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American Specialty Health Inc

Additional Locations

Phone: (858) 754-2000 Fax: (619) 297-1717 View Additional Phone Numbers 10221 Wateridge Cir #101, San Diego, CA 92121 View Additional Email Addresses http://www.ashcompanies.com View Additional Web Addresses


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Description

This health services company offers health plans, employer groups, insurance carriers, and trust funds a wide range of total population health management, fitness and exercise, and specialty health care management programs.


BBB Accreditation

A BBB Accredited Business since

BBB has determined that American Specialty Health Inc meets BBB accreditation standards, which include a commitment to make a good faith effort to resolve any consumer complaints. BBB Accredited Businesses pay a fee for accreditation review/monitoring and for support of BBB services to the public.

BBB accreditation does not mean that the business' products or services have been evaluated or endorsed by BBB, or that BBB has made a determination as to the business' product quality or competency in performing services.


Reason for Rating

BBB rating is based on 13 factors. Get the details about the factors considered.

Factors that lowered the rating for American Specialty Health Inc include:

  • 13 complaint(s) filed against business

Factors that raised the rating for American Specialty Health Inc include:

  • Length of time business has been operating
  • Response to 13 complaint(s) filed against business
  • Resolution of complaint(s) filed against business


Customer Complaints Summary Read complaint details

13 complaints closed with BBB in last 3 years | 6 closed in last 12 months
Complaint Type Total Closed Complaints
Advertising/Sales Issues 1
Billing/Collection Issues 1
Delivery Issues 0
Guarantee/Warranty Issues 0
Problems with Product/Service 11
Total Closed Complaints 13

Customer Reviews Summary Read customer reviews

3 Customer Reviews on American Specialty Health Inc
Customer Experience Total Customer Reviews
Positive Experience 0
Neutral Experience 0
Negative Experience 3
Total Customer Reviews 3

Additional Information

BBB file opened: May 01, 1998 Business started: 11/09/1994 in CA Business incorporated 05/27/1999 in DE
Licensing, Bonding or Registration

This business is in an industry that may require professional licensing, bonding or registration. BBB encourages you to check with the appropriate agency to be certain any requirements are currently being met.

These agencies may include:

California Department of Insurance
Consumer Services Division, 300 South Spring Street, Los Angeles CA 90013
http://www.insurance.ca.gov
Phone Number: 800-927-4357
Fax Number: 213-897-5961
The number is 0B89313.

Type of Entity

Corporation

Business Management
Mr. George DeVries, CEO Mr. William M Comer Jr., CFO
Contact Information
Principal: Mr. George DeVries, CEO
Number of Employees

1,199

Business Category

Insurance Companies Health Care Management


Additional Locations

  • 10221 Wateridge Cir #101

    San Diego, CA 92121 (800) 848-3555 (800) 678-9133 (619) 578-2000 (800) 972-4226 (858) 754-2000

  • PO Box 509077

    San Diego, CA 92150

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BBB Customer Review Rating plus BBB Rating Overview


BBB Customer Reviews Rating represents the customers opinions of the business. The Customer Review Rating is based on the number of positive, neutral and negative customer reviews posted that are calculated to produce a score.

Customer Review Experience Value
Positive Review 5 points per review
Neutral Review 3 points per review
Negative Review 1 point per review

BBB letter grades represent the BBB's opinion of the business. The BBB grade is based on BBB file information about the business. In some cases, a business' grade may be lowered if the BBB does not have sufficient information about the business despite BBB requests for that information from the business.
Details

BBB Letter Grade Scale

BBB Rating Value
A+ 5
A 4.66
A- 4.33
B+ 4
B 3.66
B- 3.33
C+ 3
C 2.66
C- 2.33
D+ 2
D 1.66
D- 1.33
F 1
NR -----
Star Rating scale

  Average Score
5 stars 5.00
4.5 stars 4.50-4.99
4 stars 4.00-4.49
3.5 stars 3.50-3.99
3 stars 3.00-3.49
2.5 stars 2.50-2.99
2 stars 2.00-2.49
1.5 stars 1.50-1.99
1 star 0-1.49

BBB Customer Review Rating plus BBB Rating is not a guarantee of a business' reliability or performance, and BBB recommends that consumers consider a business' BBB Rating and Customer Review Rating in addition to all other available information about the business. If the BBB Rating is NR then only Customer Reviews are used for the Star Rating.

Complaint Detail(s)

10/30/2015 Problems with Product/Service | Read Complaint Details
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Additional Notes

Complaint: In Jan 2015 my employer changed and we had to shift from **** ****** to ***** insurance. ***** insurance plan says 60 PHYSICAL THERAPIST VISITS PER YEAR PER PERSON. My son needed continuation of physical therapy in Jan 2015 to treat his elbow injury and my APPEAL for an out of network Physical therapist who he jhad been seeing since Dec 2014 (**** ******** *******) to be considered in-network PT was DENIED. MY sons elbow never fully healed and in July, 2015 my son's elbow injury started again with a pain of 9 out of 10. Our pediatrician once again gave us a referral to get PT, upset that we had stopped PT when it was helping. Now, American Specialty Health (ASH) refuses to cover more than 12 appointments of PT even though the pain in not fully treated (it varies from 3 to 8 depending on activity). ***** OUTSOURCES decisions of PT to American Specialty. ASH does not talk to customers of ***** after I was on hold for 30 minutes. ***** has created a chronic elbow injury in my son by outsourcing medical decisions to ASH instead of ***** doctors. Our pediatrician and physical therapist both agree to continue his PT until pain is completely gone since he is also a growing teenager, but *****'s outsourced doctors are hiding as middlemen and preventing correct medical treatment which may affect a teenagers growth.

Desired Settlement: Insurance should cover physical therapy as needed to support good health and growth in a teenager: even past 60 annual appointments if needed for pain-free lifestyle and healthy body.

Business Response:

please see attached response that was sent via US mail to the complainant today. 

Mr. ****,


American Specialty Health (ASH) has reviewed the complaint you submitted to the BBB regarding services rendered to your son, ****** ****, by ****** ******** ******** ***. Your complaint indicates that your son’s benefit plan allows for 60 physical therapist visits per year and that ASH refuses to cover more than 12 appointments of physical therapy.


