Insurance vs Wellness



The struggle is real. When it comes to dealing with insurance companies, your well-being is only as important as the money it will save the insurance companies. For over 10 years I have worked alongside as many insurance companies as possible to make sure that my patients were getting the best care with the least amount of financial stress and concerns. This past year, it became overwhelming, and I am afraid patient care will suffer if I continue to try to work through this bureaucracy.

“When it comes to dealing with insurance companies, your well-being is only as important as the money it will save the insurance companies.”

I have decided to cancel my contract with American Specialty Health (ASH)- a third party billing company that is exclusively affiliated with the following insurance companies: Aetna, Blue Shield/Blue Cross, Cigna, Health Net, Kaiser and Sharp. My reasoning for making this decision is three-fold.


Ethics. Logistics. Finances


Ethics: Quantity vs. Quality


I pride myself on patient care and attention. I have been accepting and working with insurance since 2010. American Specialty Health has been growing as a third party biller and over the past year has acquired almost every major insurance company under their umbrella. This has left me spending more time dealing with insurance companies than with my patients. Dealing with the insurance business model creates a level of insensitivity that does not work for my vision of promoting my patients’ health.


Logistics:


I tried working with billing companies and considered creating an in-house billing department. In order to justify the cost of this I had to double my patient load and felt that it impacted the intimacy of my patient-practitioner relationship. I would have to nearly triple the size of my practice in order to maintain the American Specialty Health contract.


Finances:


Although you may see higher numbers on your Explanation of Benefits statements, the current reimbursement cap from ASH is $41 per treatment- this includes your co-pay. More and more often, I am being denied ANY payment and very often ASH denies further treatments based on what they determine is medically necessity. This is not the way I wish to practice or put my education to its best use.


In conclusion:


I have chosen to no longer work with the insurance companies that are more focused on their bottom line than your well-being. If you are an existing patient, I will do all I can to continue your care and treatments. Thank you for your patience and understanding.

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