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Your Billing Questions Answered
I hear a lot of the following questions: I am afraid I may doing something illegal. I have heard I cannot have different fees for the same service.
It's Time to Review
It is amazing to see the changes that are occurring in the acupuncture profession. Let's look at some of the news and events that have contributed to this growth and awareness.
Targeting the Bad Apples in the Bunch
While everyone was focused on the conversion to ICD-10, the Office of Inspector General for Health and Human Services released a new report on chiropractic titled "CMS Should Use Targeted Tactics to Curb Questionable and Inappropriate Payments for Chiropractic Services."
The Concussion-Subluxation Complex
In the Aug. 1, 2014 issue of Dynamic Chiropractic, I reviewed some of the literature demonstrating the role of the chiropractic adjustment in post-concussive care.
Omega-3 Fish Oil: An Underappreciated Element of Men's Health
As a clinician with many male patients -- and as a man myself -- I am all too aware of the fact that we like to convince ourselves that we are doing great, when that may be the farthest thing from the truth.
Acupuncture Rising: From Acupuncture Anesthesia to Assisted-IVF, Part 2
Acupuncture's cultural and historical roots go back to the emergence of Chinese civilization. For more than 2,000 years, acupuncture needling has been continuously practiced on the largest population in the world.
One Size Does Not Fit All: Exercise and Nutrition According to Your Yin/Yang Body Type
There are countless new exercise and nutrition plans out there, emphasizing the latest ground-breaking research and claiming to revolutionize the way we view health.
The Modern Application of Ancient Mei Rong
Chinese Medical Cosmetology (Mei Rong) has a well-documented and venerated history dating back to the Qin (221-206 BC) Dynasty.
Footsteps of the Sages: An Apprenticeship with Dr. Kezhan Zhang
When I met Dr. Kezhen Zhang in May 2013, I was his translator and the integrity, creativity, and passion he demonstrated as a practitioner and advocate of the medicine convinced me to travel to Beijing to study with him.
Diagnose Sprain Injuries in MVA Cases With Dynamic X-Rays (Pt. 1)
Am I the only person to notice hospitals are doing a seemingly insufficient job lately in their initial radiological workup of motor vehicle accident (MVA) victims?
Mechanism: Experimental Approaches to Understanding Acupuncture, Part 1
The clinical benefits of acupuncture are difficult to ignore, but also can be difficult to explain to a Western audience. For nearly 50 years, relentlessly inquisitive scientists and physicians have been working toward a conceptual model to explain acupuncture.
Too Many to Remember: Tips to Revive Your Ortho / Neuro Test Skills
When I was at Palmer in the mid-1980s, we were given a set of notes in one of our diagnostic courses. The notes covered approximately 70 orthopedic and neurological tests for various regions of the body.
Chinese Herbs and Pulmonary Fibrosis: A Case Study
"Mary M."* recently celebrated her 90th birthday. Even the former sheriff dropped by to kiss the hand of this diminutive retired teacher, to honor the years she interpreted for him during interviews with Latinas and Latinos.
Acupuncture and Oriental Medicine in the West
We know acupuncture and Oriental medicine as the indigenous medicine of East Asia; in particular China, Korea and Japan are the countries of origin of this wonderful healing system.
F4CP Making a High-Impact Impression
The Foundation for Chiropractic Progress has released details of its 2016 strategy, certain elements of which are already in play. The strategy includes ads, posters and other resources available to all F4CP members.
Tailor-Made Knee Pain: The Sartorius Muscle
A patient was referred to my office after receiving treatment from various providers with no results. The patient was training for the Olympics as a marathon runner and was unable to run or walk without severe medial knee pain.
Syncretism: Acupuncture and Public Health in Cuba
"Syncretism" is defined as a union of diverse tenets or practices. On a recent trip to Cuba designed to demonstrate the integration of Traditional Medicine and biomedicine, our group witnessed this union firsthand.
Making Sense of an Increasingly Obvious Conclusion
Where's U.S. health care heading? Like it or not, the list of telltale signs is growing to a point that stands out to even the most myopic observer. Consider this list of facts as you look into the future of health care in the United States:
Dietary Fat and Prostate Cancer: An Important Update
K.M. Di Sebastiano and M. Mourtzakis published a review paper examining the role of dietary fat on prostate cancer development and progression late last year that does a stellar job of summarizing the available data on fat and prostate cancer.
Born to Energize the Human Spirit: Recollections of Sig Miller
Sig Miller, longtime executive director of the Association of New Jersey Chiropractors (ANJC), passed away on Sept. 17 after a long battle with cancer.
Which Way is the Energy Going? Are You Burning Yourself Out?
One of the simple methods that I use to define Yin/Yang theory to patients is to ask the question, "Which way is your energy going?"
Pro-Con: Swaddling for Newborns
The practice of swaddling has been used for thousands of years and was popular until the 1700s, when it was slowly abandoned by many cultures that considered it old-fashioned or barbaric.
Designing a Fitness Plan (Part 1)
It doesn't matter if you come to my practice for pain relief, weight loss, healthy aging or something else. The formula I talk about for each patient's fitness strategy is pretty much the same.