Your benefit program requires verification of medical necessity for services to be considered covered under your plan. In this case, records were submitted by ****** ******** ******* on 8/17/15 for dates of service 8/5/15 – 9/15/15 for 12 physical therapy visits. The submitted request was processed under #********. The Medical Necessity Review (MNR) Response letter sent to you and copied to ****** ******** ******* indicated that 7 dates of service with 4 units per date of service were verified as medically necessary. Under the program administered by ASH on behalf of *****, members can receive payment for the first five visits of the calendar year to a physical therapy services practitioner without the need for medical necessity verification. After the first five visits of the year or after a request for medical necessity verification is submitted, any other services require submission of medical records to ASH for clinical evaluation.


On 8/28/15, ASH received a request for verification of medical necessity for a date range of 8/25/15 – 10/16/15 requesting 8 additional dates of service (#********). The Medical Necessity Review (MNR) Response letter sent to you and copied to ****** ******** ******* indicated that 6 dates of service with 4 units per date of service were verified as medically necessary during the date range requested.


The documentation submitted indicated that the patient is functioning at a very high level including continuing to play tennis for 5 to 6 days a week for one and one half hours per day as well as conducting teaching tennis clinics. It was reported that initial complaint of pain was 8 out of 10 and had improved to mild pain level of 3 out of 10. Strength testing was reported with mild limitations of forearm musculature as 4+ to 5/5 (5/5 equals normal strength or no deficit). Ranges of motion for right forearm were reported as mildly decreased to normal ranges with some hypermobility at end range of supination and extension which could be related to younger age (bone growth not completed and increased elasticity of muscle, tendons and ligaments) or due to the continued repetitive nature of this injury. Functional Outcome Measure (FOM), DASH was reported to have improved from a score of 16.38, to 12.93, both indicating minimal disability. FOM score change was less than 4 and did not meet minimum clinically detectable change. Orthopedic stress testing for the medial ulnar collateral ligament noted intermittent mild symptoms only during periods of flare ups however no report of ligamentous laxity or a positive test on findings submitted. There was no other report of objective findings indicating that there were any other deficits in the right arm. An overall review of the clinical findings, nature and stage of the condition, as well as the repetitiveness of the injury, a total of 18 visits is more than the appropriate amount of care for this recurrent chronic condition. With the member’s ongoing high level of activity that continues to exacerbate his elbow symptoms described above, there is no indication that additional visits would resolve the mild clinical deficits or decrease his complaints of pain to 0/10.


****** ******** ******** ***. has the option of submitting a request to reopen the most recent medical necessity review should they have additional information to support the needed services. In addition, if future services are needed, ****** ******** ******** ***. can submit a new request to ASH for verification of medical necessity. You may also be able to file an appeal directly with ***** if you would like the denied services to be reviewed again. Please contact ***** directly to submit such an appeal.


In response to your concern that ASH could not speak to you about your concerns, ASH is not delegated by ***** for the handling of member phone calls. ASH directs all member calls back to ***** for customer service handling. ASH apologizes for the long hold time you experienced when contacting us. We strive to provide the best possible customer service and will use your feedback to help improve our level of service.


Should you have any questions, please contact me directly at ************ extension ****.


Sincerely,






***** ********
****** ******** ******** **********
American Specialty Health

Consumer Response:

Better Business Bureau:

I have reviewed the response made by the business in reference to complaint ID ********, and have determined that this proposed action would not resolve my complaint.  For your reference, details of the offer I reviewed appear below.
I called ***** at ************ ext **** several times and left a message asking to call me back but have not received a phone call to clarify ASH's decision, and my 7 says to respond to BBB are approaching. Since the pediatric patient has a history of elbow/ shoulder pain that gets exacerbated when his physical therapy stops, the PT and pediatrician both agree to continue therapy till the pain has been gone for few months and the growing joint is more stable as the therapy has significantly reduced pain. I would appreciate if ASH can approve 1X week visit for remaining 2015 as we are well within the 60 physical therapy limits allowed by ***** per subscriber.
Also, my son was gone for a school trip and has 2 visits left including a visit planned today. I called ***** to check on currently approved dates, but they said ASH is closed. ASH's letter to BBB and copied to me says currently approved visits need to be completed by 10/16/15 while ***** says 10/6/15. Since ***** says ASH is the decision maker, I am assuming ASH letter to me is correct and currently approved visits can be completed by 10/16/15. 


Regards,

******* ****



Business Response:

ASH would like to provide clarification on the covered dates and the unpaid services.

The approved medical necessity review has date of services for 6 office visits for the date range 8/25/15-10/06/15, indicating that the 6 visits must be completed on or before 10/06/15.  As per instructions on practitioner response form (the form the treating physical therapist received), the treating physical therapist (PT) can submit a Reopen/Modification form to request a date extension up to 30 days so member can utilize those 2 remaining  already approved visits that were not completed on or prior to 10/06/15.  At this time, the treating PT has not requested a date extension or any additional treatment beyond what was already approved.

 

For any additional continued care beyond the already approved timeframe, the practitioner (treating PT) can submit a new request for medical necessity review with updated clinical findings to be reviewed for medical necessity. Medical necessity determinations are made based on individual patient factors and ASH clinical practice guidelines.  In addition, individual benefit limitations may include coverage exclusions as well as maximum allowable number of visits.

 

 

 

 

5/2/2015 Problems with Product/Service | Read Complaint Details
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Additional Notes

Complaint: I have ***** Open Access Plus - Choice or high end option health insurance through my employer. Unfortunately they only offer *****. For 2014 my Benefit Plan provides unlimited chiropractic visits per year. My Chiropractor has been reimbursed for all my visits until October 2014. In December 2014, I received 2 letters from American Specialty Health telling me that claims for chiropractic visits on 10/10/2014 and 11/10/2014, as well as all future claims needed to be reviewed for 'medical necessity' in order to be eligible for reimbursement. And since my Chiropractor is 'out of network', I had to fill out their Out of Network Medical Records Cover Sheet and supply my medical records with diagnosis and treatment codes. I gave this paperwork to my chiropractor and she forwarded the requested information to American Specialty Health. I have since received more letters from American Specialty Health (in January and now in February) requesting the same information for these 2 chiropractor visits from 2014. Why do they keep harassing me? My Health Benefit for 2014 provides for UNLIMITED Chiropractic visits. And oh by the way, my Health Benefit costs me about $340 per month in 2014. Why am I paying for benefits that American Specialty Health is trying to deny? My chiropractor chooses NOT to be part of their network and she has forwarded the requested information to them. And they are harassing me about claims for $60 - really???!!! I am attaching the scanned in document regarding the 10/10/2014 claim as well as page 1 of the 11/10/2014 claim.

