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Cyber Threat Checklist: Defend Your Business With These 10 Steps
Living in an internet connected society brings many conveniences and benefits. The power of the internet to connect us with customers, store data, and find information has opened the door for many small business owners to grow and flourish.
Practice Pearls: There's More to ROM Than Meets the Eye
As part of my neuromusculoskeletal examination, I perform range-of-motion (ROM) evaluations. I can "eyeball" the range and measure, I can use a goniometer and measure, I can use my phone app and measure, or I can use various other instruments to help determine degrees of motion.
Regenerative Medicine: How to Do It by the Books
The "lay of the land" for regenerative therapies, including but certainly not limited to adult stem-cell treatments, seems to change almost daily.
Dropping Insurance: 4 Steps
My office manager just got off the phone with the secretary of a long-standing patient. I have treated this woman and 10 members of her family for more than a decade. She has, as have all of my patients, paid my fee at the time of service since I dropped insurance in 1997.
Transforming Exam Delivery
The NBCE Board of Directors has never wavered on its promise to deliver an excellent, on-campus computerized testing experience to students. Likewise, there has never been a compromise to the delivery of fair, valid and legally defensible exams.
Spring Allergies & The Spleen: Looking at Pattern Differentiation
As the season of Spring fades away and we shift into the warm summer months, many patients suffer from chronic allergies. This is by far one of the most common issues I see in the clinic as well as often mistreated and misdiagnosed.
Prompting Memory: How to Stimulate Cognition
Recently I gave a talk titled, The Art of Memoir – Tapping the Past to Sharpen the Present at a senior lunch event in Austin, Texas.
State by State: Chiropractic Leads Changes in Health Care
Monumental legislative bills in support of the chiropractic profession were passed recently in Washington, West Virginia and Oregon. Here is a review of this important legislation, state by state...
Catch the Workplace Wellness Wave
Do you offer workplace wellness services to local businesses? If not, you might want to consider this lucrative channel for expanding your practice. Workplace wellness programs and wellness-related benefits have grown in popularity over the past several decades.
Missed Causes of LBP: It's the Syndrome, Not the Subluxation
When I read the chart notes of other chiropractors, I am usually disappointed. They list what vertebrae are fixated or misaligned. They may describe the involved fascia and muscles.
A Novel Way to Prevent Elderly Falls: Toe Strength
In any given year, nearly 40 percent of senior citizens ages 70 and older will fall at least once. Each fall significantly increases the risk of not only sprains, strains and contusions, but also fractures.
Official NCCAOM Practice Tests
The National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM) is excited to announce the launch of the new NCCAOM Exam Preparation Center.
The Acupuncturist and the Opioid Crisis: Conquering Pain & Addiction in the U.S.
The current opioid epidemic dominates the discussion among national health leaders, recovery advocates and families nationwide. Opioids include heroin as well as prescription pain relievers such as oxycodone, hydrocodone, codeine, morphine, fentanyl, and others.
It's Time for a Functional Approach to Chronic Illness
It seems one of the more modern buzzwords is chronic, referring to diseases – that is to say, "ongoing and incurable." However, we can take a different perspective and recognize that, although the body may have been traumatized and injured, healing should always be viewed in the realm of possibility.
Bastyr University: On the Front Lines of the Pain Epidemic
At University of Washington's Harborview Medical Center, the Seattle region's only Level I Trauma and Burn Center, the demands for in-patient care are dramatically different from a private clinic environment.
Paving the Way to Integrative Health & Wellness
Jared Polis (D-Colorado) and Mike Coffman (R-Colorado) launched the integrative health and wellness (IHW) caucus in October, 2018.
Multi-Dimensional Acupuncture: 3D, 4D & 5D
Maggie is an intuitive healer and workshop leader who I met on a recent hike. While we were talking she told me how she had to take it easy because of her knees. She said that her doctor told her that she has the early signs of arthritis.
Prevention: Stop Recurrent Urinary Tract Infections
The recurrent urinary tract infection (UTI) is one of those nuisance conditions that can play havoc with quality of life, and this particular infection is much more common than most people realize.
Reducing Allostatic Load & Stress Through Heightened Awareness
Your contemporary mental health and psychotherapy colleagues may often approach the treatment of allostatic load as a mental health condition and use prescription psycho-pharmaceutical medicine to affect general and specific central nervous system (CNS) pathways and brain neuro-chemistry medicine to alleviate the associated symptoms.
Acupuncture's Standard of Care
Both a concern and critique of acupuncture, frequently espoused by the bio-medical community is, "there is no standard of care in acupuncture." The following is why I believe this statement is disingenuous at best.
