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Thoracolumbar Syndrome: The Great Mimic
The thoracolumbar junction is a common area of joint dysfunction. The most obvious cause is dysfunctional breathing or lack of diaphragmatic breathing. Treating this breathing problem will ultimately be the long-term cure for the syndrome.
MPA Media Wins Seven Publishing Awards
MPA Media, publisher of Acupuncture Today, among other titles, has been recognized for editorial and design excellence with an unprecendented seven publishing awards by the ASBPE, the nation's largest organization for business-to-business publications.
The Science Behind Happiness
Are you happy right now? Whether yes or no, there are a myriad of reasons why you feel that way. A whole academic discipline has developed to find out what causes or obstructs happiness, and how to amplify it.
The Truth About Herbs
I appreciate the effort and research put into the article written in the June issue of Acupuncture Today regarding pesticides and Chinese herbs.
Let the Patient Tell Their Story
Often when a patient presents with an injury, they want to tell their story. People by nature like to talk about themselves, particularly when they're worried about their health.
A Commonly Missed Spinal Fixation: The Upper Lumbar Spine (Part 1)
When we think of lower back pain, we tend to think in terms of the lower lumbar spine and the SI joint. These joints and their discs are obviously important. However, we tend to miss fixations that occur just above – in the upper lumbar spine. Three questions come to mind: 1) Why is the upper lumbar spine so important? 2) Why do we miss the fixations here? 3) How can we adjust them?
News in Brief
NBCE Launches Computer-Based Testing Era; California Chiropractors Get Expanded DOT Exam Privileges; New Jeff Hays Documentary.
Rethinking GMO: Less Panic, More Context
Some of you may have noticed that after writing parts 1 and 2 of “Genetic Modification of Organisms for Human Consumption” a while back [Nov. 15, 2013 and Jan. 1, 2014 issues], part 3 never appeared.
Healing Community Trauma in Israel and Palestine
It's the beginning of August and Israel and Hamas have just agreed to a 72-hour ceasefire after a month of brutal fighting. In the last four weeks, 1,830 Palestinians and 67 Israelis have been killed.
The Problem With Prolonged Sitting
We need to constantly talk to our patients about spending less time sitting and about what can go wrong with poor sitting postures. The fact is we sit too long in repetitive malpositions.
Get Ready For AOM Day
This year, AOM Day 2014 falls on Friday, (October 24th). This is a great opportunity to make your AOM Day celebration or event even bigger by extending it throughout the weekend!
The Spirit of the Point
After receiving a large amount of positive feedback on my San Zhen Protocols series, I have decided to focus this article on some relevant clinical aspects of acupuncture therapy prior to moving on to San Zhen Protocols III.
If You Get a Request for Records, Respond!
In our previous two articles, we discussed two of the main reasons for denial when chiropractic records are reviewed by Medicare contractors.
Uncle Sam Needs You
Scrutiny into the Department of Veterans Affairs (DVA) continues to grow after efforts to reform the DVA by the former Secretary of Veterans Affairs, Eric Shinseki, were deemed "a stunning period of dysfunction" by Senate Minority Leader Mitch McConnell (R-Ky.).
Help Secure Our Future by Sharing It
The National Board of Chiropractic Examiners (NBCE) conducts one of the most comprehensive surveys of the U.S. chiropractic profession every 4-5 years.
Improving Our Political Effectiveness
The November 2014 elections are right around the corner; members of Congress, governors and state legislators are all running. Now is a good time to talk frankly about our overall political involvement.
A Healthy Dose of Failure is Vital to Your Success
As an acupuncturist I tend to see people after they have already suffered for years and "tried everything." They are so desperate for some relief that they want to know everything about how to get better, right now.
Medicalization and Mindfulness
The past several years have seen a veritable explosion of research on mindfulness. Research abstracts we've published in each issue of Health Insights Today under the heading "Mind-Body News" have increasingly reported on studies about mindfulness interventions.
A Glimpse Into China's Top Brain Hospital
The sounds of the city pass through the open window are overwhelming the microphone - car horns, construction machinery - and then there's the family at the adjacent bed talking loudly on cell phones, yet you can still hear the faint beep of our patients monitoring equipment.
When Big Pharma Meets Chinese Medicine
Earlier this year, Bayer made a media splash with their decision to buy the Dihon Pharmaceutical Group Co., a Chinese TCM manufacturer.
Thoughts to Live By
When speaking to your patients about their health make sure to ponder the following points and have them assess if they are making themselves even more sick by the thoughts they have about life. Are these some of the traits and thoughts that your patients might have?
July, 2007, Vol. 07, Issue 07
Accept Insurance for Reimbursement: Should I or Shouldn’t I?
By Vivian Madison-Mahoney, LMT
We often have a tendency to look at only the surface of things. We jump to conclusions and immediately affirm that we don't want to deal with or get involved in whatever the problem is, before we really take the time to analyze the situation.
An example of this is when clients or others ask a therapist if they accept insurance for payment.Therapists immediately answer, "I'm not interested." Then often add either, "I know it won't work," or "I have heard others say it's not worth the hassle." Other statements include, "because there's too much time consumed in phone calls, paperwork, waiting for money, possible losses, preparation time, etc."
Let me ask you three questions:
Sounds silly, doesn't it? Not really, the money is there to collect from insurance cases. However, there are necessary steps to take in order to make it happen.
Insurance Acceptance is an Avenue
Insurance acceptance is not about taking insurance or medical cases. Accepting insurance for payment is an avenue to help more people, to increase your income, to open new doors for yourself and your patients, for doctors to refer, and for our profession as a whole. Insurance and medical referrals can be considered a business within your massage therapy business. Accepting insurance cases is not a means to an end. It's just another door to walk through to increase your clientele and income.
I hear those who say that accepting insurance will be the end for us, that we will have to accept insurance fees, if lower. They say we will end up having to do what insurance companies tell us to do. We are now independent and need to always fight for our right to remain independent, as well as working with individuals with or without injury or illness, and of course, to accept or not to accept insurance for reimbursement, if that is what we wish to do. Working with insurance-related patients, we need a physician's prescription, rightfully so in that we are not allowed to diagnose a medical condition. No one will force you to accept insurance for reimbursement - it is a choice you make.
When you decided to become a massage therapist, you did not have all the answers on how to do it, did you? You had to invest your time, you had to invest your dollars, then you had to be willing to learn the ropes, take the proper courses and tests to even get the first sense of direction. There were no guarantees. The same goes for the business end of accepting medical cases and insurance for payment, there are no guarantees, just open-door opportunities when and while they exist.
Accepting Medical Referrals and Insurance Is a Nine-Step Process
Before we go into the nine steps, let me ask you:
If you have answered yes to even a few of these questions with the exception of number 5, you might just be ready to learn how to take on a few medically referred patients and to accept insurance for payment from those whose insurance companies will reimburse you directly.
Remember, to bill insurance, you should know the ropes by receiving proper training. Know, too, that medical cases are legal cases and must be prescribed by attending physicians, documented properly and billed accurately; using only codes within your scope of practice. Also, you must charge fees that are ethical, customary and payable.
Know that not all kinds of insurance will reimburse you, not all patients have insurance and not all patient conditions are covered. We still are in the baby stages, taking one step at a time. We still are trying to be accepted and recognized in the insurance industry. To bombard the insurance companies with threatening or disrespectful behavior and brazenly overcharging and over-coding is not how we got this far.
Here are the nine steps to accepting insurance for reimbursement:
Good luck and let me know how the process works for you!
Click here for more information about Vivian Madison-Mahoney, LMT.
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