resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Get Ready For AOM Day
This year, AOM Day 2014 falls on Friday, (October 24th). This is a great opportunity to make your AOM Day celebration or event even bigger by extending it throughout the weekend!
Thoughts to Live By
When speaking to your patients about their health make sure to ponder the following points and have them assess if they are making themselves even more sick by the thoughts they have about life. Are these some of the traits and thoughts that your patients might have?
The Life & Legacy of James Sigafoose, DC (1933-2014)
Surrounded by his family and closest friends, Dr. James M. Sigafoose passed away quietly on Thursday, July 3, 2014. With his wife of 60 years, Patsy, along with his children, Tina, Daun, Kieth, Selina and Carey – all chiropractors – at his side.
MPA Media Wins Seven Publishing Awards
MPA Media, publisher of Acupuncture Today, among other titles, has been recognized for editorial and design excellence with an unprecendented seven publishing awards by the ASBPE, the nation's largest organization for business-to-business publications.
Your Patients' Best Health Resource
There is nothing as powerful as information. The right information has won wars, saved lives and changed hearts; lack of information has led to hesitation, poor decisions and unintended consequences.
From the Other Side of the Table
People come to us to gain freedom from pain, to feel better, to live better. As D.D. Palmer stated, "We Chiropractors work with the subtle substance of the soul." Therein also lies the rub.
The Spirit of the Point
After receiving a large amount of positive feedback on my San Zhen Protocols series, I have decided to focus this article on some relevant clinical aspects of acupuncture therapy prior to moving on to San Zhen Protocols III.
Take Care of Your Skin: Tips to Pass on to Your Patients
Many of our patients are not aware that the largest organ in the human body is actually the skin. Accounting for 16 percent of total body weight and covering up to 22 square feet of surface area, the skin is more than just a "covering," as originally thought.
Decompression-Traction: A Core Treatment Method in Chiropractic's Future
We're all competing for new patients. We're competing for new patients with physical therapists, massage therapists, medical specialists and hospital fitness centers. We're even competing with side-effect-ridden medications that quit working every four hours.
Ringing in a Fiscal New Year With a Recommitment to Cost-Effectiveness
Back when the Foundation for Chiropractic Education and Research was in its heyday, I used to send out New Year's greetings and virtual noisemakers to some close friends on July 1 – the beginning of our new fiscal year – wishing for prosperity in the year ahead.
The Science Behind Happiness
Are you happy right now? Whether yes or no, there are a myriad of reasons why you feel that way. A whole academic discipline has developed to find out what causes or obstructs happiness, and how to amplify it.
Detoxification for Athletes: The Key to Winning Performance
One of the most dangerous culprits that affects an athlete's ability to perform at an optimum level also happens to be one of the most elusive.
Building the DC-MD Bridge
From MDs practicing integrative holistic medicine to the family internist, many DCs are enjoying unprecedented attention from their allopathic colleagues.
Healing Community Trauma in Israel and Palestine
It's the beginning of August and Israel and Hamas have just agreed to a 72-hour ceasefire after a month of brutal fighting. In the last four weeks, 1,830 Palestinians and 67 Israelis have been killed.
How to Find Your Ideal Patient – and Help Your Ideal Patient Find You
Just imagine: You're at the front desk looking at the scheduler and a smile creeps across your face. Row after row, name after name, hour after hour; you're blessed with an entire day of ideal patients. Every day should be like this, you whisper. Exactly!
News in Brief
Oregon Gov. John Kitzhaber (a medical doctor, no less) proclaimed October 2014 "Oregon Chiropractic Health and Wellness Month" in an official proclamation signed Aug. 25, 2014.
A Healthy Dose of Failure is Vital to Your Success
As an acupuncturist I tend to see people after they have already suffered for years and "tried everything." They are so desperate for some relief that they want to know everything about how to get better, right now.
Don't Forget About the Performers
Donald Petersen Jr.'s recent article, "Your Chance to Go Back to High School" [May 1, 2014 DC], focused on the injuries incurred by high-school athletes and the subsequent opportunities for the chiropractic profession.
History of Animal Acupuncture: Part II
In Part I of this article, I had gone back to 1969 and tried to describe the atmosphere and events of that year that engulfed many of the younger generation, some who were all the core members of the National Acupuncture Association.
The Truth About Herbs
I appreciate the effort and research put into the article written in the June issue of Acupuncture Today regarding pesticides and Chinese herbs.
A Glimpse Into China's Top Brain Hospital
The sounds of the city pass through the open window are overwhelming the microphone - car horns, construction machinery - and then there's the family at the adjacent bed talking loudly on cell phones, yet you can still hear the faint beep of our patients monitoring equipment.
When Big Pharma Meets Chinese Medicine
Earlier this year, Bayer made a media splash with their decision to buy the Dihon Pharmaceutical Group Co., a Chinese TCM manufacturer.
January, 2001, Vol. 01, Issue 01
Medically Necessary and/or Insurance-Related Cases for Therapists
By Vivian Madison-Mahoney, LMT
I would like to express my excitement and appreciation for this wonderful opportunity to be able to communicate and share with you my most passionate subject: physician-referred, medically necessary insurance cases.My goal will be to inform, guide, and assist you in this sometimes complicated yet ever-rewarding adventure.
The following are some of the many issues we will cover in future articles in Massage Today:
In this our first issue, I will discuss what determines a medically necessary case, and help you understand the importance of physician-referred cases (whether or not you have intentions to or are able to accept insurance cases for payment in your region). I will also discuss how and when to make reference to a "patient" vs. a "client."
Medically Necessary Cases
To be classified as a medically necessary case to be eligible for insurance coverage, a physician must determine that the patient has a specific diagnosis. A professional examination and history of the patient is needed to determine a diagnosis. This must be obtained by one trained and licensed to practice medicine for which the diagnosis is given.
Definition of "Medically Necessary"
Medicare and most insurance companies define "medically necessary" as: "Services or supplies that:
Legalities of Medically Necessary Cases
Medically necessary cases need to be viewed as legal cases. Documentation must be maintained, accurate and in order for possible legal purposes in the future.
Physician-Referred Cases May Not Necessarily Be Insurance-Related Cases
A case that is medically necessary or referred for therapy by a physician is not necessarily an insurance-related case. One may have been diagnosed with a disease or injury and referred to you by a physician, but not have any type of insurance coverage. When treating a physician-referred case, you must keep accurate documentation, regardless of whether the case is covered by insurance.
You cannot bill an insurance company for any treatment that has not been determined by a physician's diagnosis to be medically necessary. This does not mean you cannot treat medically necessary cases referred by physicians.
Whether or not you are allowed to bill for insurance cases will be determined by many factors. Licensure or certification, insurance company requirements, and your state and local laws or rules may come into play.
There were no laws or rules in Florida that pertained to insurance billing for a massage therapist when I began in 1984. Therapists set the pace, and insurance companies paid for therapies performed and billed by a licensed massage therapist. You also may have to set the pace in your area.
Patient vs. Client
Physicians like to claim the title "patient." Attorneys like to claim the title "client." When a physician refers a case to you, this person is referred to as a "patient."
What has worked well for us the past 15 years is to always refer to the patient as the "physician's patient," and not claim them as "my patient." As one who works under the authority of a physician, by way of a prescription, we are acting as an extension of the physician, so to speak.
If you realize this, it will:
No information given within these articles is meant to override your licensing or state and local laws or requirements, or to take the place of legal counsel. It will always be your ultimate responsibility to know the laws and rules of your state and locale, and those of your licensure or certification boards.
Click here for more information about Vivian Madison-Mahoney, LMT.
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