More Strong Words for American Specialty Health
Editor’s Note: The following letter was sent to Richard Garcia, American Specialty Health (ASH) appeals / grievances representative, in late August. It has been edited lightly for punctuation / grammar.
Dear Mr. Garcia,
Thank you for your letter of August 8, 2023, responding to my “grievance” regarding ASH network reimbursement rates.
Your response is the same tired and nonsensical line I’ve been hearing from ASH for years and decades. “The reimbursement rates that are offered to our participating providers are based on many factors, including provider office location, our existing network size in surrounding areas, health plan client needs and expectations, member numbers, and market demographics and other market specific dynamics.”
This verbiage excludes the cold, hard fact that your reimbursement rates have not increased in DECADES, while the value of the dollar is less than half it was 30 years ago when rates were the same as now, and staff salaries, rents, and the price of health insurance have far more than doubled. ASH requires its providers to render the highest quality ethical treatment to all of your insured, to carry a high level of malpractice insurance, and to complete far more paperwork than is required by other health plans and certainly for our cash patients. (My non-insured patients pay TWICE the amount of ASH reimbursement and my fees are modest for my geographic area.)
Is your salary the same as it was in 1993? Is the reimbursement of the ASH CEO and other executives the same as it was 30 years ago? Why does ASH expect us to be satisfied with that level of compensation when the leaders of ASH would never dream of doing so for themselves?
Of course, I could quit being a provider for ASH if I am so dissatisfied. But I have many good patients who receive high-quality care from my office who would be devastated if I did so, and a number of them depend on their insurance coverage to give them access to excellent chiropractic care which they could not access otherwise, and they deserve to be provided such care.
I urge the powers that be to take another hard look at this situation and to stop exploiting their providers and instead step up to fulfill their mission, which is not simply to make as much profit as possible, but to genuinely support high-quality providers to provide excellent care to their insureds.
I look forward to further response to this letter from the highest level of ASH management.
Mha Atma S. Khalsa, DC
Los Angeles, Calif.
Editor’s Note: Comment on an article, address a trending topic, or share your thoughts on any issue relevant to the art, science or philosophy of chiropractic by submitting a short letter to the editor to editorial@mpamedia.com. Include your full name, degree(s), and the city and state in which you practice. Submission is acknowledgment that your letter may appear in an upcoming issue, and could be edited lightly for grammar and style guide considerations.
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