resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Sit or Stand? Analyzing a Mixed Message
I'm more than a bit confused. At my age, that seems to be a rather common occurrence. However, today more than ever, I'm getting a mixed message.
Chronic Pain: Become Part of the Solution
I have lectured to more than 7,000 chiropractic physicians over the past five years regarding the chronic pain and opioid epidemic in this country.
Increasing the Value of Spine Care: CMS Approves New Low Back Pain Registry
The Centers for Medicare and Medicaid Services has approved the Spine IQ Low Back Pain Registry as a qualified clinical data registry for the Physician Quality Reporting System (PQRS) in 2016.
Kansas Achieves Licensing Law
Kansas Governor Sam Brownback signed House Bill 2615 into law on Friday, May 13, 2016. HB2615 includes provisions for the licensure of acupuncturists in the state of Kansas.
What You Say Isn't Always What Patients Hear
A few years ago, my aunt Edna (name changed for the purpose of this story) suffered a stroke. After a short hospital stay, she was transferred to a nursing home for rehabilitation. When she arrived at the nursing home, Edna requested a private room.
Introducing the Acupuncture Today Digital Edition
In response to the changing habits of our readers, Acupuncture Today will introduce a digital edition of the publication (in addition to our print edition) beginning with the August 2016 issue.
Tai Chi Documentary Premier
First Run Features recently announced the world theatrical premiere of Barry Strugatz's documentary The Professor: Tai Chi's Journey West, which premiered last month at the Laemmle Music Hall in Los Angeles.
Three Tips to Help You Analyze the Acupuncture Case Studies of the NCCAOM Exam
Confirm the answer quickly by the elimination method. Case study:
After two treatments for back pain, a patient presents for a third
session complaining of rapid breathing and wheezing that is made worse
during cold weather.
AOM Hospital-Based Practice: A Future Reality?
The natural evolution of health care on the planet is integrative health. We may have some challenges ahead, but based on my research, all indicators are pointing in a positive direction. There seems to be an evolving consciousness among our patient population that is "getting it."
Acupuncture's Impact on the World
For several years, I have been hearing about the town of Rothenburg, Germany. It seemed just a dot on a map until I arrived. It is the home of the TCM Kongress which began in 1968. It has been held annually for 47 years and it has only missed one year.
Treating Hip & Groin Pain With Abdominal Release of Upper Lumbar Nerve Impingements
Have you encountered patients with groin and hip pain you can't seem to solve? You know it's not a worn-out hip; you suspect the pain is somehow connected to the spine. But somehow, you just can't help them break through.
How to Stay Sane During the Elections: Understanding Through the Lens of Chinese Medicine
In Chinese Medicine philosophy, everything consists of Yin and Yang. The law of polar opposites – one cannot exist without its opposite.
An Emerging Partnership Model
Maryland University of Integrative Health (MUIH) has educated integrative health and wellness practitioners for the last 40 years, originally as an acupuncture clinic and school. The institution's transformative, relationship-centered programs integrate traditional wisdom with contemporary science
Adventures with the San Jiao
Those of us who have been in practice for several decades relish the way meridians and points reveal new diagnostic clues and new insights. I love to encourage my students to see this as an adventure that goes way beyond the textbooks.
Acupuncture Muscle Trigger Point and Oriental Medicine Sports Therapy
It is difficult to ascertain the internal condition of professional basketball player Lebron James during game one of the 2014 NBA finals, in which he developed debilitating muscle cramps that led to his premature removal from the game.
Beating the Odds: Interview With Para-Powerlifter Adeline Dumapong-Ancheta
Since October 2015, the FICS Foundation, the charitable organization affiliated with the International Federation of Sports Chiropractic (FICS), has been supporting disabled athletes internationally.
A Long-Overdue Win for Oregon Medicaid Patients - and the Implications for Other States
Beginning July 1, 2016, Oregon Medicaid patients with spinal pain (cervical, thoracic, lumbar, pelvic) who are determined to be low risk based on a biopsychosocial assessment tool (STarT Back – Keele University) can receive four chiropractic visits per episode.
The Pertinent Negative
We all have to perform evaluations on patients. Most of us don't like doing it – exams take time, and worse it takes even more time after the evaluation to put together a narrative summary of the findings. Sometimes, this process becomes downright tedious.
Insuring Quality Control in Herb Importation: An Interview with Wilson Lau
Wilson Lau is the vice president of Nuherbs, a Chinese herb importation company based in San Leandro, California. Before joining Nuherbs, he trained as a lawyer specializing in FDA law.
Believe it or not, an estimated one-third of your patients have eaten some form of fast food within 24 hours of their appointment with you.
What's New in Phytonutrition: Mangifera Indica, "The King of Fruits"
One hundred percent pure Indian green mango fruit (mangifera indica), harvested at a special degree of ripeness for efficacy and taste, can now be concentrated as a phytonutrient nutraceutical powder.
Multivitamin Supplement May Reduce Breast Cancer Recurrence
There is a great deal of controversy regarding the value of multiple vitamin supplements in cancer prevention.
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.
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.