Asuris to require pre-authorization in 2014

Some health plans are beginning a program which requires providers to receive care plans from the insurance company. This change affects acupuncture, massage, chiropractic care, physical therapy, occupational, and speech therapy. This program will restrict your access to visits and my ability to receive reimbursement for care beginning Feb. 1st, 2014. At this point, this change will NOT affect those who are on Regence’s federal employee plans (FEP) or Uniform plans. If you have a question about whether this change will affect your plan, let us know or contact your insurance company.

Your treatment plan will be given to us by Asuris and we are bound to it

The number of visits you may be allowed and the time line by which you need to receive them will be determined by your insurance carrier, regardless of any plan prescribed by your physician. For example, Asuris or Regence may determine that you should be treated for 4 visits over 30 days.  You would be required to come for all 4 visits in 30 days, or any request for additional visits may be denied. You would not be allowed to come for any additional visits until we get approval for them. Limitations may be placed upon certain services determined  to be unnecessary to your care. We cannot collect any compensation from either the insurance company or you for any treatment methods which differ from the treatment plan.

Pain management may not be covered

In the case of conditions that are not resolved within the alotted time frame,  your insurance may refuse to cover additional visits. Many of our patients have chronic pain conditions which will need some level of care indefinitely. Regular care here can help with pain management. This type of care will likely not be covered. We will be allowed to do what we can for you in your initial care plan, but coverage may not be available for  routine care for pain management, preventative care, or “drop in” care for acute situations. If you have another injury or complaint, or if you are re-injured, we will be able to submit documentation for another care plan to treat you.

Seth Popham LAc, LMP 
Traditional Chinese Medicine
A Notice to Patients 
covered by Asuris: