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Advice for Am Specialty Health (ASH) Clinical Treatment Forms?

I am a relatively new provider in the American Specialty Health (ASH) network. First, let me say that I have had a positive experience thus far with ASH. Their reimbursement system is timely and efficient. For those of you who also participate, what has been your experience with the clinical treatment forms (CTFs), which are used to evaluated medical necessity? All of my ASH clients have a waiver in which they receive 5 sessions that do not need documentation with the CTF. Beyond the 5, a CTF must be submitted to ASH to determine whether more sessions will be allowed.

I am wondering whether other practitioners find that it is more efficient to be ask for all the sessions you think you may need in a year or be more conservative and ask for, say, 5 or 10 at a time? Any other advice on getting CTFs approved?

Thanks,

Mark

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Permalink Reply by Cindy Greenwood on August 11, 2011 at 6:30am

I don't have any experience as a Massage Therapist Provider, but when I worked for a Chiropractor only a couple were ever approved for any treatment beyond their minimum. The ones that WERE approved would be allowed 2-3 more treatments and that was it. I think that it is very time consuming to work with insurance in general - but trying to submit documentation to show medical necessity...having to "fight" with the carrier for "scraps" is frustrating AND time consuming.

I am glad to hear that you have had good experience with ASH/ASHN. Several years ago I cannot say that was the case. Payments were not timely and they were far less than any other insurance carrier, and at that time the co-pays were very high.