resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Is the New Medicare Reporting Exemption Right for You?
What you've heard is not a rumor – there will be exemptions for providers of Medicare patients, with no penalties assessed for offices that do not do Quality Payment Program (EHR, PQRS, MACRA and MIPS) reporting.
Why I Quit Doing House Calls
My father was a chiropractor who did house calls, so when I became a DC, I figured doing house calls was part of the job. My March article recalled my experience as a small boy, accompanying my dad while he went to patients' homes to treat them.
Is It Time to Rethink Mental Illness? (Pt. 1)
Invariably, patients will ask their chiropractor about depression or various mental illnesses. Some practitioners will reflexively offer a cervical adjustment, suggest St. John's wort or contemplate a referral to a specialist.
Women's Hormones: A Western & Eastern Perspective
Sometimes it may seem that you require a degree in medicine to understand hormones and how they function.
The Visual Error Scoring System: A Concussion Tool
Postural stability and oculomotor function are the most easily recognized physical indicators of neurologic motor dysfunction associated with concussions.
Balancing Spring Challenges
As the winter months come to a close and warmer spring weather appears, patients may begin to present with new challenging pattern presentations.
Creating Good Business Buzz
What do patients really think about working with you? Rarely do you hear the whole truth. Those who improve may be candid in their gratitude.
An Integrated Approach to Chronic Pain
Findings from a unique Medicaid pilot project in Rhode Island involving high-use Medicaid recipients from two health plans were recently presented to the state's Department of Health, demonstrating stellar outcomes with regard to medication use, ER visits, health care costs and patient satisfaction.
New Relationships, Old Trauma: AOM & Other Healing Strategies
Being in love is one the most beautiful and enjoyable experiences. Most of us are willing to pay almost any price to have that experience, and still often find it elusive or fleeting. Navigating the ups and downs of loving relationships are often challenging — even for the most psychologically balanced among us.
An Unexpected Diagnosis: The Result of Lacking Communication
A couple years ago I had a case that showed me the importance of open communication between health practitioners. We need to show up with less fear, and let go of our judgments so we can do better for the patient.
Bill With Confidence: Learn What to Collect
Q: I am trying to understand what I may collect from my patient when there is insurance. Do I have to accept the amount allowed by the plan or may I collect up to my billed amount? Please note, I am not a member of any insurance plan.
Taking the Chiropractic Message to the Press
"There is no better place on earth to have a news event," the National Press Club boasts, and it's easy to understand why: Every year, the 108-year-old Washington, D.C.-based organization hosts countless press conferences on the hottest topics impacting America and often the world.
Eczema & Acupuncture: A Sound Solution (Part 1)
Eczema affects approximately 3.5 percent of the global population and is one of the most common skin complaints seen by dermatologists.
A Daily Strategy for Heavy-Metal Detox
In modern society, we are constantly exposed to heavy metals such as cadmium, lead and mercury. These heavy metals have no essential biochemical roles in our body, and conversely, can cause us a great deal of harm if they build up to toxic levels.
Universal Design: Principles & Practice
In many respects, universal design serves as the core of ergonomics. It's also a good tool to use when designing a return-to-work program for injured and/or ill patients. Let's take a closer look at universal design and why it should matter to you and your patients.
A Major Role in Back Pain: The Multifidus
Back pain affects roughly 80 percent of the population at one time or another and is one of the leading causes of doctor visits.
Clearing Blocks: A Way to Improve Cosmetic Acupuncture
As a Five Element acupuncturist who teaches facial acupuncture classes nationally, I was surprised to learn that one of the basic principles I was taught in school is unfamiliar to most acupuncturists.
Raditation & Your Smartphone: Is it Worth the Risk?
If radial arteries could talk (and in my experience they can to some extent), they would say, "Step away from the smartphone." At least that is the message I am receiving loud and clear as I feel the pulses of many patients.
News in Brief
ACA Adopts New Governance Model; ACA 2017 Awards; CCA Helps Calif. DCs "Share the Love"; $1 Million to Help Advance the Profession; D'Youville Raises the Bar on Anatomy Education; ErRatum.
August, 2001, Vol. 01, Issue 08
Insurance Billing & Reimbursement Issues
By Vivian Madison-Mahoney, LMT
Here are a few pointers regarding insurance billing and reimbursement. Follow some of the guidelines below, take it slow and easy, and advance your way to success!
If you need phone numbers for the Divisions of Insurance or Workers' Comp in your state, call me at: 865-436-3573 or email at: and I will get back to you as soon as possible.
Regarding Discounted Fees for Services
Since so many of you ask my opinion on the subject of discounted fees for alternative care services to insurance companies, I will offer just that: my opinion, for what it's worth.
There is a lot of talk, both positive and negative, about CAM and insurance companies wanting to contract with massage therapists to give discounts for their services. There is much I could say on this topic, but briefly, let me tell you what I think. Insurance companies wish to have therapists give discounts for their subscribers, which in turn helps them sell policies or compete with other carriers to sell policies to employer groups, etc. This discount is given by providers most often in turn for the promise of the subscribers finding massage therapists or other alternative care providers in their directory of providers.
Just because you are in the directory is not a sign that you are a "provider" in the network in the usual sense. It is an agreement to be placed in the provider network booklet, directory or policy to inform the subscriber that you are willing to provide services at a discounted rate for a nonmedical, non-insurance related case.
I personally feel that therapists should be allowed to make their own decision as to if they desire to provide discounts in exchange for the listing -- just as it should be the decision of each massage therapist whether to accept medically referred cases and insurance reimbursement for such services.
I do not feel that anyone should be making the decisions or rules as to who should accept these types of cases. If the physician prescribes the treatment or therapy as medically necessary; if the therapy prescribed is within the therapist's scope of practice/licensure and/or certification; if the insurance companies are willing to reimburse you for your services; if the patient wishes to receive the therapy; and if the physician and the therapist decide that it is in the best interest of the patient, themselves, and their office, then it should then be the therapist's decision and only theirs.
For anyone else to make rules and regulations to limit ones income potential is unmerited. The same goes if rules were put into effect requiring a therapist to have to accept insurance cases. I feel it should be each individual's personal decision.
Here are some questions I would like you to ask insurance carriers and/or credentialing companies who submit applications to you, offering discounted fees to their subscribers for your services:
There are many more questions to consider, but these should serve as food for thought for now.
Click here for previous articles by Vivian Madison-Mahoney, LMT.
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