Two insurers agree to reprocess Conn. chiropractic claims

Bryan Cohen Aug. 2, 2011, 2:32pm


HARTFORD, Conn. (Legal Newsline) - Connecticut Attorney General George Jepsen announced on Tuesday that two health insurance companies have agreed to reprocess and review chiropractic benefit claims.

Jepsen raised questions about Aetna and American Specialty Health Networks Inc. after several complaints were made by chiropractic providers on behalf of themselves and their patients after their claims were allegedly denied improperly under state law. The providers were concerned that Aetna's claims administration agreement with ASHN, which began on July 1, did not include all the chiropractic services covered under state law.

Connecticut law requires that health insurance plans cover chiropractic care to the same extent coverage is provided for services rendered by a physician.

"Aetna's prompt and fair response to this issue means providers will be paid for covered services and Aetna's enrollees will continue to receive the care to which they are entitled," Jepsen said. "Everyone benefits from this cooperation."

Licensed chiropractors in Connecticut are permitted to provide a wide range of services, including X-ray and other diagnostic technology, preventative care, and the administration of foods and vitamins. If health insurance plans cover those services when provided by physicians, they must also cover the services when provided by chiropractors in the state.

Aetna said that its claim system will be updated to include the procedure codes for qualifying services a chiropractor can provide in the state. ASHN will review eligible claims submitted since July 1 and reprocess those that were denied incorrectly. There was no estimate available on the number of claims affected.

ASHN has provided claims administration and other services for chiropractic benefits available under Aetna's health insurance plans, with the exception of Aetna's Traditional Choice plans, in the state since July 1.

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