Diagnosing & Treating Aggressive Energy
Recently, there has been an article, and subsequent discussion, about the subject of Aggressive Energy (AKA "AE"), including ways to detect its presence and an alternative method of treating it.
Better With Chiropractic
While chiropractic care is receiving high levels of exposure these days, most pain patients who consult with a health provider still do so with their primary-care MD. And of course, that means in most cases, they're receiving standard medical care, not chiropractic.
NBCE to Reinstitute Computer-Based Exams
The National Board of Chiropractic Examiners (NBCE) has announced it will reinstate computer-based testing in January 2019 courtesy of a partnership with testing and assessment solutions provider Prometric.
News in Brief
Parker University Launches New Open-Access Research Journal for Chiropractic; Western States, Cleveland-KC Name New Deans of Chiropractic Colleges; Sherman College Goes Tobacco-Free; Life University Wins 11 Awards.
Chiropractic's Next Frontier: Adjusting the Microbiome
Restoring a healthy microbiome to help treat disease may be the next frontier in chiropractic offices around the country.
First World Spine Care Graduate: Hildah Molate
Hildah Molate, the first World Spine Care (WSC) scholarship student, graduated from Palmer College of Chiropractic earlier this year and is now working at the WSC community spine clinic in Shoshong, Botswana.
New Opportunities for DCs
For decades, the model chiropractic practice has been the single-doctor practice. Recent surveys have found that approximately two-thirds of U.S. doctors of chiropractic still practice this way, with another 20 percent practicing in multiple-chiropractor practices.
Old Trend, New Risks: Heavy Weight Training
With more opportunities to exercise than ever, a greater selection of exercise options, and the subsequent opinions supporting and challenging their merits, it's easy to be confused as to which approach is best.
TCM Codes for the World
I just received an email concerning the ICD-TM11 codes. The World Health Organization (WHO) will be presenting the new ICD-11 codes to World Health Assembly very soon.
August, 2006, Vol. 06, Issue 08
Off the Beaten Path
By Vivian Madison-Mahoney, LMT
After much thought, I finally decided to share with you some history of massage & insurance billing and some of my own personal history. You will see & know as you read this, if I could do it so can you!!
Auto Accident - Ultimately Leads Me To You
I was involved in a rear-ended auto accident in 1979 that left me with constant & severe neck, thoracic and shoulder pain for many years.I was lost and depressed because there seemed to be no way out, physically, emotionally or financially. At this time I knew nothing about chiropractic or insurance let alone massage therapy. My daughters laugh when they reminisce that they used to fight over who sat in front with mom so they didn't have to "rub" mom's neck when we were driving down the road. (One is now an LMT)!!
Saved by a Chiropractor
After months of pain, a friend led me to a Chiropractor who treated my condition, helping me to be able to hold my neck and head up more than 20 minutes at a time without pain and weakness. After my auto insurance benefits were exhausted this Chiropractor hired me to work for him. It was here I learned the ropes of running a medically oriented office from front desk, appointment setting, selling homeopathic products, developing x-rays, ultrasound, electrical stimulation and traction. In addition I kept the office clean, did the laundry and transported his son to & from school along with delivering health food products etc. to his wife's Oriental health food store 55 miles away. I also performed phlebotomy in his blood laboratory, consulting patients on the results of their food sensitivity tests, (I became a FL Licensed Nutritionist), All of this for $4.00 an hour and no benefits! (How I wish I could locate him today to thank him for all he taught me and for my successes because of him).
This Chiropractor eventually became involved with a massage school just opening in Palm Beach County. He informed me he was sending me to this school to become a massage therapist. I was NOT a happy camper. All I needed was for him to tell me one more thing to do!
Massage Therapy School
I attended massage school in the evenings (one of six students). After working from 8:00 am until 6:00 pm at the office I was so tired I could hardly hold my head up. My magnificent massage instructor, Alex Spassoff who many of you know, will tell you, "Vivian learned it all by osmosis". He says, "Vivian was the most UNLIKELY to succeed." At least in massage school I received massage therapy, which soon totally relieved all the years of pain and weakness. This all took place while raising my three daughters. Luckily I remained close friends with my ex- husband who helped with them in the evenings. Time went on, school ended, I took the exam, scared to death to be the only one to fail. But I passed with flying colors, receiving my license in December 1984.
