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Power to the Patient
Against a backdrop of splintered political parties, polarizations within nations, civil unrest, and distrust of established government (such as the growing anti-Washington, D.C. sentiment) comes the not-so-surprising finding that health care authorities and practitioners (with perhaps the exception of insurers) are turning over more and more powers to the individual patient.
Getting Paid by Medicare Is Getting a Major Adjustment
The 2015 Medicare Access and CHIP Reauthorization Act (MACRA) was signed into law to implement a new approach to clinician payments and replace the Sustainable Growth Rate formula.
Natural Cancer Prevention: Pomegranate for the Prostate
In recent years, the ingestion of pure pomegranate juice (8 ounces per day) has been shown in clinical studies with human subjects to slow, and to some degree, reverse, the progression of prostate cancer – the second leading cause of cancer death in North American men.
Pediatric Asthma: A Case Study
I have had very good success with pediatric asthma, combining acupuncture with Chinese herbal products. Treatment is given over four to eight months, twice monthly, with herbal formulas rotated every month.
Decoding the Mystery of Medical Insurance Acceptance
In the constantly evolving profession of acupuncture, one of the least understood areas is medical insurance acceptance. The profession is filled with controversy surrounding this topic: Is it ethical?
Going Beyond Just Feeling Good
We all know that most patients come to us for some pain complaint: neck pain, back pain, sciatica, carpal tunnel, etc. We also all know that acupuncture is a great first-line care for these issues, as well as supporting overall health and wellness.
Update from the International AIDS Conference
The 21st International AIDS Conference in Durban, South Africa, brought together more than 15,000 of the world's leading scientists, activists, funders, policy makers, and consumers from 153 countries.
Six Things Every DC Should Know About the Zika Virus
The Zika outbreak continues to spread across the continental United States and U.S. territories. We offer this brief overview on this important public health problem for the practicing doctor of chiropractic.
Treating Peripheral Neuropathy: Multi-Faceted Approach Including Laser Therapy
Peripheral neuropathy affects at least 20 million people in the United States1 and nearly 60 percent of all people with diabetes suffer from diabetic neuropathy. Many suffer from the disorder without ever identifying the cause.
ITB Syndrome: Treat the Tensor Fascia Latae
Iliotibial band syndrome is usually the result of repetitive knee flexion, such as in runners or cyclists. Pain may be experienced in the knee and/or the hip. The patient may express a sense of the hip dislocating, popping or snapping.
Dysautonomia: The Medical Condition You May Already Be Treating
TCM practitioners have spent thousands of years healing patients without knowing or needing the names of their diseases as defined by allopathic medicine. We have syndrome names that are both poetic and efficient.
Four Ways to Attract Patients
Acupuncturist A has been in practice for six years and has struggled since day one. She spends as much time and money on marketing as she can, but since her practice is slow, her budget isn't that big.
Pediatric Footwear: Function Over Fashion
As practitioners, it is not uncommon for parents to bring us their children to treat or ask us questions related to the pediatric population. Children's feet tend to be a perplexing region for parents and practitioners alike.
Workers' Back Pain: Causes, Costs & Solution
You will want to share two important papers published in the past several months. Why? When read separately, each provides valuable information relevant to your patients, community and practice; together, they tell a compelling story.
Treatment Success at the Won Institute
According to the World Health Organization's 2003 report titled, "Acupuncture: Review and Analysis of Controlled Clinical Trials," acupuncture has been shown to improve many physical, emotional, and mental conditions.
First Annual ICD-10 Updates Take Effect
Yes, there was an update to ICD-10 codes on Oct. 1. It was a regular update to the diagnosis coding system and will take place every Oct. 1, just as it did when the ICD-9 system was in place.
Upgrade to "Parker 2.0" in Las Vegas
Continuing your education and refining your practice: two key elements of a successful chiropractic career. Parker Seminars promises both as it celebrates its 65th anniversary in Las Vegas next February, according to Parker University President, Dr. William Morgan, and seminar consultant Dr. Mark Sanna.
Using the Lens of Chinese Medicine
One of the most common medications I see in clinical practice on a daily basis is fluoxetine or Prozac. Consequently, I hear many complaints concerning the side effects of this medication and am frequently asked by patients to help manage these side effects with acupuncture and Chinese medicine.
National Board Apologizes for Testing Issues
The National Board of Chiropractic Examiners (NBCE) has issued a formal apology following a series of computer-based testing malfunctions that impacted two separate examinations (March and June 2016) and caused "widespread confusion and frustration" to the nearly 1,500 examinees taking the tests.
