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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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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:
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 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.
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.
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?
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.
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?"
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.
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.
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.
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.
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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