Desired Settlement: American Specialty Health needs to honor the benefits that I am paying for and reimburse my chiropractor and above all STOP HARASSING ME!!!!!!

Business Response:

The attached letter was mailed to the complainant today.  Thanks!

February 25, 2015


******* ****
** ***** **** *****
************* ** *****                                                           

RE:      Response to Complaint Filed with the Better Business Bureau (Complaint ID ********)

American Specialty Health Group (ASH Group) received your complaint from the Better Business Bureau (BBB) related to your concerns about your ***** plan and services you received from your chiropractor, Lori Pinto, D.C.  Dr. Pinto is not participating with ASH Group at this time and is considered an out of network practitioner. ***** has contracted with ASH Group to perform verification of medical necessity for their customers’ out-of-network chiropractic benefits on behalf of *****.  ***** benefit plans may require verification of medical necessity for services to be considered covered services. ASH Group implements its review process in accordance with the coverage requirements specified in your ***** issued benefit plan.  ASH Group begins verifying medical necessity for claims involving out-of-network benefits after the first five visits of each calendar year per unique patient/provider combination.  In this case, ***** did pay your first five visits in 2014.  For services supported by ASH Group, ***** then forwards related claims that require medical necessity verification to ASH Group.  If documentation that medical necessity has been verified is not already on file for out-of-network claims, then ASH Group requests medical records from the customer, with a copy to the treating practitioner, in order to verify medical necessity.  You are responsible for submission of such records to support the medical necessity of the services; however, some practitioners will voluntarily do this on behalf of their patient. You can submit the records directly if your practitioner is not willing to submit records on your behalf. 

While your submitted complaint states that your chiropractor has submitted the records related to dates of service 10/10/14 and 11/10/14, ASH Group does not have those records on file.  To expedite processing, those records can be sent directly to me by fax at ************ or by email at ****************. 

Should you have any further questions, please contact me directly at ************ extension ****.

Sincerely,



***** ********
Senior Manager, Operations
American Specialty Health

Consumer Response: Better Business Bureau:

I have reviewed the response made by the business in reference to complaint ID ********, and have determined that this proposed action would not resolve my complaint.  For your reference, details of the offer I reviewed appear below.

My chiropractor already forwarded the requested information to ASH Group.  I guess the ASH people need to look a little harder to locate that communication.

Regards,

******* ****



Business Response:

ASH has searched in all possible locations but cannot locate the required documents or confirm that they were submitted.  We apologize for any inconvenience it causes but we would need the documentation resubmitted.  It can be faxed to ************ or emailed to ****************.

 

Thanks

Consumer Response:

Better Business Bureau:

I have reviewed the response made by the business in reference to complaint ID ********, and have determined that this proposed action would not resolve my complaint.  For your reference, details of the offer I reviewed appear below.

Well - this just goes to show how ****** up the insurance industry is.  It is quite sad that the right hand has no idea what the left hand is doing.  I received a letter from ***** on March 10, 2015, stating that these chiropractor visits from October/November 2014 had been approved.  My chiropractor also told me that ***** finally reimbursed her for those visits.  I guess ***** forgot to tell that to American Specialty Health.  So technically ASH Group's proposed action doesn't resolve the complaint because ***** already resolved it.

I'm done dealing with these ******.  It's just a waste of time.

Regards,

******* ****



Business Response:

ASH apologizes for the confusion on the issue. We were not aware that ***** had paid the claims.  ASH does not pay these particular claims directly and is not made aware when they are paid.  If you have further issues, you are welcome to contact me at ************ ext ****.  Thanks

 

***** ********

Senior Manager, Operations

Consumer Response:

]

Better Business Bureau:

I have reviewed the response made by the business in reference to complaint ID ********, and find that this resolution would be satisfactory to me.  Iwill wait for the business to perform this action and, if it does, will consider this complaint resolved.

Regards,

******* ****

5/1/2015 Problems with Product/Service | Read Complaint Details
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Additional Notes

Complaint: I have submitted several health insurance claims for chiropractic services I have received from my provider to American Specialty Health over a period of 5 month. Every claim I have sent them is followed by a letter from them requesting more information. In each case I and my doctor have provided the requested information. Claim #1 submitted for upper cervical vertebrae adjustment I received over the month of May and June 2014 was approved for reimbursement Claim #2 submitted for upper cervical vertebrae adjustment I received over the month of July and August 2014 was DENIED Claim #3 submitted for upper cervical vertebrae adjustment I received over the month of September was DENIED because they claim the services (upper cervical vertebrae adjustment) is not professionally recognized and is considered to be scientifically implausible. They approved me for the same exact services for the month of May and June. Claim #4 submitted for upper cervical vertebrae adjustment I received over the month of October was 62.5% approved for reimbursement again for the same exact services they are denying for July, August, and September. How can the company approve me for upper cervical vertebrae adjustment in May and June and deny me for the same services in July, August, and September but then approve me for October. There medical decisions are not consistent. There reimbursement process is antiquated. It takes over a month to get an answer from them.

Desired Settlement: I would like all of my medical claims approved for payment by my healthcare provider including payments for claims being submitted for November 2014, December 2015 and January 2015

Business Response:

please see attached letter being placed in the mail to the copmlainant today. 

April 20, 2015

******* *****
*** ******** *** ***** **
********* ** *****

RE:      Response to Better Business Bureau (BBB) Complaint ID #********

Ms. *****,


American Specialty Health (ASH) has reviewed the complaint you submitted to the BBB regarding claims for services rendered to you by chiropractor ****** *******.  Your complaint questioned the denial of claims from July, August and September, 2014.  You also expressed concern that claims for similar services had been paid in May and June, 2014, and again in October, 2014.

Your benefit program requires verification of medical necessity for services to be considered covered under your plan, whether those services are rendered by a participating practitioner or a non-participating practitioner.  In this case, since you sought services from a non-participating practitioner, you are responsible for ensuring that sufficient information for verification of medical necessity has been submitted in order to allow your claims to be processed.   

