resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
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.
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.
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.
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.
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.
Help Secure Our Future by Sharing It
The National Board of Chiropractic Examiners (NBCE) conducts one of the most comprehensive surveys of the U.S. chiropractic profession every 4-5 years.
Thoracolumbar Syndrome: The Great Mimic
The thoracolumbar junction is a common area of joint dysfunction. The most obvious cause is dysfunctional breathing or lack of diaphragmatic breathing. Treating this breathing problem will ultimately be the long-term cure for the syndrome.
News in Brief
NBCE Launches Computer-Based Testing Era; California Chiropractors Get Expanded DOT Exam Privileges; New Jeff Hays Documentary.
Uncle Sam Needs You
Scrutiny into the Department of Veterans Affairs (DVA) continues to grow after efforts to reform the DVA by the former Secretary of Veterans Affairs, Eric Shinseki, were deemed "a stunning period of dysfunction" by Senate Minority Leader Mitch McConnell (R-Ky.).
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.
Let the Patient Tell Their Story
Often when a patient presents with an injury, they want to tell their story. People by nature like to talk about themselves, particularly when they're worried about their health.
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.
Improving Our Political Effectiveness
The November 2014 elections are right around the corner; members of Congress, governors and state legislators are all running. Now is a good time to talk frankly about our overall political involvement.
The Problem With Prolonged Sitting
We need to constantly talk to our patients about spending less time sitting and about what can go wrong with poor sitting postures. The fact is we sit too long in repetitive malpositions.
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!
Medicalization and Mindfulness
The past several years have seen a veritable explosion of research on mindfulness. Research abstracts we've published in each issue of Health Insights Today under the heading "Mind-Body News" have increasingly reported on studies about mindfulness interventions.
Rethinking GMO: Less Panic, More Context
Some of you may have noticed that after writing parts 1 and 2 of “Genetic Modification of Organisms for Human Consumption” a while back [Nov. 15, 2013 and Jan. 1, 2014 issues], part 3 never appeared.
A Commonly Missed Spinal Fixation: The Upper Lumbar Spine (Part 1)
When we think of lower back pain, we tend to think in terms of the lower lumbar spine and the SI joint. These joints and their discs are obviously important. However, we tend to miss fixations that occur just above – in the upper lumbar spine. Three questions come to mind: 1) Why is the upper lumbar spine so important? 2) Why do we miss the fixations here? 3) How can we adjust them?
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.
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?
If You Get a Request for Records, Respond!
In our previous two articles, we discussed two of the main reasons for denial when chiropractic records are reviewed by Medicare contractors.
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.
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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