There are no application fees, membership fees, credentialing fees or provider seminar
fees for ASH providers. Providers will either be charged a per-claim Administrative
Processing Fee or be eligible for an Incentive Payment based on the amount of electronic
transactions with ASH.
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 Agreement to participate in these programs.
No, 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
90 days of the first date of service requiring approval. In most cases, ASH allows
the first five office visits in the calendar year 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.
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.
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 our Provider Credentialing
department at 800.972.4226 and one of our credentialing representatives will assist
you.
ASH has provided an 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) phone 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) phone 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 and a
demonstration of how ASHLink works.
Once you become an ASH provider you will automatically receive information on how
to activiate our ASHLink account.
Please call our Provider Services department at 800.972.4226 and one of our representatives
will assist you.