Antitrust Lawsuit Acupuncturists/Chiropractors/Doctors vs American Specialty Health Price Fixing

We could not remain in-network with Blue Shield of California due to ASH's low rates and unmanageable paperwork and approval process, which seemed more like a way to deny coverage and payment for services than anything else.

The low reimbursement set for medical nutrition therapy for registered dietitians has made our group unable to participate in the Anthem Blue Cross network. This has harmed many of our Anthem Blue Cross clients as they have to pay out of pocket for their medical nutrition therapy

And Licensed Massage Therapists too! We lose money (not break even) on every ASHN patient we see. We have to limit the number of patients we can treat as a result of the ridiculous reimbursement rates.

Dietitians are experiencing the same thing with ASH!

I have been either been paid poorly and unjustly is have been completely not paid for necessary treatments for a patient. A 3 mm Lumbar disc herniation with radicular pains did not justify 3 treatments in 1 month. Are you kidding me? I’m unjust, unfair and a detriment to patient health

ASH has a special department only works to deny the payment to practitioners...

ASH’s only reasons for existence are to deny healthcare to patients and payments to practitioners.

ASH claims patients have 30 visits but accuse the practitioner of over utilization if we try to use anything over 8 and then we get reprimanded. Reimbursement is a joke and what's worse is we are unable to tell our patients what the actual reimbursement is. ASH should be stopped before they ruin all of the California insurance plans and make our profession seem more shady due to their own fee schedules.

ASH is poorly organized, makes a profit as an unnecessary middle man which drives up costs to the patients’ healthcare costs and significantly decreases payment to the hard working providers who operate as small businesses delivering care to patients. As acupuncturists, our treatments are expected to outperform medical, other medical procedures, engage quality of life, and demonstrate effective outcomes yet we are reimbursed so low that it barely covers the overhead of the business. Our business is at a loss for ASH patients after paying our clinic overhead, billing staff (as their billing is highly complicated it takes a lot of our biller’s time to coordinate each patient’s billing), and receptionist to ensure each patient can reach us and schedule in the timeframe required by ASH. They require we see a patient immediately, but their medical review process delays care. They require we screen for tobacco and weight management yet they don’t cover those conditions nor do we get reimbursed for lifestyle counseling.

They need to be stopped. They are a disservice to our profession.

ASH wants to provide affordable prices at the expense of the practitioners doing all of the hard work. Affordable to them. Please help us stay in business...although wouldn't it be nice to thrive!!!

This agency is a poison, the longer time you have, the more damage you will get! Very unkind!

Yes we are getting paid less

This is awful and should be illegal

Acupuncturist Enough of low pay by ASH

This outfit is only in business to collect money from insurance companies by denying contracted benefits. They have no medical staff or legal standing. They are illegally interfering with medical treat and are practicing medicine without licenses.

Alternative health practitioners provide a valuable service, and deserve to be able to make a living doing what they have been well-trained to do. Insurance companies have too much say in the marketplace already, and patients suffer as a result.

Acupuncturists deserve to be paid fairly. We spend 3-5 years obtaining a master’s degree in Chinese medicine and pass 3-4 board exams in order to get licensed to practice. We carry a large debt load in order to pay for our education, much like doctors, but when we graduate there are no hospital jobs or salaries waiting for us. We sustainably get patients out of pain and prevent unnecessary surgery and opiate use. We spend more time with our patients then medical doctors. We often catch medical red flags and know when to send patients to their PCPs. We have real relationships with patients and can inspire change in diet and lifestyle- we are trusted with all sorts of medical advice. I believe that people who take of their bodies with Chinese medicine learn more about how to prevent disease over the course of a lifetime and are LESS taxing on the medical system. We deserve and demand to be paid fairly for our work.

Agreed!

It's about time.