resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Advice for Young Doctors
When I began practice, I was just shy of my 25th birthday. I was young and I looked it. I had been told this would be a problem when starting a practice – and it was. Older patients often paused when they entered for care.
Looking For Answers In Many Places
I am sure we have all heard the old adage: "When the only tool in your toolbox is a hammer, everything starts to look like a nail."
Deciphering The New CMS 1500 Claim Form
Q: I am confused on using the new 1500 form, particularly Block 14 and Block 15. What is required and how do I properly fill these out? And do I actually have to use this new form or may I continue using the old version?
Primary Lateral Sclerosis: A Condition With a Chiropractic Connection
Primary lateral sclerosis (PLS) is a slowly progressive, adult degenerative disease of the upper motor neurons characterized by progressive spasticity or stiffness. It is a clinical diagnosis that has been avoided because it is (largely) a diagnosis of exclusion.
F4CP: New Campaign to Promote Chiropractic as a Career
The F4CP has announced a "targeted cooperative campaign" that will engage doctors of chiropractic and chiropractic students, as well as chiropractic colleges, chiropractic media, state associations and vendors, to encourage DCs to recommend a chiropractic career to patients, family and friends.
The Gluteal-Knee Connection
The underlying causes of knee pain and dysfunction are rarely isolated to the knee. The knee is a relatively stable joint with limited intrinsic ability to adapt to aberrant motion.
Inside Liver Failure, Cirrhosis and Cancer
The Liver belongs to Wood in Five Element Theory and is in charge of Dispersing and Expanding which means all the processing and detoxifying of harmful substances such as medications and chemicals require the efforts of the Liver.
Best Practices for Website Success
If one asked 10 years ago whether a website was relevant I was the first to suggest no. Yet as the world moves increasingly towards electronic information there is a dire need to have a website for your practice. Your website is actually your electronic calling card.
Hazards in the Environment Making Your Patients Sick
Working both separately and together, Western and Chinese medicine have many successes in the treatment of the myriad diseases that afflict human beings in modern times.
Offline Marketing Techniques: Opportunities to Help Grow Your Business
In a world becoming increasingly dominated by connected devices, when we think of marketing, we often think of online and social media marketing. Considerable attention is given to Facebook and Twitter, as well as CPC [cost-per-click] advertising.
The Kidney Official
The Kidney is known as the Official Who Controls the Waterways. In Western medical terms, a major function of the Kidneys is to filter the blood. Every day, a person's kidneys process about 200 liters of blood to sift out about two liters of waste and excess water.
Spotlight on Acupuncture Research at IRCIMH
Acupuncture and Traditional Chinese Medicine were well-represented at the International Research Congress on Integrative Medicine and Health (IRCIMH)- 2014 which took place in Miami from May 13–16.
Talking to Skeptical MDs: "Just the Facts, Ma'am"
The first lesson in public speaking is to know your audience. This is particularly applicable when talking to skeptical medical doctors about chiropractic. You have to understand where they are coming from and speak the language they understand.
Not Another Typical Drug Company Lawsuit
It's becoming more common to see drug manufacturers negotiate "false claims" settlements for millions and billions of dollars.1-2 Most of these settlements have to do with violations in the marketing of the drugs they produce and sell.
Super Bowl Chiropractor
With opening night of the 2014 National Football League season only a month away, what better time to talk to Dr. Jim Kurtz, team chiropractor for the defending Super Bowl champion Seattle Seahawks?
Post-Concussion Patient Care: Relevance of the Chiropractic Adjustment
There is a widespread understanding within the profession of the general guidelines for care of the concussion patient. These include guidelines for physical and cognitive rest, return to normal activities and so forth.
Looking Back: Abstracts From Chiropractic History
D.D. Palmer's Technique for the Posterior Apical Prominence; An Early Attempt to Achieve Consensus on Subluxation; Chiropractic Subject Headings: Past, Present and Future; Mabel Palmer: A History of Chiropractic That Almost Wasn't.
Healing With Simple, Healthy Food
When it comes to your health, there is no better way to take control and create positive outcomes than by focusing on diet and lifestyle. As chiropractors, you know the power that regular self-care has for your patients.
Medical Qigong for the Heart: Part II
Chinese Medicine is rich in commentary regarding the emotions and how they affect our qi.
Getting Athletes Back in the Game: Low-Level Laser Therapy for Sports Injuries
Sports injury rehabilitation is all about getting back in the game quickly and with optimal health. A relatively new tool for the treatment of sports injuries is finding global success, and it is doing so in a fast, efficient way.
Healing With Hope
Ella is a Gulf War veteran and a survivor of military sexual trauma. Like hundreds of veterans, Ella was on 11 different medications for depression, anxiety, insomnia, irritable bowel syndrome and chronic pain.
The Acupuncture Success Express
Time is passing very quickly these days. We are atoms half the way through the year of the horse. You could call it "horse racing season" for this profession. Perhaps it is time for reinvention during this time.