Money in the Mail
Less than a week after receiving my license, the office was closed, I was driving away when a lady drove up, stopped me, got out of her car and asked, "are you the massage therapist?" I answered affirmatively and she proceeded to show me a prescription for massage therapy for 3 times a week. She said, "I have my own doctor and do not want to come here but want to know if you could come to my house, give me my massages and bill my insurance for payment?"
I was flabbergasted. I told her I had no clue how to do it or if I could even bill her insurance for massage let alone be paid for it. But I decided right then and there to never turn down an opportunity. I told her I would give it a try. (The one thing I refused to do for $4.00 an hour was to bill the doctor's insurance cases.).
She was my last out of 7 to 9 treatments a day, seeing her three times a week from 9:00 p.m. to sometimes 11:00 at night. Due to her injuries, she was one of the most difficult patients I have ever worked on. After my first session with her, I went home & sat in the middle of my bed with a claim form. I worked on that form until about 2:00 a.m. trying to get it ready to send to State Farm. I finished to the best of my ability, mailed it in and low and behold in about three weeks I was paid the $45.00 charge for my first insurance case! In the meantime I did the rest of her treatments on faith until I knew the insurance would pay.
I was so excited!! I had always wanted to be in some sort of business where I could receive money in the mail! I was on my way. After this, she referred me to her mom, another auto accident case, and more money in the mail!
From there my insurance business grew and grew. My first big goal was to have a place of my own where I could have a telephone instead of just a beeper, traveling from school to school, house to house, motels to hotels and beauty shops to tanning salons.
The Beginning of Insurance and Massage
I located a place of my own and as time went on I ended up with more than 175 physicians from all specialties referring to my facility. Of course I had to hire other therapists to help with our growth. Over the years we grew from 600 square foot to 3,900 sq ft. facility, treating and billing up to 500 patient visits a month (averaging 28 to 32 patient visits daily), nearing half million a year and on fees as low as $35.00 to $75.00 per hour for years. There were no rules, no guidance, no one else doing this to my knowledge, especially not on this scale and definitely no one taking on Workers' Compensation cases. I learned it the hard way, one step, one error and one success at a time. The Florida State Massage Therapy Association President and Legislative Chair, at the time, asked me to serve as Insurance Committee Chair as they learned of my successes. To this day I'm still happy to be serving in that capacity. I am also proud to say that since then I've been able to be instrumental in helping others on this path today.
The Soap Opera Begins
"Edge of Night"
On 7/11/87, tragedy struck our family. My 16-year-old daughter was in a horrendous auto accident where she remained in intensive care in a coma, unrecognizable for 3 months. The driver died 2 weeks after and she too was not expected to live due to her collapsed lungs and severe brain damage.
Daily I was at the hospital to be with her, working on her to keep her body from curling into the fetal position, keeping her legs and arms straightened out, trying to constantly stimulate her to awaken. Her sisters, Darlene & Lori and my granddaughter Ashley all stood by her side every waking moment, as did her dad and two of my very closest friends. Thank God I was now a massage therapist. The neurologist said to me, "she would not be in as good of condition as she is if it were not for what you are doing for her."
"As The World Turns"
During the time she was at the hospital the engine went out on my automobile in the parking lot of the ER where it stayed until I had time and money to get it fixed two weeks later. To top this off my children's father developed a visible swelling on his throat. We took him to the VA Hospital to be checked out. They diagnosed him with Squamous Cell Carcinoma, cancer of the neck and tongue. We had to admit him in the VA Hospital in Miami, about 75 miles south of us, daily making this trip as well.
After nearly two months of one test and one operation after the other the doctors released Cecil from the VA hospital. On the day of release we asked if the cancer was cleared only to have the doctor say, what cancer? He never had cancer!! Hey, does it ever end?
Then after Dawn's 3 months in intensive care she was transferred to a traumatic brain injury rehabilitation center in Bradenton FL, 173 miles west of us. Here she remained in a coma for 9 months before awakening on Easter Sunday. For the first year we traveled this route three times a week and two times a week for the next year to be with her. Patients, friends and family made those regular trips with me. To say the least, hotel bills and auto expenses were overwhelming. All this time I was still running my office from my pager, the hospitality phone in the intensive care unit and pay phones. Thank God for my loving family, patients, very close friends and all of the wonderful therapists who worked for me. It actually got to the point when people asked how things were going, I could only laugh & say, "I'm waiting for the next soap opera episode."
Make no mistake there is no way in heaven or hell I would have made it through all of this without all of these wonderful people including my daughter Lori who did all of my billing, collecting and running the office while I was away. Thank God for my successful massage therapy business!!