Integrative Cancer Care: Chiropractic for Chemotherapy-Induced Hiccups
Hiccups (singultus) are a frequent occurrence during cancer treatment. The cause of the hiccups may be the chemotherapy drug itself, such as Cisplatin; or the prophylactic use of corticosteroids such as Decadron, which is used to prevent nausea and/or vomiting.
April, 2004, Vol. 04, Issue 04
A Word About Insurance Reimbursement
By Vivian Madison-Mahoney, LMT
I hope you don't mind, but I need a moment to get up on my soapbox. First, however, allow me to take you down my memory lane. I was born and raised in the Catskill Mountains of New York.I lived with my mom, dad, two brothers and two sisters in a three-room tarpaper shack on 40 acres of enchanting woods; it was a two-mile walk to our one-room schoolhouse. Eventually, my family "graduated" to what I call a converted chicken coop, but at least the boys and girls had their own rooms, and we had pull-chain electric lights and an indoor flushable toilet! My dad obtained a three-line telephone and an old "snowy" screen TV. I even learned what a nickel was; up until then, I'd only seen pennies.
When our school closed, we were transferred to a school with 30 students per classroom. The experience was so frightening, I never did adjust and with less than a year to graduation, I quit. I was naive and afraid of people. I took a job working at a summer resort and, through the years, had many other jobs: waitress, telephone operator, salesperson, church librarian, Montessori school bus driver, and real estate agent. In the late 70s, I was in an auto accident that left me in constant pain. I located an effective chiropractor that, interestingly, understood the insurance system. When my benefits were exhausted, he continued my treatments while employing me as his chiropractic assistant where I did everything: laundry, X-ray developing, phlebotomy, patient therapies, selling vitamins, appointment-setting, mopping, and errands - for $4 an hour. I did this while trying to raise my three little daughters.
The point of all this is: These experiences taught me to appreciate everything. I learned that time changes things, though not overnight. I learned that if you are diplomatic, kind, and wait your turn, you could get anything you want. I learned to stand up for and fight for my rights; I learned what is right, and that being honest and desiring to give rather than take brings about the best rewards in life.
That said, the insurance issues I want to write about are these: I see advertising on insurance seminars, manuals, and other things that I know contain false and/or misleading statements. I hear from therapists daily who feel they have been "scammed"; other therapists tell me they have been taught to bill up to $200 per session because they live in Denver, San Francisco, or other big cities. Folks, ask for credentials and proof of what is being taught at these seminars before you jump in. I, and others, have worked long and hard to protect this profession; unfortunately, if this fraudulent behavior continues, I see massage therapy going straight down the tubes when it comes to insurance reimbursement.
We didn't get to this point of insurance company reimbursement by taking advantage of patients or insurance companies. We got into the system through the back door, by giving good service at fees more reasonable than others who use the same codes or provide the same services. Insurance companies are not looking for ways they can pay us; they are looking to cut costs. Why do you think they try to get massage therapists or alternative health care providers to discount their fees for subscribers? They're looking for ways to give policyholders benefits at no cost to them - instead, it comes out of your pockets!
Do you think that we - who came on board last - will come out on top, if massage advertisements or statements threaten to sue insurance companies? We need to use some common sense. This is a helping profession. Although we deserve to be decently compensated for our work, insurance reimbursement is not a "get rich" scheme. Taking advantage will surely leave us out of the system.
Until recently, insurance companies never cut our rates. Other health care providers are fighting uphill battles and having their rates rationed by some insurance companies in some states and in parts of Canada. We have a long way to go, and are presently sitting on the edge; it could go either way. It is up to you and me. Are you in it for the long haul or for the dollars you can get today? This can be our beginning or our end - again, the difference is up to us. Insurance companies can write anything they want into or out of a policy. When insurance companies decide to write massage therapy out of their policies, we are up a creek without a paddle - it's as simple as that.
I try to be careful when it comes to these issues because I do not want it to sound like "sour grapes." But I do it because I love this profession, I love you, and I want our reimbursement by insurance companies to last a long, long time. I want for insurers to search us out for the quality service we provide: the best for less - not for peanuts - just for less. Yes, we can say we are worth so much because we work hard, put in a lot of hours, and have a great deal of training, but what will all of this mean when you cannot make money in the massage business?
There are many dedicated therapists and massage therapy associations working to get us "in the system" the right way. The old saying, "One bad apple can spoil the entire basket," still holds true today. Let's work together to get insurance companies to see the benefits of massage therapy, provided by trained massage professionals, for patients, employers that cover insured people, and the insurance industry, as a whole. Well, it's time to get down off this box!!
Click here for more information about Vivian Madison-Mahoney, LMT.
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