In this case, records were submitted on 7/31/14 for dates of service 5/31/14 – 6/28/14 for 1 new patient exam and 8 office visits.  The submitted request was processed under MNR#10500197 and reviewed for DOS 05/31/14 to 06/28/14.  The Medical Necessity Review (MNR) Response letter sent to you and copied to Dr. ******* indicated that 8 office visits during that range of dates were approved and the new patient exam was denied.  The new patient exam was denied because this service had been previously submitted for payment and was a duplicate.  Under the program administered by ASH on behalf of Empire Blue Cross Blue Shield, members can receive payment for the first five visits of the calendar year to a chiropractic practitioner without the need for medical necessity verification.  After the first five visits of the year or after a request for medical necessity verification is submitted, any other services require submission of medical records to ASH for clinical evaluation. Even though these initial office visits for these dates of service in 2014 were approved, the response letter called attention to significant deficiencies in the documentation submitted. For example, the MNR Response letter outlined what additional detail would be needed should additional treatment be needed.  Such information was noted as including specific findings and clinical details within your treatment records such as appropriately documented range of motion findings.  The detail and rationale for services that were noted in our response are necessary to verify why the particular services requested, such as the new patient exam, were medically necessary. .  

On 11/11/14, an MNR form requesting DOS 07/01/14 to 08/29/14 for 1 established patient exam and 16 office visits was submitted.  The submitted request was processed under MNR#10604375.  The requested services were denied as not medically necessary and you and Dr. ******* were provided detailed information regarding the rationale for this clinical denial.  The denial reasons communicated included that the range of motions findings were not clearly described so that the treatment provided could be verified as medically necessary.  Likewise, the daily chart notes did not provide significant enough detail about your condition to verify the medical necessity of the services rendered.  , orthopedic testing was not performed,.  The denied services also included requests related to Thermography.  The denial reasons specified that those requests were denied because current clinical studies do not support the usefulness of Thermography in evaluating your documented conditions, e.g., subluxations or pain in the spine or arms and legs.   

On 12/23/14 an MNR form requesting DOS 09/01/14 to 09/29/14 for 1 established patient exam and 7 office visits, 1 neurological test (electrodiagnostic surface EMG) and 1 cervical x-ray was submitted.  The submitted request was processed under MNR#********.  The requested services were clinically denied as not medically necessary.  The response letter to you and Dr. ******* outlined that the requested examination was denied because the submitted findings did not meet the criteria for an examination.  The letter went on to state that the requested dates of service were denied because the palpatory findings were not clearly described, the range of motion findings were not clearly described, orthopedic testing was not performed, the daily chart notes were inadequate, and the need for electrodiagnostic testing was not supported in the medical record as there was no documentation of a neurological examination being performed that would have supported the need for electrodiagnostic testing.  On 01/12/15 Dr. ******* spoke with the clinical reviewer that had rendered this determination.  The clinical reviewer discussed the case with Dr. ******* and identified to him the deficiencies and inadequacies within the medical records.  He reviewed with Dr. ******* the objective reporting requirements, and faxed to Dr. ******* information about appropriate documentation to assist Dr. ******* and provide him with a packet of forms he may use to address these concerns.  The clinical reviewer also provided an explanation on how he may submit a ReOpen form along with additional information for reconsideration of these determinations based on that information. 

On 02/10/15, a ReOpen/Modification for MNR#******** was submitted for DOS 09/01/14 to 09/29/14 for 1 established patient exam and 7 office visits.  Despite additional information being provided, the requested services were clinically denied as not medically necessary as the new information did not support the medical necessity of the services performed.  Specifically, a Back Index form and a Low Back Pain and Disability Questionnaire indicating some low back pain and some low back limitations were submitted along with a Neck Index form that you completed.  The score on the Neck Index form was “0”, indicating no neck pain, no restrictions in activity and the ability for you to perform normal activities without neck pain.  The notification letter included information that clinical committees have determined adjusting the upper cervical spine (neck area) to treat chief complaints unrelated to the cervical spine (e.g., lumbar or lower back pain) is not established as clinically effective, is not professionally recognized (not widely accepted and used) and is considered to be scientifically implausible.

On 12/23/14 an MNR form requesting DOS 10/02/14 to 10/27/14 for 1 established patient exam and 8 office visits was submitted.  The requested services were clinically denied as not medically necessary under MNR#********.  The notification letter to you and Dr. ******* indicated that the services were denied because the submitted information did not meet the criteria for an established patient exam, the daily chart notes were inadequate and did not provide significant details about the your condition, and that the submitted information was generic and did not contain specific information regarding your treatment.  On 01/12/15, Dr. ******* had a clinical discussion about MNR#******** (involving DOS 10/02/14 to 10/27/14 for 1 established patient exam and 8 office visits) with the clinical reviewer that reviewed the case.  During the conversation Dr. ******* provided additional clinical information sufficient for this clinical review to approve five office visits.  The discussion did not provide sufficient clinical information to approve the established patient exam or the remaining three office visits.

Based on the information above, the main cause of the discrepancy between services being approved and being denied is related to the documentation submitted by Dr. *******.  At this time, you can work with Dr. ******* to obtain additional documentation to submit to ASH for further review of medical necessity or you can file an appeal directly with your health plan. 

Should you have any questions, please contact me directly at ************ extension ****.

Sincerely,



***** ********
Senior Manager, Clinical Operations
American Specialty Health

4/9/2015 Problems with Product/Service | Read Complaint Details
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Additional Notes

Complaint: This company handles the chiropractic claims for our insurance company. they say that they have a very simple submission process for claims, which our Chiropractor and his staff graciously agreed to submit for us. They precisely followed instructions on the claim form including the instruction to fax the claim to ash. when we contacted a ASH to make sure that they had received the claim, customer service said that they throw away all faxes that come to that number. They provided no explanation as to why they would do this or why this fax number was listed on their instructions. They told us that the claim would have to be mailed. Again, the chiropractic office helped us out and mailed the plane to a ASH. A number of weeks passed, and we called them again only to be told that it can take approximately 6 weeks to process claims and that they could not provide any status updates or even confirm whether or not they had a claim. Then Friday March 13, we called again and they stated that they still had no record of the claim. They also said that they have 2 small offices and that one office could not tell us what the other office may or may not have received and that things can be lost between the two offices. This is completely unacceptable! Our claim represents a substantial amount of money, and it is our belief that they are behaving in a fraudulent and unethical manner in delaying the process for so long, that the submission time frame deadline will expire. at the very least, customer service representatives are rude and unhelpful and they make the claims process impossible.

Desired Settlement: I believe that they have this claim since they have received it via fax and mail, and that if they say they do not have it so this is a lie. I want this claim process immediately and without further runaround.

