Attorney General George Jepsen announced Tuesday that Hartford health insurer Aetna and American Specialty Health Networks Inc. have agreed to review and reprocess chiropractic benefit claims that may have been denied improperly under Connecticut law.
Aetna was responding to questions raised by Jepsen after several complaints were made by chiropractic providers on behalf of themselves and their patients.
The complaints were that Aetna’s claims administration agreement with San Dieog-based American Specialty Health Network, which took effect July 1, did not include all the chiropractic services covered under state law.
Connecticut law requires health insurance plans to cover chiropractic care “to the same extent” coverage is provided for services rendered by a physician, Jepsen said.
“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.”
Chiropractors licensed in Connecticut are permitted to provide a wide range of services, including the use of X-ray and other diagnostic technology, the administration of foods and vitamins and preventative care. If health insurance plans cover those services when provided by physicians, they also must be covered when provided by chiropractors in Connecticut.
Jepsen said Aetna told his office that the claim system will be updated to include the procedure codes for qualifying services a chiropractor can provide in Connecticut. In addition, ASHN will review eligible claims submitted since July 1 and reprocess those denied incorrectly.
