Horizon BC/BS of NJ has  notified all in network Chiropractic providers that beginning January 1, 2020, all Chiropractic claims will be overseen by American Specialty Health Networks (ASHN).  ASHN is a company which reviews claims and determines whether care  is “medically necessary”.  They will also be overseeing physical therapy, occupational therapy, speech therapy and acupuncture for Horizon claims.

ASHN has notified us that claims will be reviewed for necessity after 5 visits.  At that time, if they deem the care is not necessary, it will be denied.  Having dealt with ASHN before, it is very likely that many claims will be denied and it will be much more difficult for you to receive your full benefits.   For more information click here to read an article posted both on NJ.com and printed in the Star Ledger last week.    NJ.com Article 

The contract between Horizon and ASHN must be  reviewed by the Division of Banking and Insurance (DOBI).  If you are concerned about the impact that this alliance might have on your benefits, you can click the following link to urge state representatives to tell DOBI not to approve the contract.  As of this week, legislators have received 170,000 emails from citizens concerned about their benefits.   Express your concern HERE.

Whatever happens with this merger, know we will do all that we can to see that you get the care that you need at an affordable fee.