Business Response:

Attached you will find the response to the complainant that was placed in the mail today.

 

Thanks

 

April 7, 2015

***** *******
*** ******* ***** ********** ** *****

RE:      Response to your complaint submitted to the Better Business Bureau (ID********)

***** *******,

American Specialty Health has reviewed the complaint you submitted to the Better Business Bureau (BBB) related to claims submissions for your treatment.  While we understand that your provider may have faxed claims to us, unfortunately such a submission is not an appropriate manner to submit claims to us.  Claims for chiropractic services under your health plan are required to be submitted to ASH on paper. Research of our records has not revealed that your claims were recorded as having been received.  To help remedy your situation in relation to these claims, you or your chiropractor can submit claims directly to me for expedited handling.  The claims in issue here can be emailed to me at tracyma@ashn.com or mailed to me at: **** *** ******* *** ****** ** **********.  Please make sure to address the claims to my attention for faster handling. 

Our records indicate that during a call on 1/23/15 between you and ASH staff you were advised ASH had no claims on file for your services.  At that time, you indicated that your chiropractor had faxed in the claims. The representative then told you that claims sent by fax are rejected.  During a subsequent call you made on 2/6/15, an ASH representative also informed you that the claims were still not on file.  The ASH agent advised that claims can only be mailed or submitted online and that faxed claims are not accepted.  The agent did indicate that claims are processed in a different location and that if something had recently been submitted and wasn’t on file yet, then there would not be a way for the representative to confirm it had been received.  Information received via mail or on-line usually is processed and available in our files within five business days.

For clarification on the information you were provided, ASH does not throw out claims sent via fax.  However, ASH does not maintain a fax number for the receipt of claims.  Claims sent to other unrelated ASH fax numbers may not be received in the correct department.  Additionally, the agent that indicated that claims are processed at a different location than where they are received was incorrect.  In fact, all claims properly mailed to the designated address are received by ASH in a designated central location to ensure timely and appropriate handling.  Such documents are scanned upon receipt for processing and tracking.  Once scanned, the documents are available to our staff in various locations to access electronically in order to expedite processing. 

ASH apologizes for any incorrect information provided to you during your calls.  We strive to provide the best customer service and will use your feedback as a tool for coaching training. 

Again, to help resolve the current issue, you or your chiropractor can submit those claims directly to me for expedited handling.  The claims can be emailed to me at **************** or mailed to me at: **** *** ******* *** ****** ** **********.  Please make sure to address the claims to my attention for faster handling.  Please note that this is an exception to assist you with this current matter. 

Should you have any questions, please contact me directly at ************ extension ****.

Sincerely,



***** ********
Senior Manager, Clinical Operations
American Specialty Health?

 

?

Consumer Response:

 

Better Business Bureau:

I have reviewed the response made by the business in reference to complaint ID ********, and find that this resolution would be satisfactory to me, IF it is carried out as promised. 

One note regarding the handling of faxed claims, the business response from representative ***** ******** stated "ASH does not maintain a fax number for the receipt of claims.  Claims sent to other unrelated ASH fax numbers may not be received in the correct department." However, I would like to point out that the instructions on the ASH website (*****************************************************************************) give two options for submissions of claims. Option A states "Obtain your medical records yourself for the dates of service you want verified as medically necessary and send that information by fax to the fax number below or by mail to ASH Group at the address below." Option B states: "Ask your non-participating practitioner to communicate directly with ASH Group to verify medical necessity. If your practitioner is willing to do this on your behalf, we have developed reporting tools for your practitioner to use. The practitioner can assist you in meeting your obligation to obtain medical necessity verification by: Completing the Medical Records Cover Sheet (***********************************************************************) ..... He or she may fax the Medical Records Cover Sheet along with the forms to ASH Group at the number below or mail the forms to the address below." If no fax number is maintained for the receipt of claims, why is a cover sheet with fax numbers provided for the appropriate routing of faxed claims, and why is the fax referred to on both options? Further, it is highly questionable that both faxed and mailed copies of the claims both were never received and appropriately processed.

In good faith, I will respond to Ms. Matthews offer of personal expedited processing and attempt to obtain a copy of the documentation from my chiropractor (in the hopes that they kept a copy of what they mailed to ASH), and I will submit this claim directly to her. I will wait for the business to perform the promised action and, if it does, will consider this complaint resolved.


Regards,

***** *******

 


 

3/12/2015 Problems with Product/Service | Read Complaint Details
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Additional Notes

Complaint: I added a clinic using the correct form. ASH cancelled my contract, something that they admitted was their mistake, and I am continuing to get denials on my claims. Also, the address online is incorrect, I have corrected this issue before manually and it is not continues to be incorrect. Also, I am not visible as a provider for my location. Every time we call it is something else that you. This is costing me thousands of dollars! Completely unacceptable and causing me severe financial distress.

Desired Settlement: FIX IT NOW! I believe that I should be elevated to the highest tier provider, something that I am close enough to be anyway, and not be bothered with denials again!

Business Response:

March 4, 2015

 

 

*** ******, ****

**** ***** **

*** ****** ** *****                                                               

 

RE:      Response to Complaint
Filed with the Better Business Bureau (Complaint ID ********)

 

American Specialty Health Group (ASH Group) received your complaint
from the Better Business Bureau (BBB) related to your concerns regarding claims
that have been denied due to an address issue. 
ASH Group has researched your complaint and found that there was an
error made on ASH Group’s part that caused the incorrect denial of claims.  ASH Group’s records show that you submitted
the proper documentation in a timely manner in order to add a new address
location.  Unfortunately, there was a
manual error that caused your primary address to be deleted from the ASH Group
system.  Your address has now been
accurately updated in ASH Group’s system and is reflecting on the website
correctly as well.  ASH Group has
identified all of the claims that denied in error and has reprocessed those
claims for payment.  Applicable interest
has been applied to claims that required interest to be paid.  All payments were processed as of 2/27/15 and
paid to you electronically through Electronic Funds Transfer.    

 

ASH Group apologizes for the inconvenience this error has caused you
and that we were unable to resolve it sooner. 
ASH Group appreciates you provding this feedback as we use this type of
information and feedback to improve processes to better serve our
customers. 

 

Should you have any questions, please contact me directly at
800-972-4226 extension ####.

