American Specialty Health Plans Of California (ASH)
American Specialty Health Plans Of California, American Specialty Health Inc Or ASH, ASH is a Huge Rip-Off and Scam Artist Organization

My husband and I have been covered under Anthem Blue Cross via COBRA since 1/1/09. We have paid all of our premiums on time and Anthem has always accurately reflected our coverage eligibility.

Through our Anthem Blue Cross coverage, my husband and I supposedly should each have 20 covered acupuncture and/or chiro visits per calendar year. Since Anthem Blue Cross subcontracts with ASH (American Specialty Health) to administer eligibility, authorizations and pricing for both acupuncture and chiro care services, ASH needs to show a member as eligible before any authorization requests and treatment plans can be submitted to them.

It is now almost April and my acupuncturist is still unable to verify ASH eligibility for my husband and I. She is also still unable to submit online authorization requests or treatment plans for us.

I have contacted Anthem numerous times about this situation. I have also talked to my former employer group and ASH. Through the intervention of an Anthem supervisor, supposedly ASH has now finally "manually added me and my husband" to their database (it took 2.5 months to do this!).

Two weeks ago, I received a letter from ASH telling me that they have authorized 1 additional acupuncture visit past the 5 that are automatically granted. I have had 6 acupuncture treatments done this year and I still need more treatments for real medical conditions!

Supposedly Anthem is working on a reconsideration of my authorization problem with ASH. It has been 2 weeks since the reconsideration request was filed. How long is it supposed to take beyond that? I can't get a straight answer from Anthem on this and ASH is impossible to talk to (believe me, I've tried talking to their customer service people a number of times!)

ASH is committing insurance fraud in my opinion and I'm not the only victim of this. I've been told by my acupuncturist that ASH NEVER authorizes the full number of patient visits so that YOU can NEVER access your full chiro/acupuncture benefit (supposed to be 20 visits per calendar year). ASH drags their feet on authorizations, keeps screwing up your eligibility information (so that they can say you are ineligible for coverage), and they wait as long as possible to pay their claims. Does this sound like an ethical company to you? Or is it actually Anthem who is the problem since THEY PAY ASH to administer chiro and acupuncture benefits? Either way, stay away from ASH if at all possible. They are HORRIBLE to deal with for the patient and for providers!

Hopefully the Department of Managed Health Care will soon really start to crack down on ASH and, if necessary, Anthem for non-coverage of chiro and acupuncture benefits.

Company: American Specialty Health Plans Of California (ASH)
Country: USA
State: California
City: San Diego
Address: 777 Front Street
Phone: 6192978100

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