resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
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.
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.
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.
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.
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 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 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.
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.
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.
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.).
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.
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 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.
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.
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.
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!
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?
News in Brief
NBCE Launches Computer-Based Testing Era; California Chiropractors Get Expanded DOT Exam Privileges; New Jeff Hays Documentary.
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.
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.
August, 2001, Vol. 01, Issue 08
Money and Ethics
By Ralph Stephens, BS, LMT, NCTMB
As the insurance debate heats up, emotions are kindled. As emotions become involved, logical thought goes out the window. Please try to put your emotions aside as you read the following five points regarding financial and ethical considerations in being an insurance provider.Ponder them carefully, and use them to help form your opinions, rather of rallying to the call of your emotions.
"We could help more people if we could get insurance reimbursement," is the rallying cry to justify monetary cravings. If helping more people is indeed the true desire, offer your services on a donation basis. Then everyone can afford you. You'll have all the people you have the strength to work on. Of course, this is unacceptable to most therapists who seek insurance because, in reality, it is the money they seek. That's fine - there's nothing wrong with getting paid for your services. Massage is a valuable service, and a physically demanding one at that. This limits how many hours a day one can work -- something not understood by insurance companies. You deserve to live a comfortable life. Money is required for that.
Now the question becomes, "Is there more money available to a therapist working for insurance, or working in a cash practice?" Let's do the math on insurance network programs. Let's accept their claim that they will send you 30% more clients if you accept a 25% rate cut, and see what eventually happens.
If you add their 30%, you gain six new clients. If only those new clients are participants with the "Alternative Care" company plan, here's what happens:
However, if your regular, full-paying clients find out about this "deal" and go with the insurance company, what will happen? Let's say 10% of your clients sign up, so now 40% of your clients (10.4, which I'll round off to 10) are now paying $37.50. That's $375 + $800 = $1,175. You should note that you will now be doing six extra massages for $175 total ($29.16/hr., not $37.50/hr.).
As 60% of our clients join the company, our income slowly dissipates as we work more hours.
At 100% of clients belonging to the company, which is not unreasonable considering what PTs and DCs do, and how fast the word spreads: 26 clients @ $37.50/hr = $975/week.
In other words, you make $25.00 less than when you "only" had 20 clients. Do six more massages, make $25 less. Work more for less. That is what insurance plans bring. Note that the insurance networks cap what you can charge. A therapist who now charges $70/hr. will only get $35/hr. tops on some plans -- a 50% deduction from regular fees.
The above example is for an access plan in which you get paid at the time of service by the patient. If you want third-party payment insurance reimbursement, you get to spend the additional time necessary to file and follow-up on all the paperwork or e-filings. More work, for the same or less pay. Gets better all the time, doesn't it? What would possess a logical, thinking mind to do this?
In other professions, providers/therapists have jacked their rates way up so that, after the insurance discount, they still make what they want/need. Responsible clients/patients are punished so severely that they have no choice but to buy insurance. They cannot afford health care because of insurance. This is by careful, premeditated design.
Back to the issue of helping more people. Helping more people now is not possible, because those people have made choices that prevent them from affording our services at the prices we want to charge. Soon we will not be able to help patients because the gatekeeper sends them to a PT or limits the number of appointments they can have. A plan or physician could allow only eight massage therapy visits a year, even for chronic conditions, like fibromyalgia. Worse yet, with insurance driving up prices, few people will be able to afford massage out-of-pocket. This has happened to every other profession, and it will happen eventually with massage.
If you do not have enough patients now, insurance may look like a way to get ahead fast. It may even look like a way to reach new patient populations -- to help those who choose not to afford massage. "80% of something is better than 100% of nothing" makes insurance cases sound tempting initially. The reasons most therapists have low patient loads is they do not have adequate therapeutic, personal and/or promotional skills.
Invest in acquiring better skills, rather than in learning how to play the insurance game. Skilled therapists become very busy no matter where they live. More people in stress and pain are looking for help than we can ever serve. Acquire the skills to help them and you will never need or desire to subject yourself or your patients to the abuses of insurance.
Click here for more information about Ralph Stephens, BS, LMT, NCTMB.
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