Oct 20, 2020

Dear Friends –

Today is a sad day – the first in 10 years that I’ve had to send a letter of this sort.? The short version is that I have decided to resign participation with American Specialty Health (ASH). This isn’t a decision that I have taken lightly, and am still frustrated by having to make. But it is my job to preserve the clinic for the future and largest good possible. I will not turn my business into a mill.

I realize you’ll have questions, so here are answers to the biggest ones.

1. What does this mean?

By withdrawing from the ASH network, I am an out-of-network (OON) provider for ASH and insurance companies who use their panel including HealthNet, Molina, Providence, and in some cases Cigna. This means that if you have OON benefits (and most plans do), you will pay a different rate to see us than an in-network provider.

2. What happened? / why now?

Over the past four years, the insurance industry has been going through sweeping changes. I knew that these changes were problematic, but chose to give the new system a fair chance. That system has added a significant administrative burden, increased your hassle, (know those forms you have to fill out every 5 visits?), reduced your visits, and slashed reimbursement to an unsustainable rate. This year has been a year of weighing the pros and cons of a panel. Unfortunately, I have decided that this was not a relationship I could maintain or justify.

3. When does this take effect?

Wednesday, October 20, 2020, I submitted the resignation with a written separation date of October 20, 2020.

3. Real numbers – what’s the difference between in and out-of-network?

It depends on your plan. Roughly, it means that your copay/coinsurance might go from $10 to $30 or your deductible may increase. There are too many different plans to make general quotes. The best advice is to let the office call your specific plan, get the low-down, and explain the options to you.

8. What other options do I have?

Open enrollment for many employers & insurance plans is coming up. While it rarely makes sense to select a plan based on alternative care benefits alone, if you have other plans offered and are anticipating surgeries/etc – do your homework. Maybe there is a different option that makes sense for you.

If you have an HR department – let them know that providers are leaving this panel. Employers have a stronger voice with insurances than we do. ?

If you have some time – call Member Services at the phone # on the back of your card. Tell them how you feel. It is incredibly frustrating as a consumer to pay for a thing that doesn’t meet your expectations. Especially if you had limited buying options to begin with and the price of your thing continues to go up.

And if you’re feeling particularly sassy – call an elected official or the WA Insurance Commission (1-800-562-6900; https://www.insurance.wa.gov/file-complaint-or-check-your-complaint-status). Make your voice heard!

In closing – this sucks. But I offer deep and humble thanks to all of you – for your trust, support, loyalty and friendship through 11 years in business. It is my sincere hope that I can continue to be your provider of choice in acupuncture. But even if life takes us in different directions, you will always have a home and friend here. Call if there is anything I can do – even if it’s just helping you find the next best people to help you heal.

With heaviness, love & hope –

Kim Blaufuss, EAMP, Dipl Ac