REGENCE to require pre-authorization in 2014
Regence is beginning a program which requires providers to receive care plans from the insurance company. This change affects acupuncture, massage, and chiropractic care. It also affects physical, occupational, and speech therapy you might get elsewhere. This program will restrict your access to visits with us and our ability to receive reimbursement for care on Feb. 1st, 2014. At this point, this change will NOT affect those who are on Regence’s federal employee plans (FEP) or Uniform plans. If you have a question about whether this change will affect your plan, let us know or contact Regence.
Your treatment plan will be given to us by Regence and we are bound to it
The number of visits you may be allowed and the time line by which you need to receive them will be determined by Regence, regardless of any plan prescribed by your physician. For example, Regence may determine that you should be treated for 4 visits over 30 days. You would be required to come for all 4 visits in 30 days, or any request for additional visits may be denied. You would not be allowed to come for any additional visits until we get approval for them. Regence may also limit certain services it deems to be unnecessary to your care. We cannot collect any compensation from either the insurance company or you for any deviations from the plan. We will have to refuse you any treatments or services not approved during the course of your care plan.
Pain management will not be covered
If you have a condition that we cannot ”fix” within a short time line (1-3 months), Regence will likely be refusing to cover ongoing visits. Many of our patients have osteoarthritis, fibromyalgia, herniated discs, and other types of conditions which will need some level of care indefinitely. Your semi-regular care here keeps you running and helps manage your pain. This type of care will likely not be covered. We will be allowed to do what we can for you in your initial care plan, but Regence will not cover routine care for pain management, preventative care, or “drop in” care. If you have another injury or complaint, or if you are re-injured, we will however be able to submit for another care plan to treat you.
All is not hopeless! You still have unlimited access to care
While your insurance may be limiting the number of your visits they will pay for, we are still available in unlimited quantities. If Regence refuses care for your condition, or you would like treatment beyond what was approved, we can create our own care plan! While having to go outside your insurance coverage is frustrating, it does allow you to get your treatments here, how you want them and when you want them.
If you have any questions regarding Regence’s new pre-authorization policies, please let us know.