American Chiropractic Network (ACN) controlling PT visits? (Full Version)

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webrehab -> American Chiropractic Network (ACN) controlling PT visits? (April 7, 2006 8:12:00 PM)

Many of you in private practice probably have heard of ACN, United Health Care owned, now overseeing PT visits and reimbursement for services. $65 per visit is what they are offering from what I understand.

Are they trying to lowball other networks like PTPN and PTP?

How do you feel about a chiropractic group telling you how to do PT?

Just another problem that eventually leads to less/poorer quality care for the patient.

Anyone's thoughts?




goodlooks58 -> Re: American Chiropractic Network (ACN) controlling PT visits? (April 10, 2006 1:51:00 AM)

I talked to the CA chapter APTA nad they said not to join ACN as APTA is fighting on the national level with UHC. The west coast Director for ACN quit so everything is controlled by their central national office. Seems like everyone wants to pay $65 for PT visits e.g. Medrisk and now ACN. Everyone reading this: please go to APTA's website and they have made up a sample letter to wite to UHC. No matter what everyone is saying that ACN is not a chiro network, I do not beleive them...it is a chiro network and I am not going to sit aroud and take %#*% from them. So every PT (staff and owner) we need to join to fight this common enemy. If someone else can live on $65 per visit..more power to them , I surely cannot. In my town Massage therapists are making $45 for 1/2 hour i.e. $90 per hour. In my area a staff PT costs $40 per hour. My rent alone is $3.00 per sq. foot. Reimbursements in the years I have been in pracice, has not kept-up to the cost-of-living and now ACN is trying to bully me with a letter stating that if I don't join then they are entitled to pay my out-of-network payment to the subscriber/patient. So then I have to go call/collect with the patient..this puts another strain of collection.
Does everyone reading see the grave effects on the PT's pocket-book?
Aabout "less/poorer quality of care" I think insurance cos are betting on PT's behaviors..they know PTs are suckers to the ethics and consience. e.g. I still use moist heat and Ice packs and ultrasound on my patients when appropriate. I don't get paid for it and I loose also on the time my staff or myself spent on the pts doing these modalities. Pts in general do not short change pts on the type of reimbursements I think we just don't have the conscience to do less. Yes, there are cooked PTs out there who are there just for a buck, but bad apples are there in all professions.




KIDPT23 -> Re: American Chiropractic Network (ACN) controlling PT visits? (April 10, 2006 7:22:00 AM)

That is exactly my concerns! I can't see getting only 50 -75 dollars a visit when personal trainers and massage therapists are getting 70-100 dollars an hour. I tried to state my frustrations with this before and got criticized for doing so. It needs to change.




drbuddy -> Re: American Chiropractic Network (ACN) controlling PT visits? (April 16, 2006 6:13:00 PM)

ACN started out just managing chiros, but now they are expanding to PT services as well. It's far from a 'chiropractic network' or 'chiropractic owned' network. I dont want you to think that we chiros are getting together to tell you how to practice. Chiros hate these scumbags more than anyone else.

So, instead of just having chiro scumbags telling us chiros how to practice, now they'll their very own PT scumbags telling you how to practice.

Welcome to fight. I'm sure it wont be long until ACN's counterpart, ASHN gets involved with managing PT services. Just make sure you complain loudly to the insurance companies that try to use these administrators.

The really bad thing about ACN is that ACN is owned by UHC. It's not like going to someone like Aetna and complaining about another company they have hired.




docb -> Re: American Chiropractic Network (ACN) controlling PT visits? (April 18, 2006 8:51:00 AM)

ACN is a bunch of crap. We have fought with them for over a year in our clinics. Now I see that they are "managing" PTs care.

I think with these guy's its going to continue to get worse. I have alot of friends that are PTs and if all they had were ACN pts they would be closing doors, no way could they survive on that pay scale.

