Aetna is going to be Out-Of-Network with Active Body as of July 1, 2011. Here is why:

As of July 1st 2011, Active Body Chiropractic will no longer be considered as “in-network” with Aetna. This applies to all plans (i.e. PPO, HMO, POS, etc.). Please check with Aetna as to what your out-of-network benefits are for chiropractic/physical medicine as they will most likely vary significantly from your in-network coverage.

Unfortunately, we have taken this step due to Aetna’s decision to hire a third party contractor, American Specialty Health (ASH), to manage their contracting with Chiropractors. ASH will be drastically cutting reimbursement rates for all Chiropractors to a level that is less than a third of what other insurance companies reimburse and is demanding twice the paperwork required from any other insurance company. This change will effect all Chiropractic offices. In fact, all of the Chiropractors that we have been in contact with are also being forced to drop Aetna.

Please be advised that after July 1st 2011, we will now be “out-of-network” with Aetna and will be requesting payment at time of service. The visit cost will be $80 at the time of service with our Time of Service discount program. We can provide you with a superbill with diagnosis and procedure codes directly for you to submit your own claim to Aetna. Alternatively, we can send a claim form to Aetna on your behalf for a one time setup fee of $10. If we are required to spend any time or effort in the future, in any manner, to assist you in the reimbursement process other than submitting a claim or providing a superbill, additional compensation will be required. Compensation rates for the additional time spent will be at the rate of $25 per hour and $1 per page for medical record printing. Massages rates are $105 for 1 hour and $60 for a half hour (again a $10 claim submission setup fee applies if you want us to send the massage charges to Aetna for you). If you do have out-of-network coverage, Aetna will then send a reimbursement check directly to you.

We apologize for this inconvenience, however, we were left with little choice when Aetna hired ASH. We have had a 10 year positive relationship with Aetna and it is unfortunate that they have decided to impose such drastic changes. We encourage you to contact your employer’s HR representative to complain about these changes that Aetna is imposing. Feel free to contact us if you have any questions.