Unravel Therapeutics will be closed Sun April 20, 2014 For Easter and Sun May 25 and Mon May 26 for Memorial Day

 

Group Health 

January 1, 2014

All providers are in net-work with Group Health PPO plans.  Sheryll Gregory is still the ONLY allowed provider HMO plans. There should be a designation of HMO or PPO on the member’s card.  Check your benefits before scheduling to ensure payment.

December 30, 2013

 

Regence, Blue Shield and Blue Card Subscribers

Beginning February 1, 2014, Regence will be implementing a new physical medicine program that is designed to improve the efficiency of certain treatment modalities focusing on their medical necessity.  Keeping in mind that all contracts with Regence and other carriers have medical necessity guidelines, Regence has hired a third party vendor to administer and enforce these guidelines.

The affected services are:

  • Massage
  • Acupuncture
  • Chiropractic Care
  • Spinal procedures/surgeries
  • Physical, Occupational, & Speech therapy

Care Core National, the third party vendor, will be overseeing all treatments related to the above service types for Regence. From February 1, 2014 forward, all treatments listed above must be pre-authorized by Care Core and monitored.  All providers must adhere to these physical medicine determinations of Care Core in order to be paid.

This process involves us entering in your ID and date of birth into their system for verification, benefit determination and appropriateness of service & medical necessity. Even if you have a prescription from your doctor and benefits on your plan, we must still go through this extra step in order to get paid for our work.  Since this will be a time consuming task, it is likely that we will be unable to schedule appointments as you call in.

So far, the only groups we know to be exempt from this process is King County employees (KRC alpha prefix) & Uniform medical (UDWW alpha prefix).  All others are subject to this process.

Please be patient with our staff in the implementation of this new process.  We will do our best to make it as smooth and efficient as we can.