 

Sincerely,

 



 

***** ********

Senior Manager, Operations

American Specialty Health

3/5/2015 Problems with Product/Service | Read Complaint Details
X

Additional Notes

Complaint: I have spent several hours on the phone with American Specialty Health. Calls that were only necessary because of the incompetency of this company. I sent in several claims that went ignored for over a month. When I followed up via the telephone, they said they had no record of me or my claims. I then had to call Anthem Blue Cross (my healthcare provider) and they had to intervene since (once again) ASH was clearly incompetent and irresponsible with my records. It turns out they lost my claims. As a result, I had to return to my doctor and ask her to re-print all of the initial claims. I then had to scan and email them to the Anthem Blue Cross representative who in turn faxed them over to ASH. Several weeks later I finally received a letter from ASH stating that my claims were received and approved. However, I have yet to receive my reimbursement for any of them. This process has now been going on since at least November. Today, I called ASH again and have been on the phone for over 45 minutes. The representative told me that they have no claims on my record. After several more minutes of being on hold I was then told that they did not have all of the necessary information from me to process the claim - which is FALSE since I already received a letter from them over a week ago saying that they had received and approved all of my claims. This company is refusing to reimburse me for these services which is criminal and unethical. What's worse is I now have a few more claims from recent doctor visits that I dread having to send in since I know I will likely go through all of this again. Something needs to be done and this company needs to be held accountable for their actions. And I need my reimbursement IMMEDIATELY. I also want assurance that this will never happen again with future claims.

Desired Settlement: My deserved reimbursement. Immediately. And an effective process moving forward.

Business Response: Good afternoon,

ASH has spoken directly with the complainant and is working to resolve the claims issues and ensure proper .  ASH apologized to the complainant for the inconvenience this issue has caused.  The complainant has agreed to work with ASH on follow up and final resolution of this issue.  

1/29/2015 Problems with Product/Service | Read Complaint Details
X

Additional Notes

Complaint: I was told by three different representatives at ASH that my benefits could be used differently than they are now informing me. They will not take responsibility for giving me the incorrect information. ASH should have to pay for the befefits they said I had. I even verified yesterday about the information given to me and suddenly today it has changed. Now I've had to cancel appointments and sit in pain because of ASH's misinformation.

Desired Settlement: I want to be able to use all of my chiropractic visits I can fit in by the end of the year, I was told as long as I didn't exceed the yearly maximum of 24 that they would be covered, ASH should cover these.

Business Response:

ASH has contacted the complainant directly and resolved the case.  I have spoken directly to Ms. **** and her chiropractor.  ASH will be honoring the unlimited visits for Ms. **** for the calendar year of 2015 based on ******'s direction.  I provided Ms. **** my direct contact information for anything further.  She can reach me by email at **************** or by phone at ###-###-####.

 

Thanks

***** ********

American Specialty Health

1/21/2015 Billing/Collection Issues | Read Complaint Details
X

Additional Notes

Complaint: on December 15th I renewed my silver and fit membership online through AHS. for some reason my checking account was charged 3 times when it should have been charged only once. one payment was refunded to my checking account on the same day. I went onto their website and it showed that 2 transactions had been cancelled but one was credited them back. I then sent them 3 e-mails and never received a reply. I then proceeded to call them and they told me that the were showing 2 cancellations. I told them that my bank account had only been credited back for one of the cancellations. they said it sometimes takes 7-10 days, although I don't quite understand that as the 1st cancellation was refunded that same day. I then went to my bank to see if there were any pending credits, which there were not. the bank told me to have them send me a letter verifying the 2 cancellations. on December 30, I called them again. after 10 minutes of talking to a customer service rep and not getting anywhere, I asked to speak to a supervisor. she put me on hold and came back and said there were no supervisors available. I then asked her if she would just send me a leeter, verifying the 2 cancellations and was told "we don't do that". I asked for a supervisor to call me back, but based on my dealing so far with this company. I doubt this will happen.

Desired Settlement: I would like the $25.00 credited back to my bank account. $25 isn't going to make me rich or put me in the poor house but it's the way I've been treated through this whole thing. terrible, terrible customer service.

Business Response:

The attached letter to the complainant has been placed in the mail today, 1/16/15.

 

Thanks

Consumer Response:

 

Better Business Bureau:

I have reviewed the response made by the business in reference to complaint ID ********, and find that this resolution would be satisfactory to me.  I will wait for the business to perform this action and, if it does, will consider this complaint resolved.

Regards,

**** ******

6/2/2014 Problems with Product/Service | Read Complaint Details
X

Additional Notes

Complaint: We were notified by this company that we would be removed from their contracted businesses (which we wanted to be) in December of 2013. Our chiropractic office indicated to American Specialty Health that we wanted to be removed so that we could bill certain other insurance companies directly without having to go through them. They originally gave us a deadline of December 6th. They then ignored our request to be removed and kept extending the deadline. We contacted Aetna insurance and inquired why we weren't receiving any payments from services rendered. They told us that unless they received the paperwork from American Specialty Health we were considered to still be a part of their network. American Specialty Health ignored our request to be removed and after continually extending the deadline for an additional 2 months, told us they would take up to 180 days to send out the paperwork stating we were no longer affiliated with them. Currently, we are unable to bill certain insurance companies for services rendered until they send over the paperwork (we aren't getting paid for services done on patients with certain insurances and won't until they send the paperwork). Lastly, the woman (***** or ***** is her name) from American Specialty Health my staff has talked to has been very rude and condescending. They are a greedy company and are preventing our office from collecting insurance payments from patients.

Desired Settlement: This paperwork should have been sent over in December like we requested. I want the paperwork sent over stating that we are no longer affiliated with American Specialty Health so that we can get insurance payments from Aetna and Cigna for services rendered. Basically, I'd like to not work for free.

Business Response:

RE: Response to Complaint Filed with the Better Business Bureau (Complaint ID *******)  

American Specialty Health (ASH) received your complaint from the Better Business Bureau (BBB) related to 
your concerns about your participation status with ASH. Your complaint states that you were notified in 
December 2013 that you would be removed from contracted business and that you were given a deadline of 
12/6/13. You also state that ASH ignored your request and kept extending the deadline. 
 
ASH researched your concerns and found that ASH contacted you on 11/20/13 to follow up on a letter sent to 
your office regarding your malpractice insurance. At that time, ASH was told that you were still determining if 
you wanted to continue participating with ASH. The ASH representative advised that if ASH did not receive the 
malpractice declarations page, you would be terminated from participation. On 12/18/13, ASH again 
outreached to your office regarding the same issue. Your office manager indicated that claims had been denied 
for an address issue. The ASH representative offered to transfer the office manager to Customer Service but 
the office manager declined. The representative advised that ASH still needed the malpractice information. 
 
