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Best Practices for Website Success
If one asked 10 years ago whether a website was relevant I was the first to suggest no. Yet as the world moves increasingly towards electronic information there is a dire need to have a website for your practice. Your website is actually your electronic calling card.
Healing With Hope
Ella is a Gulf War veteran and a survivor of military sexual trauma. Like hundreds of veterans, Ella was on 11 different medications for depression, anxiety, insomnia, irritable bowel syndrome and chronic pain.
Remembering Clarence Gonstead and 50 Years of the Gonstead Clinic
Dr. Clarence Selmer Gonstead (1898-1978) took chiropractic practice from back-alley bone setting to an understandable biomechanical science. His life was dedicated to clinical competency.
Spotlight on Acupuncture Research at IRCIMH
Acupuncture and Traditional Chinese Medicine were well-represented at the International Research Congress on Integrative Medicine and Health (IRCIMH)- 2014 which took place in Miami from May 13–16.
Looking For Answers In Many Places
I am sure we have all heard the old adage: "When the only tool in your toolbox is a hammer, everything starts to look like a nail."
The Kidney Official
The Kidney is known as the Official Who Controls the Waterways. In Western medical terms, a major function of the Kidneys is to filter the blood. Every day, a person's kidneys process about 200 liters of blood to sift out about two liters of waste and excess water.
The Acupuncture Success Express
Time is passing very quickly these days. We are atoms half the way through the year of the horse. You could call it "horse racing season" for this profession. Perhaps it is time for reinvention during this time.
Deciphering The New CMS 1500 Claim Form
Q: I am confused on using the new 1500 form, particularly Block 14 and Block 15. What is required and how do I properly fill these out? And do I actually have to use this new form or may I continue using the old version?
The Science of Stretching
In 1986, Rob DeCastella set a course record by running the Boston Marathon in 2:07:51, just 39 seconds off the world record.
Curbing Label Overwhelm
For the average consumer, reading a food package can be overwhelming: natural, organic, non-GMO, gluten free, free range ... you get the picture.
Are You a Bad Chiropractic Patient?
My father was a great DC. In fact, as you might expect, he was the doctor of chiropractic I measured all other doctors against. Sadly, he died at age 61 when I was in my early 30s.
Hazards in the Environment Making Your Patients Sick
Working both separately and together, Western and Chinese medicine have many successes in the treatment of the myriad diseases that afflict human beings in modern times.
Medical Qigong for the Heart: Part II
Chinese Medicine is rich in commentary regarding the emotions and how they affect our qi.
Knee Pain From the Kinetic Chain
As practitioners of manual medicine, chiropractors often treat patients suffering from knee pain.
By the Numbers: 3 Common Financial Mistakes With Major Consequences
Warren Buffett is on record for sharing the hidden art of becoming wealthy and making it simple enough for anyone to grasp.
Immunizations by Colorado DCs: Really?
You probably didn't hear about it, but back on Nov. 21, 2013, the Board of Directors of the Colorado Chiropractic Association (CCA) adopted "immunization authority" for Colorado DCs as its No. 2 legislative goal.
Why You Should Include the Single-Leg Stance Test in Every Patient Assessment
The single-leg stance (SLS) test, also known as the single-limb stance test, unipedal stance test or one-legged stance / balance test, is often used in the geriatric population to assess static postural and balance control.
Inside Liver Failure, Cirrhosis and Cancer
The Liver belongs to Wood in Five Element Theory and is in charge of Dispersing and Expanding which means all the processing and detoxifying of harmful substances such as medications and chemicals require the efforts of the Liver.
Physical Exam 101: The Hands
I am sure you are familiar with the old adage: "When the only tool in your toolbox is a hammer, everything starts to look like a nail."
Vaccines and Chiropractic: Evidence-Based Medicine or Medical Dogma?
Right or wrong, the chiropractic profession has historically been against vaccinations. However, a growing trend within the profession is seeking to reverse this position.
Fibromyalgia: Put the Pain in Its Place
While some fibromyalgia patients respond favorably to regular chiropractic care, others experience minimal relief. Unfortunately, many of these patients must rely on pharmacological management to relieve their constant pain.
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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