Im not saying DCs and PTs should sing kum by ya and swap spit in the shower but maybethe forces that be within the 2 professions should band together and oppose this.




drbuddy -> Re: American Chiropractic Network (ACN) controlling PT visits? (April 18, 2006 2:13:00 PM)

I am trying to address this with the ACA. I am urging leaders there to contact the APTA and open up a dialogue to take care of these bastards.

PTs and chiros alike need to make this a major priority. Increasing awareness, direct access, manipulation, etc is nice, but if none of us are getting paid enough to do our job, all of that other stuff wont matter.




cmarti -> Re: American Chiropractic Network (ACN) controlling PT visits? (June 26, 2006 11:08:00 PM)

I have been excluded by UHC since I started my practice about 3 years ago. Now they are going through ACN in Wisconsin. I just received a contract to be in network. I have survived without UHC for 3 years, and I do not want to sell out to this contract...but I of course am worried if other PT providers accept these terms, ...I will lose my battle. What have the rest of you done and what was your outcome in fighting ACN? I cannot believe UHC OWNS them...I did not know this. So I think I hear it is futile to appeal to the payor directly...since in this case it is one in the same? [CODE] [/CODE]




PhilipT -> Re: American Chiropractic Network (ACN) controlling PT visits? (August 25, 2006 9:34:00 AM)

Buddy and Bryan,

It's great to have a chiro's perspective on this. I agree we should fight this as a team. The insurance companies seem to dictate which treatments are appropriate instead of the professionals in clinics who know what is best for the patients.

Phil




webrehab -> Re: American Chiropractic Network (ACN) controlling PT visits? (August 25, 2006 10:09:00 AM)

The real problem is that if the American Chiropractic Network ( a deceptive group that denies that they were/are chiros) changes behaviors of physical therapists; therefore, gets PTs to treat patients for fewer visits out of fear that if they don't they will be dropped from the network.

If they can prove their worth to other insurance companies, who's to stop them from managing all health insurance companies?

Many of my colleagues state that ACN denies that they are American Chiropractic Network - what about this url: http://www.employerhealth.com/EHR_sample_pages/sp2379.htm ?




Jeep -> Re: American Chiropractic Network (ACN) controlling PT visits? (August 25, 2006 10:30:00 AM)

digging a bit deeper on your link above is this:

http://www.theacngroup.com/about.html

"ACN Group, a UnitedHealth Group company, is the industry's leading physical medicine company. We use data and evidence-based resources to provide cost effective solutions to our clients. Using our knowledge and experience, we have designed innovative processes and technological capabilities that are targeted at improving the health care experience for the patient, the health care professional, and ultimately, for the client.

Founded as American Chiropractic Network (ACN) in 1987, the organization changed its legal name to ACN Group in 2002 to more accurately reflect the growing variety of services it provides to the health care market. Today, ACN Group's services include chiropractic management, physical therapy management, complementary medicine networks, and consumer health and wellness solutions."


Your Colleagues are correct.




touchiba -> Re: American Chiropractic Network (ACN) controlling PT visits? (August 25, 2006 12:11:00 PM)

I dont know if they've ever hid that fact. They changed the name to reflect their newly added 'services' to manage PTs and other PM providers.

Yes, if they prevail in the lawsuit and continue to show insurance companies they can save money, pretty soon they'll be managing everything from PI to work comp. I just dont see how they can cap reimbursement per visit to $40, limit you to 5 visits with tons of paperwork, then turn around and have a $30+ copay. Essentially it allows UHC to advertise that they offer PT/DC services and then not pay anything for it.

Oh, and please dont hold this against or blame chiros for these people. I dont think you'll find people that hate ACN anymore than chiropractors.




Colonial1672 -> Re: American Chiropractic Network (ACN) controlling PT visits? (August 27, 2006 7:30:00 PM)

I recently noticed that the ACA is suing ACN for "profiling".

I doubt Chiropractors are running the show over at ACN.

When will the APTA join in this fight?
My talks with ACN seem to indicate that we are next........therapists are given a "Tier 1" or "Tier 2" profile.

It is no doubt that the APTA needs its own "William Wallace" to get behind....someone to lead. Someone to go after ACN and physician owned practices.

