The AAC has started the process of reaching out to the individual plans to make sure they are prepared for the upcoming changes. Turns out, that isn’t always the case. From plans having only a small network of providers to understanding that full-scope is now going to be covered–the AAC is working with AHCCCS to make sure all the plans are ready.
Here are some current challenges:
- Ensuring that previously closed networks are opening up to ensure network adequacy
- Evaluating whether plans should maintain a 20% holdback associated with mid-level providers, which does NOT include chiropractic in AZ
- Ensuring that reimbursement codes include our full scope of services
- Are TPAs allowed to manage Federal insurance benefits?
- Determining any preauthorization requirements that would need to be met
These and more are issues and concerns that the AAC is working on getting resolutions that will allow full implementation of chiropractic service under AHCCCS.