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Welcome to the Chiropractic Networks Action Center, where you can access resources to defend your practice, read the latest news about efforts on both the national and state levels to correct the wrongful practices of certain chiropractic managed care networks, and speak up on behalf of chiropractors everywhere. |
Contact: 1(800)986-4636
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| Take Action! |
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Help ACA Gather Information
Online Insurance Data Collection Form
Advocate for Patients Through ERISA
When the plan for treatment for your patient is restricted or denied, the employer may want to know about their employees' inability to access the the benefits that have been provided for them. The following letter can be used for this purpose. Typically, ERISA legal remedies are used after care has been delivered and claims have been denied. The information sheet below provides details regarding how you can advocate for your patient's right to access their benefits.
Write a Letter to Your State Department of Insurance
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Use this template letter for state department of insurance. Please make sure that you identify the proper agency to contact in your individual state. In some states, this may not be the state department of insurance but the state office of managed care or department of health. -
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| What's Going On |
- ACA Policy Statement on Discriminatory Practices in Managed Care:
Ratified by the ACA House of Delegates, March 2002
- Resolved, that the ACA vehemently opposes these harmful and discriminatory practices, including but not limited to: limiting full scope of practice, inappropriate CPT applications and reimbursement policies, use of discount/affinity programs, restrictive limits of care, and improper utilization review. Be it further resolved that ACA staff and leadership are directed to communicate our concerns to the profession; obtain detailed data on these abuses; develop and implement a plan to halt these unfair practices; and give a status report in August 2002 and at each subsequent House of Delegates meeting.
- ACA Press Releases
- Coverage of the Story in the Media
- Unauthorized Use of ACA's Name
- ACA notifiying UnitedHealthcare (the parent company of American Chiropractic Network [ACN]) on two occasions that ACA shouldn't be cited as the source for reducing designated procedure code 98943 by 50 percent.
- ACA writing to to American Specialty Health Plans (ASHP) telling them to cease and desist from citing an ACA article as justification for reducing a treatment plan. Click here to view this letter, sent in May 2003: http://www.acatoday.com/content_css.cfm?CID=977.
A couple of years earlier, we sent them a similar warning letter when their spokespersons were implying ACA support for their activities.
- Pay-for-Performance Programs: It's Not Just a Chiropractic Issue.
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| FAQ |
- What is a chiropractic network?
Insurance companies traditionally have contracted with physicians directly to form a network of providers which it can offer to employers as those who will accept reduced "contracted rates" for services provided in exchange for the potential of more patient referrals. Much like other businesses outsource certain processes such as payroll, marketing, etc. to companies that specialize in those services, many insurers have "outsourced" the management of their chiropractic benefits to companies that contract with doctors of chiropractic and manage the utilization management of those services.
- I've heard that the ACA is involved with certain chiropractic networks. Is that true?
No. ACA published materials are often cited by chiropractic networks, however, this in no way infers the ACA's sanction of a network's practices. The ACA is very concerned about unauthorized use of its name, or references that are used in a misleading manner as you can see in this section of CNAC. If a network or insurer is using the ACA's name, please notify us by calling 1-800-986-4636 or emailing Laurie Douglass, Vice President of Insurance Relations, at ldouglass@acatoday.
- I think my network is downcoding and bundling my claims and restricting the authorization of appropriate patient care. Are there any resources the ACA offers to help me combat these issues?
The ACA opposes the practices of certain chiropractic networks whose reimbursement practices inappropriately reduce reimbursement and who impose utilization standards that compromise quality patient care. We are collecting data to better understand and combat these abuses, and we recommend that you consider submitting information about your experiences on our managed care data collection form and that you can take action by using resources like the ERISA template letters and the state department of insurance letters. Additionally, the ACA has coding clarifications available in its Chiropractic Coding Solutions Manuals and online. You may use these pieces as talking points with networks.
- When is something going to change?
The ACA is greatly concerned for the welfare of doctors of chiropractic and their patients, and is very aware of many of the issues confronting DC's in their everyday practice. We have launched this initiative to address and bring attention to the problems some chiropractic networks create for doctors of chiropractic, and intend to do everything within our power to strongly advocate on behalf of the profession. On June 13, 2006, an amended complaint was filed in multi-district litigation taking place in a U.S. District Court in Miami, adding ACA and the Connecticut Chiropractic Association (CCA) as plaintiffs and American Chiropractic Network (ACN) as a defendant. While this issue goes through the courts, ACA strongly encourages all doctors of chiropractic to take action at the state level.
There may not be an instant solution to these issues, but we have devoted staff and resources to implement many initiatives now under way. Again, the ACA strongly encourages doctors to become involved through action to protect their patients and their practices. To stay abreast of the ACA's initiatives, continue to check this webpage (CNAC: http://www.acatoday.com/level2_css.cfm?T1ID=14&T2ID=121) and monitor the latest pieces in ACA News and the Weekly EVP Report. |
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