resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
Give Yourself the Digital Advantage
When you see this article in the print version of this issue and swear you read it already, don't be alarmed: you probably did. That's because by that time, the May issue will have been available online in digital format for three weeks.
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.
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.
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.
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.
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.
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.
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.
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.
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 previous articles by Vivian Madison-Mahoney, LMT.
Join the conversation
Comments are encouraged, but you must follow our User Agreementcomments powered by Disqus
Keep it civil and stay on topic. No profanity, vulgar, racist or hateful comments or personal attacks. Anyone who chooses to exercise poor judgement will be blocked. By posting your comment, you agree to allow MPA Media the right to republish your name and comment in additional MPA Media publications without any notification or payment.