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The Acupuncturist's Problem
I want share with you some observations and insights into what seems to be the most common problem my colleagues in the acupuncture profession struggles with. If you also struggle with this problem, I hope you get a valuable "aha" moment from reading this.
Term Limits: What's in a Word?
It was the French historian and philosopher Voltaire who once declared the Holy Roman Empire was neither holy nor Roman nor an empire.
PCOM Granted Regional Accreditation
Pacific College of Oriental Medicine (PCOM) recently announce it has received regional accreditation from the Western Association of Schools and Colleges (WASC). This achievement reflects five years of hard work on the part of faculty, staff, and students.
A House Divided?
The American Chiropractic Association's House of Delegates voted on 30 resolutions at its annual business meeting in Washington D.C., but two in particular took immediate center stage due to their controversial nature.
Low Back Pain in Professional Golf: A Common Muscular Relationship
Every sport creates its own unique demands on the body. Some sports require such a myriad of body positions that assessing pathology is often difficult and unpredictable.
Applying the Thin Skull Principle
The "thin skull" principle, also known as the "you take your victim as you find them" principle, is a legal principle that can be summed up by the following statement.
Medicine is Clumsy, Don't You Be
All medical systems have clumsiness in them. If the technique isn't, the practitioner is. Everyone in every form of medicine is striving to improve. That is why we call it practice.
Marijuana, Apathy and Chinese Medicine, Part 1
This article was written in response to the unheeded acceptance of marijuana as a harmless substance that potentially does good when used for the medical relief of pain.
5 Simple Steps to Create an Effective Marketing Calendar
In the educational experience of most healthcare practitioners, business and marketing are overlooked topics.
The Tide is Rising in the Acupuncture Profession
Former President Ronald Regan said, "When the tide rises all boats float." The tide is rising for the acupuncture profession. Many forces outside the profession are helping the tides to rise.
Turning a Blind Eye to History – and Reality
The American Medical Association is taking the Supreme Court's Feb. 25, 2015 decision exactly as it always does – by turning a blind eye to history, legal precedent and reality.
Talking to Patients About Lumbar Facet Denervation (Medial Branch Neurotomy)
Lumbar facet denervation, more appropriately termed medial branch neurotomy (MBN), is a procedure that may be considered when patients suffer from recalcitrant non-radicular axial back and/or leg pain.
A View From the ER
The University of Western States has inked an innovative agreement with local nonprofit health system Legacy Health whereby UWS sports-medicine fellows can experience observational clinical rotations in emergency-room settings within the Legacy system.
Optimism = Compassion = Trust
A randomized clinical trial recently published online in JAMA Oncology examined how patients viewed their doctor based upon how the practitioner presented bad news to the patient.
5 Tips for Using Pinterest to Market Your Practice
Pinterest is a very popular, but often under-utilized, social media platform where people can bookmark, or "pin," fun and interesting things from all across the internet.
Animal Acupuncture: A Case Study in the Treatment of Traumatic Injury in the Equine
The rise of animal acupuncture in the U.S. began in the early 1970's as a result of the work by members of the National Acupuncture Association in Westwood, Calif.
Functional Hip Impingement (Part 1)
Every time I sit down to write an article, I realize how much more there is to know about musculoskeletal pain. I also learn something new every time. (I want to give special thanks to Lucy Whyte Ferguson for assisting with this article.)
The Challenges of Integrating Eastern and Western Medicine
My Masters thesis was titled, "The Challenges of Integrating Eastern and Western Medicine," which highlighted several reasons why it is hard for these two worlds to mix.
Sleep, Less Sleep or No Sleep?
I had a dream I wasn't getting enough sleep. It was a very realistic dream, even though I was probably slightly awake and not really deep dreaming. Most likely I had been dozing, caught in that twilight of sleep and wakefulness.
Integrating Art with Clinical Practice for Patients with PTSD: The Artemis Project
Are you restricted by those one-on-one clinic dynamics? Why not join colleagues and clients in experimental group settings? Three of us volunteered to do just that in Austin on behalf of women veteranss from all branches of the service.
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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