(Wisconsin, April 4) Chiropractors in WI received certified letters from Anthem BCBS announcing that they are initiating a sweeping reduction of their chiropractic provider network to supposedly “right size their provider network as a result of the ACA”.
According to Mr. Dave Michel of Petty, Michel & Associates, if you have one of these letters, you’ll be removed from the BX network on Sept 30 “without cause”, as allowed under your provider agreement.
He says that it looks like they may be targeting larger clinics in each city with higher utilization and also possibly those with a focus towards wellness,and that this doesn’t bode well for their customer base.
Dave mentioned that a similar tactic was used by insurance companies in Massachusetts with the introduction of “Romney-Care” in 2006 and after the hue and cry, chiropractic offices continued to grow. This has also been the case with offices that we have worked with when the doctor was booted from a network – stats go up!
In many cases, the out of network benefits are close to those in network.
Dave has written a letter that you can customize and send to your patients should you get hit by an insurance company claiming they need to “right size.” You can download a copy of this letter as a Word file with the link provided below.
A key to survival is patient education, not only on chiropractic, but also on chiropractic benefits. This is why we stress the Patient Financial Consultation, or the Post Report of Findings.
Lastly, Dave recommended working together as a group with your state associations and respectfully confronting any insurance company that discriminates against chiropractic services with the facts. And the facts are that chiropractic care doesn’t cost… it pays.
While you may not practice in Wisconsin, there may be a time when you receive such a letter and if you do, these suggestions can help.
For PM&A clients, if you have received a letter like this, let us know and we’ll work with you on your options.
Sincerely,
Ed