On 1/8/14, ASH contacted the office again and spoke to you directly. According to the call notes, you indicated 
that it was not a good time and would call back. On 1/10/14, your office contacted ASH and indicated you were 
going to resign from participation by submitting a letter. The representative advised that written notice was 
required and a letter would be sufficient. . On 2/13/14, your office contacted ASH in response to a notice of 
termination sent to your office for failure to submit the malpractice information. At that time, the ASH 
representative advised that because the office had been terminated by ASH, the actual termination would be 
pended with the office being considered participating until after your right to appeal the termination (60 days) 
had expired. The representative also noted that processing a termination could take up to 30 days in order 
forthe contracted health plans to update their systems in response to the notice. This information is consistent 
with the termination provision of your contract with ASH that was in effect at the time. At this point, ASH had 
not received any conforming notice of your resignation from the network. 
 
On 2/18/14, your office manager contacted ASH again and indicated that she did not want to have to wait for 30 
days for Aetna and Cigna to be notified and she wanted a letter that she could send to them. The 
representative advised that ASH is unable to provide such a letter within that timeframe. On 2/21/14, ASH 
contacted your office and your office manager indicated that you were upset with the process. She indicated 
that she would call ASH back on 2/24/14. On 2/26/14, ASH called your office again and spoke to your office 
manager. She was advised that your termination date with ASH would be 3/11/14 based on the failure to 
provide malpractice information. Your record in ASH’s system does reflect the termination date of 3/11/14, 
which is correct based on the contractual process by which ASH can terminate your participation with ASH. 
regarding the malpractice information concern. At this point and since then, ASH does not have any record of 
you submitting a conforming request to resign from the network. Written notice of termination is required per 
section 7.01 of your Practitioner Services Agreement with ASH. 
 
Our records further note that your office contacted ASH regarding concerns about not receiving checks for 
claims submitted. This appears to have been due to a change of address issue. ASH’s records show that, as 
of 2/18/14, your office indicated that checks had been received and cleared the bank. ASH is not aware of any 
outstanding claims issues with claims that were submitted for dates of service while you were contracted with 
ASH. Claims for services rendered after 3/11/14 should be submitted directly to Aetna or Cigna. You should 
contact Aetna or Cigna directly if there is a current issue with your participation status. Please keep in mind 
that it can take 30 days for that information to be updated in the respective health plan’s system. 
 
Your complaint also states that a representative you spoke to named ***** or ***** from ASH was very rude 
and condescending. While ASH’s records do not show any conversations with any ASH representative of 
either of those names or similar names, ASH apologizes if your staff had encounters with ASH that were not 
satisfactory in terms of customer service. 
 
Should you have any further questions, please contact me directly at 800-972-4226 extension ***** 
 
Sincerely, 
 
***** ********
Senior Manager, Operations

Consumer Response:

Better Business Bureau:

I have reviewed the response made by the business in reference to complaint ID *******, and have determined that this proposed action would not resolve my complaint.  For your reference, details of the offer I reviewed appear below.

I have reviewed ASH's response to our complaint with my office manager.  While there may be something in our contract that says we needed to provide written notice of termination, she was never told that over the phone.  We would continually receive faxes stating that if we didn't send them back with updated malpractice information we would be terminated.  In response, we never faxed it back because we were no longer interested in being contracted with ASH.  If ASH has in its records that my office manager was told that we needed to provide written notice of cancellation, why wouldn't we have done it back in November?  If ASH has in its records we were told to provide written notice of termination, than ASH's representatives or notes are incorrect.  My office manager will be contacting Tracey hopefully some time today.


Regards,

****** ***********

Business Response:

I reached out to the office and confirmed that they are satisfied with the response based on our conversation.  I confirmed this morning that the office has no outstanding issues. If you need additional information, please let me know. 

Thank you

1/13/2014 Problems with Product/Service | Read Complaint Details
X

Additional Notes

Complaint: I am a physician who is dissatisfied with ASH on many levels. Last week I sent an inquiry about getting out of network with ASH. I am also a college professor and was extremely busy with finals in addition to my office patients and have not had a chance to finish the process yet. Since my initial inquiry, ASH reps have bombarded me with multiple phone calls each day, including one at 12:17am today. I have three small children that were sleeping at that time and I do not appreciate ASH disrupting my household at this time. I found the name ***** ***** associated with this number through ASH and have asked for her supervisor's information to file a complaint. This is harassment and completely unacceptable behavior toward providers. I have a screen shot of the phone call as well, indicating that it was indeed placed at 12:17am.

Desired Settlement: Hold ASH accountable for their terrible service.

Business Response:

The attached letter was mailed to the complainant yesterday, 1/2/14.  Please contact me with any questions.

 

Thanks

ASH%20web%20seal%20K

 

 

 

 


 


January 2, 2014

 

Healthy Beginnings Chiropractic

******** ** **** **** ********** *** ** ****** ** *****

 

RE:      Complaint submitted to the Better Business Bureau (Complaint ID *******)

 

American Specialty Health (ASH) has received and reviewed the complaint you submitted to the Better Business Bureau (BBB) regarding concerns you have related to your communications with ASH.  Your complaint states that you sent an inquiry about terminating your participation with ASH and were then called multiple times.  In addition, you state someone called your house at 12:17 am and disturbed your family.

 

ASH’s records show that you emailed ASH on 12/9/13 requesting information on how to terminate your participation with ASH.  Using the phone number we had in our records for contacting you, a representative attempted to reach you on 12/10/13, 12/13/13, 12/16/13, 12/17/13, and 12/18/13 to provide the information you requested.  ASH apologizes if these attempts to provide the requested information were viewed as excessive.  ASH was attempting to provide the best customer service possible and did not intend to be disruptive. 

 

Regarding the phone call you received at 12:17 am, ASH often sends routine information to practitioners via facsimile using a Broadfax program that auto faxes certain communications to the number practitioners provide as the fax number for their office.  ASH’s system shows that you have the same telephone number listed for ASH to use to contact you by phone or fax number.  Because of this, the call that you received at 12:17 am was actually a fax that the Broadfax system was trying to send to your office related to an upcoming practitioner education webinar that ASH is conducting.  It was unrelated to the calls noted above and was not made by a specific ASH staff person.  We have updated the logic in our system to exclude sending faxes to practitioners who have the same phone number for both fax and phone.  This will prevent this type of issue from occurring in the future.