August, 2005, Vol. 05, Issue 08
Roberts vs. State Farm Insurance and the Medical Massage Controversy
By Vivian Madison-Mahoney, LMT
David Luther recently wrote a letter that created quite a stir throughout the massage industry. A class action lawsuit was bought against State Farm Insurance in the state of Pennsylvania titled, Roberts vs.State Farm. Mr. Luther stated that it was his company, the United States Medical Massage Association (USMMA) - formerly the American Medical Massage Therapy Association - that filed the class action suit against State Farm for downcoding. No references to this association are made on the docket or final settlement agreement. The case reads "Tracey Roberts (Plaintiff)" and states, "Tracey Roberts on behalf of herself and others similarly situated v. State Farm." The settlement agreement states that the suit was brought against State Farm for denying payment to massage therapists because they were not physical therapists.
In the letter, Mr. Luther stated that it was he who wrote the lawsuit's declaration at the request of his attorney. According to Luther's letter, his "declaration says that they [State Farm] must pay a 'medical massage therapist.'" His letter further states that when the judge asked him to define the term "medical massage" therapist: "We answered that they would be a Nationally Certified Medical Massage Therapist (NCMMT) through the Medical Massage National Certification Board," and adds, "We tried to add another clause: 'Or a member in good standing with the United States Medical Massage Association (USMMA),'" but that statement "will not be included in the decree."
The settlement agreement contains the words "medical massage therapists" many times throughout. Several concerned parties in the massage community have been writing to the attorneys and judge requesting reconsideration of that language prior to finalization. This situation has created much confusion, fear and anger. It is the opinion of many that if this (or any) case were to be ruled on with inclusion of terminology such as "medical massage" or "medical massage therapist," it would open doors for individuals, organizations or associations to establish specific criteria that massage therapists would have to meet before they could be reimbursed by insurers. This could have a negative impact on the entire profession. Were this to take place and spread throughout the insurance industry, it could severely limit the right to work and seek insurance reimbursement by thousands of massage therapists, some of whom have been receiving reimbursement now for over 20 years.
I know this because I was doing this kind of work approximately 10 years before Mr. Luther came upon the insurance scene. I remember him praising me for my manual. He said that it "helped him to collect the outstanding insurance money owed to him while unable to do massage due to an accident." He even used my "original" manual to get his start with his own medical massage office manual. These are not "opinions," but provable facts.
We are all astounded that Mr. Luther, who oversees the USMMA (a membership association), the Medical Massage National Certification Board (MMNCB), and The Medical Massage Office and Associates (TMMO) (a company through which he offers seminars), is posturing himself to monopolize the entire massage therapy profession by writing his own declaration, trying through the court system to regulate therapists as "certified medical massage therapist[s]," and further requiring that these therapists be certified only through his organizations. It seems he is trying to require insurers to allow only his "certified medical massage therapists" the use of Current Procedural Terminology (CPT) Code 97140 or other codes already in our scope of practice.
Such a requirement would be in direct conflict with several states such as Florida and Washington that require insurers to reimburse massage therapists for procedures that are within their scope of practice. It would also be in conflict with the 2005 AMA CPT® code book, which clearly states in the introduction, "Any procedure or service in any section of this book may be used to designate the services rendered by any qualified physician or other qualified health care professional." Licensing, state and national certification and training have already qualified us.
Now, about downcoding: What is it? Downcoding is when an insurer/adjuster changes a code to one of a lesser value or cost and reimburses for that code instead of the originally billed code. In all of my years of investigating bills and denials for massage therapists, insurance auditing companies, and defense and plaintiff attorneys, it has been my experience that the insurance company does not make a habit of downcoding, but actually reimburses for the code that reflected the prescribed and/or documented procedure or modality. For example, a physician writes a prescription for massage therapy but the therapist bills for myofascial release, neuromuscular re-education or others not designated on the prescription. The insurance company paid for what was only prescribed, leaving the therapist to feel that the claim had been "downcoded."
As a side note, I personally have no problem with those who use the term "medical massage" for certifying their courses and their offices or businesses, or to indicate that they specialize in working with doctors or medical referrals. What I object to are those who (without shared or documented proof) tell us that we must be certified in anything as a requirement to be reimbursed by insurance, or suggest that doctors are going to be required to refer only to "Medical Massage Therapists." Insurance companies reimburse for medically necessary care and treatment. What constitutes "medically necessary" is a medical diagnosis by a physician. What constitutes medical massage is the fact that the massage services are provided according to a prescription written with stated diagnosis by the treating physician.
If you believe I have overstepped my bounds, please forgive me. It is in the name of protection of our massage therapy profession, a profession in which we have all worked long and hard to build a positive reputation. If by some chance we are all misinformed, it is due to the letter and statements written by David Luther.
Click here for more information about Vivian Madison-Mahoney, LMT.
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