Provider FAQ
Yes, ASH will focus on providing complementary health care networks for:
- Managed care plans
- Employer groups
- Insurance companies
- Unions
- Government agencies
- Counties and cities
- Health coalitions and others
In most states, our agreement will only obligate providers to participate in the types of plans listed above. Providers are typically not obligated to participate in a complementary health network for Workers’ Compensation, auto med pay, or third-party personal injury unless they choose to through an amendment to the Provider Services Agreement.
If ASH sells a complementary health network for Workers’ Compensation, auto med pay, or third-party personal injury in your area, providers typically will have the opportunity to opt-in. If this is applicable in your state, you will not be automatically included, but you will be able to agree through a separate amendment to the Provider Services Agreement to participate in these programs.
Typically medical referral is not required. ASH’s programs usually allow patients direct access to the participating ASH provider of the patient’s choice. However, ASH does manage some benefit programs where medical referral may be required.
The fee schedule is determined by the payor and ASH. Fee schedules are set at a level intended to make complementary health care services attractive to potential health plan purchasers. All fee schedules are reviewed annually, and any changes will be noted in the end-of-year update mailing.
When submission of paperwork for approval is required, it must be received within 180 days of the first date of service requiring approval. In most cases, ASH allows the first five office visits in the calendar year (July through June in California) to be reimbursed without submission of a treatment form. In most cases, claims need to be submitted within 180 calendar days of the date of service in order to be reimbursed.
Covered chiropractic services performed by licensed chiropractic assistants that are within their scope of practice as delineated by state law are eligible for in network reimbursement if the services were performed under the supervision and control of an ASH Contracted Chiropractor and are billed to ASH under the Tax Identification Number (TIN) of the supervising Contracted Chiropractor.
Because each health plan is different and each has unique requirements, we provide a document called a Payor Summary to help you. The Payor Summaries are information sheets that define the requirements of each health plan. They will give you information such as:
- Whom to call for eligibility
- To whom to send claims
- Which codes are accepted for payment
- Which fee schedules are applicable
Yes, please see the
Clearinghouse List [pdf].
Yes, ASH will provide Payor Summaries for every plan eligible in your state.
The members actually select the participating provider of their choice. ASH typically works with health plans that allow direct-access complementary health benefits. Thus, members are able to self-refer to you for complementary health services. ASH or our client health plans distribute provider directories listing names, addresses and phone numbers of all participating providers.
ASH does not deny any provider’s application based on geographic limitations alone. While we do not actively recruit in areas where our networks have reached a level sufficient to service our membership, we do process all applications received as well as pursuing member and client nominations in support of existing and new business opportunities.
Yes. Like all licensed networks, we are obligated to recredential our network every two or three years. Therefore, you will need to be recredentialed in order for us to comply with this requirement.
If you are interested in becoming an ASH provider, please call 888.511.2743 and one of our network recruiters will assist you.
To check the status of your provider application, please call Provider Credentialing at 800.972.4226 and one of our credentialing representatives will assist you.
ASH has provided a
Clinical Quality Guidelines online.
To report any changes to your address, phone number, tax ID, or other clinic information you have several options: 1) complete the electronic Provider Status Change Request form and submit through ASHLink; 2) contact the Provider Relations department at 800.972.4226 option 4; or 3) print a copy of the Provider Status Change Request form from the Resources > Forms section on ASHLink and fax the completed form to 866.545.2746, toll free.
To report any changes to your address, phone number, tax ID, or other clinic information you have several options: 1) complete the electronic Provider Status Change Request form and submit through ASHLink; 2) contact the Provider Relations department at 800.972.4226 option 4; or 3) print a copy of the Provider Status Change Request form from the Resources > Forms section on ASHLink and fax the completed form to 866.545.2746, toll free.
Fax ASH a completed Direct Deposit Authorization Form. This form is available in the Resources > Forms section of the ASHLink Web site.
Have the prospective provider call us at 888.511.2743 and an ASH network recruiter will assist them. (You can also refer them to the
Provider Benefits section of this Web site for more information.)
ASHLink is a free Web site available to contracted ASH providers for accessing information and conducting business online. Visit the
ASHLink Extranet page to view a summary of ASHLink's features.
Once you become an ASH provider you will automatically receive information on how to activate your ASHLink account.
Please call Provider Services at 800.972.4226 and one of our representatives will assist you.