I suspect it is only a matter of time before I am kicked off UHC b/c my stats don't measure up to the average "Network" provider.

Meanwhile, network providers are rewarded for kicking their patient's out early with more referrals from the insurance.

Don't get me started on Orthonet.


Tom H.




PhilipT -> Re: American Chiropractic Network (ACN) controlling PT visits? (August 28, 2006 6:35:00 AM)

I do remember Orthonet. I had my patients send in complaints about having their insurance / PT visits limited directly to the insurance company. Eventually we no longer had to ddeal with Orthonet again.




james097 -> Re: American Chiropractic Network (ACN) controlling PT visits? (August 29, 2006 2:29:00 AM)

Colonial,I liked your reference to William Wallace.
I was born in the same Shire where his monument is. His methods though may be extreme for this present day. His claymore is there complete with handle which is overlaid with the skin of an English duke whom Wallace flayed, that is a band of skin removed from the heel to the forehead. Whether the duke was alive at the time we don't know.
Jim McGregor




Colonial1672 -> Re: American Chiropractic Network (ACN) controlling PT visits? (September 2, 2006 8:34:00 PM)

Hey PTPTDPT,

Can you tell me exactly what you did and why it worked with regards to Orthonet?

As far as I know, this is a managed care program used by some insurance companies (in NJ it is Aetna, and Oxford mostly). Whenever I call for benefits for some of these patients, I am told to go through orthonet. On some I am not. Depends on the patient's plan.

You can post here (so others can benefit) and/or email me directly at Colonial1672@verizon.net

What state do you work in?

James097,

I love the movie. But seriously, I feel like the APTA are like the rich Nobles and the average therapist goes off to "secret meetings" that do nothing.

Thanks,

Tom




kburns -> Re: American Chiropractic Network (ACN) controlling PT visits? (September 26, 2006 3:31:00 PM)

Referring to Zeke's post above, I have informed my out of network UHC patients, that ACN has turned their PPO plan into an HMO therapy plan behind the enrollees back.
As many private practices elect to drop UHC, so drop the number of PT practices they have to chose from.
Prior to the Pacific (or Pathetic) Care - UHC merger, Pacific Care used the same contract for their HMO and PPO providers. Both were a flat fee agreement vs. the typical PPO fee schedule. PT's still signed up regardless. So it should come as no surprise to PT's that UHC adopted the same program.

Has the APTA ever released a formal statement against any insurance company's practices? Or have they supported a grass-roots effort to eliminate coverage in certain areas to pressure the insurance companies to change reimbursement? Hospitals and MD's do it all the time. We need to follow their lead.

My $.02,

kbpt




touchiba -> Re: American Chiropractic Network (ACN) controlling PT visits? (September 26, 2006 9:32:00 PM)

Us chiros have tried to organize, but our counsel warns us about antitrust laws. I dont think the APTA can say much about the situation, other than choose your network participation wisely.




USAPT -> Re: American Chiropractic Network (ACN) controlling PT visits? (April 10, 2007 10:15:00 AM)

Our UHC rate has dropped to $45/visit with visits to 6 to 10....and these are for post-op ACL, RCR, etc

anyone else seen a drastic change in their reimbursement?




Lucien -> RE: American Chiropractic Network (ACN) controlling PT visits? (September 28, 2007 3:42:23 PM)

Our PT reimubrsement has been around $45 dollars with united health care/ACN network. I did call ACN and was informed only to send a fax about why the reimbursement should be higher. This is so much BS, the APTA needs to put the majority of there attention on sinking reimbursements as what will it matter with "vision 2020" and having all Doctors of PT when the remimbursement will be so bad it want matter. I think every outpatient PT needs to call ACN and demand better!!!. I have 2 clinics and i will not give into this lowball remibursement crap. If we have a attitude that nothing can be done then nothing will be done. We have to believe that our reimbursement will be at a minimal $100.00 and fight for it!. The APTA needs to make reimbursement there #1 prioprity......
PT in Baton Rouge




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