I tell you all of this to say that you never know when something may happen that will take your job away from you or you away from your job if you do not have something or someone to back you up in an emergency. If it had not been for our successes in the massage therapy & insurance related business I would never have had the time or money to be with my family members in this dismal time.
Another Major Setback
In 1991 our insurance company that covered my daughters medical bills decided to pull out of the State of FL leaving us with no coverage. If it were not for my success with massage insurance patients she would have been placed in the horrible county home versus staying home with private CNA care which I personally paid for to the tune of $4,600 to $6,200 a month, for nearly 2 years until we were fortunate to have access to the Federal Med-Waiver Program due to her injuries prior to age 18.
We got through it all. Not unscathed by any means. Each of us still has to deal with it, each in our own way each in our own time. Dawn is still very disabled, unable to do anything for herself, speaking in soft whispers or spelling each sentence one word at a time. But we are all so thankful for her super personality, fantastic memory and outstanding sense of humor, always making those who care for her laugh and enjoy her company. Her blonde hair, blue eyes and super sweet smile & expressions take her a long way with everyone she meets. (Her massage therapist is amazingly patient, helping her to write letters to mom after her massage session).
Helping Others Through It All
Through all of this I continued to work, trying my best to help massage therapists with insurance related issues & questions. Presenting seminars and working with the FSMTA to help change rules & create laws to help massage therapists to be able to continue to bill and be reimbursed by insurance companies.
Writing the very first insurance billing manual for massage therapists and becoming approved to provide insurance seminars I had my retirement days in mind, hoping that my career, in spite of every negative event would eventually lead to a pretty good retirement from the office while continuing to help others.
A Different Kind of Trauma Strikes
Then what we consider another heartbreaking, traumatic event took place in our lives. That was the appearance in my office of a certain male individual. This person came into my life asking for help with his documentation software program. I trusted him; he had charisma and a great sense of humor. I finally agreed to assist by using our therapists and myself to beta test his program for a few weeks, guiding him on certain aspects of this program with my insurance & documentation knowledge. With 12 therapists at the time and myself we thought we could help him to complete what he said was "his creation" because it sounded like what I referred to as the "missing link" in our business.
Little did I know at the time that he would eventually plagiarize my original manual of 18 pages (mostly my forms) to jump-start himself with his own insurance billing manual and career. The deception, false and misleading information that followed in massage magazines and in our industry has been so devastating to me, my business and my hopes of retirement that I had planned to have solidly built by this time in my life. No, competition is not a problem; it certainly helps but only when it is candid and sincere and not self- serving.
What's Our Future With Insurance?
I find it discouraging lately with so many therapists working so very hard being ethical, reliable and fair while others are beginning to take advantage of patients, insurance companies and other massage therapists, this includes some chiropractors, massage therapists as well as others who exploit our profession for personal and immediate gain. I'm afraid to say that if we don't get a handle on it, pull in the reigns, fight for our rights and stand together for what is right and fair, all that we have worked so hard for, all the grounds we have gained will be a thing of the past. I say this because I keep a steadfast eye on the entire insurance industry nationwide and have always had a good sense of trends and directions. I now see us teetering on a fence. Which way do we want to go?
Where I Stand Now
So for now I will continue to stay in the game, answering questions, trying to resolve problems and provide information to massage therapists on a nationwide basis in hopes that some will realize that it is as important to make a minimal investment in insurance billing materials and supplies (as a sub business of their massage career) as it was to invest in their schooling and massage tables, etc. to become a massage therapist in the first place. To do it right is to protect you from delays, denials, reductions, losses & aggravations, to turn challenges into rewards.
It has gotten to the point recently that therapists call me for a code, a form, or a question that leads to a half hour or more on the phone (which I am truly more than glad for) but then there are those who tell me they know all about billing and all they need is the massage code. Then they do not want to make a minor investment to purchase a manual or whatever is needed to get comprehensive straightforward information. And yet that same person will take courses that often cost hundreds to thousands of dollars from someone else, then call me for help because they didn't or couldn't get the information from those whom they took those expensive courses from.
YOU CAN DO IT, I want to let you know once again, if I could do it in spite of all the negative events in my life then YOU CAN DO IT TOO! But you must be willing to invest in yourself and in your future. I will then be more than delighted to go the extra mile to hold your hand for as long as it takes and for no charge.
To all of you who have been super supportive & appreciative I want to say a very special thank you from the bottom of my heart. You're the ones who make it all worthwhile; you are the reason I'm still here! And I hope this continues for a long time to come!
Click here for previous articles by Vivian Madison-Mahoney, LMT.
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