efforts to make their programs more cost-effective to employers. He argues

that this is the reason chiropractors work the way they do - seeing so many

patients at once - not because they are greedy nor because that is their

preferred mode of working, but because it is

financially necessary, since their insurance payments are so low. I wouldn't

want this to happen with the acupuncture profession too, so this was part of my

decision as well.

 

 

 

jlshutt <jlshutt wrote: Hello all! I was just wondering if anyone has

been accepting ASHP and

has been having a good experience? I have been dealing with them and

they are quite demanding. Please feel free to describe your experience

with me as I am re-evaluating whether or not to cancel my agreement

with them. Thank you,

 

Jamie

 

Chinese Herbal Medicine offers various professional services, including a

practitioner's directory and a moderated discussion forum.

 

 

 

[Guest guest]

Hello,

 

I thought I'd give my two cents worth, as well, on

ASHP...

 

In my private practice, with few exceptions, I have

chosen to never deal with insurance companies, because

of the hassle they tend to put one through, and the

resulting lessening of the actual reimbursement that I

would receive as a practitioner. I decided this while

still in acupuncture school at NESA.

 

However, when I first moved to San Francisco from

Boston now three years ago, I worked for a brief time

at Quan Yin Healing Arts Center, where I worked as an

acupuncturist in this acupuncture clinic, serving the

public's health - which was more like a volunteer

position, as the pay is very low (understandable when

one is working in the public health field). I also had

an administrative position and did some work

organizing their herbal pharmacy, among other things.

 

In any case, as an acupuncturist there I was asked to

go through the laborious process of applying for and

becoming an ASHP provider. It took several months and

a curious amount of paperwork to finally be accepted.

But after the application process, other staff more

familiar with jumping through hoops than I took to the

task of getting the reimbursement, which was far lower

than I or other competent and knowledgeable

acupuncturists should be paid. So I didn't have to

deal with any of the paperwork involved after that

point.

 

At the same time, I had my private practice starting

up in the Mission district of SF (which is still going

quite well, I am grateful to say) and had one patient

who had ASHP and I thus was required (because if you

are on their list, my understanding is you can only

charge the patient the $10 co-pay and then wait to

receive $30 from ASHP) to take their insurance. So I

submitted the forms myself and had many back-and-

forth conversations before I received $30 (and the

resultant liver qi stagnation) for, maybe, two of the

sessions out of, I think 8, that I had sent in (This

was a few years ago now, but I think that's accurate).

 

At any rate, it was a frustrating experience and I

quickly decided to end my contract with them, which I

did in writing, after I stopped working at Quan Yin

(after a year of service) and so it wasn't necessary

anymore.

 

So, this is a long story but thought I'd share my

experience and say, I am of the opinion that it is

much better to not deal with them, if one can, unless

you have front desk staff or an office manager, etc.,

who is patient and can learn how to jump through the

appropriate and ever-changing hoops they put you

through. When you factor the time spent calling them,

sending in forms, having the stress of it, the

reimbursement is even more minimal.

 

Also, if you are open to it, go see the film " Sicko "

which exposes quite a lot of the real interest behind

insurance companies which, unfortunately but not

surprisingly, is not increased health, well-being and

health care of the people who buy it, but, rather,

increased profits for the insurance companies

themselves. We need a better system in this country,

as I'm sure we are all well aware!

 

 

Best,

Renee Hahn, Dipl OM

1452 Valencia Street

San Francisco, CA 94110

415.722.1723

 

 

 

______________________________\

____

Sick sense of humor? Visit TV's

Comedy with an Edge to see what's on, when.

http://tv./collections/222

[Guest guest]

By the way, they make money not only from your pocket, but from the pocket of

insured also who have to pay co-payment for every vesit. I have an old lady who

used to pay co-payment for $5 and I get from them only $35, the next year they

told her to pay $10 copayment and from them I get $30. The third year they

increased copayment to $20 and from them I get only $20 Is it fair? They are

robber barons without any ethics

 

Yuri Ovchinnikov

[Guest guest]

Hi All,

 

I am resubmitting some of the info from my previous message in table form (some

of the columns were merged in the orginal message).

 

Typical Initial Patient Visit with same day treatment

Typical Follow-up Visit with treatment

 

99203-25

 

Initial E/M Low Severity

$100

99213-25

Follow-up E/M Low Severity

$75

95831

MMT, Extremity/Trunk

 

$40

97024

Infrared (TDP lamp)

 

$30

95851

ROM, 1 section

$50

97813

Electro Acupuncture

$55

97024

Infrared (TDP lamp)

$30

97140

Myofacial Release

 

$55

97813

Electro Acupuncture

 

$55

 

Total

$140

97140

Myofacial Release

 

$55

 

 

 

 

Total

$330

 

 

 

 

 

Steve Sterling <acusteve1 wrote:

Hi Jamie and everyone,

 

I went through the application process with ASHP (lots of paperwork) to become a

provider and here is what I have to say. They asked me if I did direct moxa and

since I was trained in Japanese acupuncture and that is part of our treatment

method I said yes. Then the asked me to write an essay about my understanding of

the technique and requested any research articles substantiating the technique

(apparently they are concerned about their patients getting burned). I complied

with their request. Then they told me that I would have to change my malpractice

insurance to not require my patients to sign an arbitration agreement with the

American Acupuncture Council (AAC). I like that type because let's say that a

patient of mine conjures up a law suit (God forbid); if I didn't have

arbitration then my insurance company could legally settle out of court with the

patient. This could go against my license and could even jeopardize my license

to practice. To me this would be

a bad thing!

 

In addition, ASHP would only reimburse me $40 per patient visit and would not

allow me to charge any co-pay. To me that is price fixing and it doesn't come

close to covering my fee.

To avoid legal issues that could arising out of the concept of price fixing,

let's take a look at a typical (hypothetical) insurance bill:

 

Typical Initial Patient Visit with same day treatment Typical Follow-up Visit

with treatment

99203-25 Initial E/M Low Severity $100 99203-25 Initial E/M Low Severity $100

95831 MMT, Extremity/Trunk $40 97813 Electro Acupuncture $55

95851 ROM, 1 section $50 97024 Infrared (TDP lamp) $30

97813 Electro Acupuncture $55 97140 Myofacial Release $55

97024 Infrared (TDP lamp) $30 Total $140

97140 Myofacial Release $55

Total $330

 

These values are based on the Relative Value Unit (RVU) established by the

American Medical Association.

RVU = W+PE+M

Relative Value Unit (RVU)

Work performed by the physician (W)

Practice expense or overhead of physician (PE)

Physicians malpractice expense (M)

 

My 2007 RVU Conversion Factor (CF) = $37.8975

RVU x Conversion Factor = Reimbursement (How much is charged)

[Guest guest]

Hello,

 

I just want to thank you all for sharing your experiences with me. I

am happy to say that I have withdrawn my application with ASHP. I

really appreciate all of your info Steve. I am a relatively new

acupuncturist from PCOM only a year and half since all of those fun

boards... I relocated from La Jolla to Alameda and found myself open

to what was going on already in my new establishment. The Wellness

center accepted this ASHP and since I was given referrals I guess I

followed suit treating these patients. I have only been here since

May and I guess there is always a learning curve to a new practice.

Thank you again!

 

I am still playing with this billing software and trying to get more

effient with it Practice Mate through Office Ally if anyone has any

tidbits or experiences I am all ears. I still feel that Medisoft was

much more accomodating.

 

Perhaps Renee if you have anytime i would love to hear about your

practice in the Mission district in SF.

 

Cheers!

 

Jamie