North Carolina Acupuncture Board Files Dry Needling Lawsuit
In early September, the NCALB filed a complaint against the North Carolina Board of Physical Therapy Examiners over the issue of dry needling, a form of acupuncture that uses solid needles to puncture the skin and muscle tissue to relieve pain.
February, 2002, Vol. 02, Issue 02
What Will Happen to Insurance in the Future? How Will You Be Affected?
By Vivian Madison-Mahoney, LMT
Have you ever seen (or set up) an extensive domino arrangement? It can take hours, sometimes even days to set them all up in one design. But if someone accidentally touches one, especially at a strategic location, slowly but surely they will all tumble down.
As I read, check, and listen to reports about insurance companies, this sort of "tumbling" event seems an inevitability in the coming months and perhaps years.Don't be surprised if you hear more and more reports of losses from insurance companies and increases in premiums, not just because of the "Attack on America" on September 11, 2001, but also because it is just a "good" time to do so.
I predicted the downfall of the managed care system in the Florida workers'compensation arena the very day we heard it presented at one of the annual Workers' Compensation Educational Conferences. The changes brought outcries from patients, insurance adjusters, physicians and employers alike.
In 2001, the rules were changed to eliminate the mandatory regulations for employers to use the managed care system when seeking medical care for their employees. When people band together, things can change!
The problems and losses insurance companies are facing today will necessitate changes to provide future coverage in all aspects and types of insurance coverage, including auto; home; business; health; disability; and life insurance.
These changes may be beneficial in the long run, as insurance is long overdue for a good overhaul. I feel that you will find insurance companies and employers alike looking for alternative ways to be creative. This will be necessary especially in health insurance for employers to be able to continue in the future to afford to offer coverage for their employees.
However, these kinds of changes also scare me, because it appears from what I have read that the costs will be shifted more to those who are ill, injured or in need of coverage or prescriptions. Within this system, how will those who make little wages ever be able to afford to cover their own medical expenses, when they already have problems meeting the minimal expense of their portion of policy premiums under the current system?
Changes will be necessary for you and I to be able to afford coverage. It will be necessary for those who have no insurance to be able to receive coverage. Somewhere, sometime, someone will come up with the right solution -- and then someone else will find a way to cancel it out!
Remember years ago when Hillary Clinton came upon the scene and tried to make sweeping changes in the insurance industry? Shortly thereafter, managed care ensued, or as some called it, managed cash, for some of the executives and corporate offices of the managed care companies. One of the major insurers even reported that it cost them over a million to save even less than that.
My suggestion is that everyone drop all policies and let the insurance companies chips fall where they may. Then maybe we can get some creative ideas from the insurance companies that work for everyone! Or maybe we'll find that the money we save from insurance premiums will for all of our losses and medical needs! However, that is probably not going to happen, because too many of us are motivated by fear, fear of failure, fear of losses, fear of dying and fear of leaving others to do without.
How Will These Changes Effect You, the Massage Therapist?
That depends, it depends on if we are all willing to band together and insist that we are a part of the health care system, especially when what we do is deemed by diagnosis to be medically necessary and prescribed by physicians.
We are health care providers, in addition to being able to offer or include a variety of diverse services such as spa treatments. This puts us in a wonderfully unique position, unlike other health care providers. It is a position we need to protect and preserve!
It really bothers me that some therapists are content to accept referrals by being listed in insurance company provider directories. This is not health care coverage. This is insurers' getting massage therapists to acknowledge that we are willing to set our fees at a much lower rate, in order to "possibly" obtain a few clients who happen to see us in their provider directory. (Doing this willingly is to reduce our own fees, not the insurance companies reducing them for us, as some fear will happen).
Under the above-mentioned circumstance,s we are not providers in the medical sense of the word. We are basically discounters for our services for those insurance subscribers, whether or not they have a medical condition.
It is just a way to offer our services to a select group, while in turn, the insurance companies eliminate reimbursement for medically necessary, prescribed services that they pay others for, whether or not they are trained or licensed to perform the service.
True medical coverage is when the policy reimburses a provider of services all or a portion of the bill for a medical condition from the insurance policy proceeds, not when the policyholder, subscriber or member pays the full cost, whether or not it is discounted.
Let me leave you with this thought to ponder. Massage Therapy Code 97124 has been a covered procedure listed in the American Medical Association (AMA) Current Procedural Terminology Code Book (CPT) for many, many years. This code was a reimbursable code long before massage therapists' ever contemplated billing for it.
If the procedure of massage therapy is considered a reimbursable, medically necessary treatment for an illness, injury, or other diagnosed medical condition, then please tell me why those of us who are trained, licensed or otherwise qualified to perform massage not be reimbursed for it by insurance?
A final note: Some insurance companies and adjusters do recognize the benefits of massage therapy. For more than 16 years, they have not only been willing to reimburse a massage therapist for this service, but many of them refer patients to massage therapists.
I mention this to emphasize that many years of hard work and major progress will all come to an end if we do not band together for our rights and for the elimination of discrimination against us. Whether massage therapists should accept insurance for reimbursement or receive medical referrals is and should always be a personal choice.
Click here for more information about Vivian Madison-Mahoney, LMT.
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