 

ASH thanks you for bringing this matter to our attention and apologizes for the disturbance caused to your family by the late night phone call.  ASH’s records show that you have not initiated the process to resign from participation.  If you’d like to do so, please call ###-###-#### and select option 4.  Should you have any questions, please contact me directly at ###-###-####.

 

Sincerely,

 

***** ********

Senior Manager, Clinical Operations

American Specialty Health

9/27/2013 Advertising/Sales Issues | Read Complaint Details
X

Additional Notes

Complaint: The agent on the phone failed to say the "the yearly fee of $25.00 was not refundable if we cancelled the agreement within a reasonable time frame. We agreed to the health plan on August 12, 2013 and called that same day to cancel the "deal" because it did not fit our use of the health club that we use. We've tried multiple times to call 877.427.4788 but get the same response that the fee is "non-refundable"

Desired Settlement: We want those separate $25 ($50) to be refunded to our Discover account

Business Response:

RE: Response to Complaint Filed with the Better Business Bureau (Complaint ID *******)


American Specialty Health (ASH) received your complaint from the Better Business Bureau (BBB) related to your concerns about your enrollment payments made to Silver&Fit for your fitness program provided by your insurer, HealthPartners.  Silver&Fit is a subsidiary of American Specialty Health, Inc.      

Silver&Fit has researched the issue and found that you did contact our customer service team to enroll with a fitness club on 8/12/13.  We also show that you called to disenroll the same day.  While the materials distributed during open enrollment with HealthPartners indicate that the enrollment fee of $25 per enrollee per year is non-refundable, the customer service agent did not provide this information at the time of telephonic enrollment on 8/12/13.  Therefore, we are making an exception to our non-refund policy to refund you for your enrollment fee totaling $50.  You can expect to receive this refund as a credit on your charge account within 4 weeks from the date of this letter.

Should you have any further questions, please contact me directly at 800-972-4226 extension ****.

Sincerely,

***** ********
Senior Manager, Operations

9/18/2013 Problems with Product/Service | Read Complaint Details
X

Additional Notes

Complaint: American Specialty Health contracts with ****** **** ***** of California. They are suppose to share information and update them accordingly. I am a Chiropractor and I recently changed my clinic address. I had notified both companies. It had been two months and still, the address is not changed. I called ****** and they said ASH is suppose to send the information. I called ASH and they said they had sent the information. Both companies refuse to contact each other to resolve this issue and I am stuck in between without getting paid for two month - and counting. I had called ASH numerous times, and they said the person in charge is not available and that they would call back once she steps into the office. It had been two weeks, and they never called. ASH promised a 4 to 8 weeks processing time to update clinician information, and that time had already past. I just called today and they told me to wait another 4 to 8 weeks. That is simply unacceptable.

Desired Settlement: Finish the job that American Specialty Health promised to do. It is a simple address change and they can drag this thing on and on. Unacceptable. I want ASH to fix this whole mess and get my clinic information updated with the companies they contract with.

Business Response: RE: Response to Complaint Filed with the Better Business Bureau (Complaint ID *******)

American Specialty Health (ASH) received your complaint from the Better Business Bureau (BBB) related to your concerns about your office address update with ASH.    

ASH has researched the issue and does show that you submitted your address update to ASH on 6/4/13 requesting the effective date of the change to be 6/4/13.  While your agreement with ASH requires a minimum of 60 days notice for an address change, ASH was able to make an exception and make your new address effective in ASH’s system 6/4/13.  However, ASH is unable to make such exceptions when reporting provider changes to contracted clients, such as ******.  ASH’s records show that ASH reported the updated address to ****** on 6/17/13.  

As you know, the claims impacted by this concern are claims payable by ****** under the network access arrangements that are supported by ASH.  ****** must update their processing systems in order for claims under these programs to pay correctly.  Claims payable by ASH have not been impacted since ASH has made the address update in ASH’s systems.  

ASH is currently working with ****** to get the address updated in the ****** system as expeditiously as possible.  

Should you have any further questions, please contact me directly at 800-972-4226 extension ****.

Sincerely,

***** ********
Senior Manager, Clinical Operations
American Specialty Health

8/15/2013 Problems with Product/Service | Read Complaint Details
X

Additional Notes

Complaint: They maintain that because of law they cannot send me claims correspondence electronically that they must send copies to me by snail mail of everything they send to my chiropractor. This company is a sub-contractor of CIGNA yet they do not offer an electronic/email option for correspondence like they do.

Desired Settlement: I demand that they comply with my request for an electronic/email option for this correspondence. My argument is that they would still be HIPAA compliant and would save time and money for their business in the long-run, plus they would also then be in compliance with the Paperwork Reduction Act. I have no use whatsoever for the reams of paper and envelopes that they send me. It all gets recycled. It is a waste of trees. I have asked them multiple times to change their policy, but they claim "it's the law". I think they are just lazy.

Business Response: Please see attached letter to the complainant that was placed in the mail today. 

August 7, 2013

 

 

**** ******

**** ***** ** ************ ** *****  

                                                              

 

RE:      Response to Complaint Filed with the Better Business Bureau (Complaint ID *******)

 

American Specialty Health (ASH) received your complaint from the Better Business Bureau (BBB) related to your concerns about written correspondence from ASH. 

 

While ASH understands that you desire to receive required notices from ASH via email or online, we are not able to accommodate that request at this time.   ASH will have to continue to send correspondence via US mail as permitted by HIPAA and state laws involving such notices

 

In regard to your reference to the Paperwork Reduction Act, this act is designed to reduce the total amount of paperwork burden the federal government imposes on private businesses and citizens. The Act imposes procedural requirements on agencies that wish to collect information from the public.  To this extent, it is ASH’s understanding that this law does not impact ASH’s operations or preempt state laws otherwise permitting the member communications you’ve noted to be sent via mail.

 

ASH appreciates the feedback and strives to provide excellent customer service to those we serve.  ASH will continue to evaluate opportunities for service improvement and will implement changes as priorities are identified. 

 

Should you have any further questions, please contact me directly at ###-###-####.

 

Sincerely,

 

 

***** ********

Senior Manager, Clinical Operations

American Specialty Health