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Don't Forget About the Performers
Donald Petersen Jr.'s recent article, "Your Chance to Go Back to High School" [May 1, 2014 DC], focused on the injuries incurred by high-school athletes and the subsequent opportunities for the chiropractic profession.
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.
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.
Building the DC-MD Bridge
From MDs practicing integrative holistic medicine to the family internist, many DCs are enjoying unprecedented attention from their allopathic colleagues.
The Life & Legacy of James Sigafoose, DC (1933-2014)
Surrounded by his family and closest friends, Dr. James M. Sigafoose passed away quietly on Thursday, July 3, 2014. With his wife of 60 years, Patsy, along with his children, Tina, Daun, Kieth, Selina and Carey – all chiropractors – at his side.
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.
Your Patients' Best Health Resource
There is nothing as powerful as information. The right information has won wars, saved lives and changed hearts; lack of information has led to hesitation, poor decisions and unintended consequences.
Ringing in a Fiscal New Year With a Recommitment to Cost-Effectiveness
Back when the Foundation for Chiropractic Education and Research was in its heyday, I used to send out New Year's greetings and virtual noisemakers to some close friends on July 1 – the beginning of our new fiscal year – wishing for prosperity in the year ahead.
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.
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 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.
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?
Watch Out for Red Herrings
In clinical practice, when one condition mimics another, it makes it difficult to obtain an accurate and timely diagnosis.
Decompression-Traction: A Core Treatment Method in Chiropractic's Future
We're all competing for new patients. We're competing for new patients with physical therapists, massage therapists, medical specialists and hospital fitness centers. We're even competing with side-effect-ridden medications that quit working every four hours.
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.
From the Other Side of the Table
People come to us to gain freedom from pain, to feel better, to live better. As D.D. Palmer stated, "We Chiropractors work with the subtle substance of the soul." Therein also lies the rub.
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.
News in Brief
Oregon Gov. John Kitzhaber (a medical doctor, no less) proclaimed October 2014 "Oregon Chiropractic Health and Wellness Month" in an official proclamation signed Aug. 25, 2014.
History of Animal Acupuncture: Part II
In Part I of this article, I had gone back to 1969 and tried to describe the atmosphere and events of that year that engulfed many of the younger generation, some who were all the core members of the National Acupuncture Association.
Take Care of Your Skin: Tips to Pass on to Your Patients
Many of our patients are not aware that the largest organ in the human body is actually the skin. Accounting for 16 percent of total body weight and covering up to 22 square feet of surface area, the skin is more than just a "covering," as originally thought.
Detoxification for Athletes: The Key to Winning Performance
One of the most dangerous culprits that affects an athlete's ability to perform at an optimum level also happens to be one of the most elusive.
How to Find Your Ideal Patient – and Help Your Ideal Patient Find You
Just imagine: You're at the front desk looking at the scheduler and a smile creeps across your face. Row after row, name after name, hour after hour; you're blessed with an entire day of ideal patients. Every day should be like this, you whisper. Exactly!
February, 2008, Vol. 08, Issue 02
A New Year Brings New Changes
By Vivian Madison-Mahoney, LMT
Well, last year was certainly a busy one. I have answered around 1,800 to 2,000 phone and e-mail questions from massage therapists, presented 23 seminars, sold hundreds of manuals and home study courses, and wrote several articles for massage publications. All of that and yet I can't seem to scratch the surface of getting information out to all therapists who are interested in working with and accepting referrals from physicians and directly billing insurance for their services.
I will be making changes this year in that I am beginning a consultation service rather than answering questions for free, as in the past several years. While helping massage therapists increase their income and cut their losses is my pleasure, I feel certain you will understand that I should be earning a living for my services, just as you expect to be paid for yours.
My next three articles will be based mainly on FAQs, beginning with this issue. I also will be conducting some informal surveys and asking for your assistance to gather information or stories on the efficacy of massage directly from your clients and your first hand experiences.
1. How do I go about being a provider for insurance companies?
Don't waste your time calling insurance companies asking to be a provider. You do not have to be a provider to bill insurance, unless you live in Washington state or Florida (and then only with those companies who allow or require you to be an "in-network" or "participating" provider). Most insurance companies do not yet accept massage therapists as in-network or participating providers. Services we provide are out-of-network or as non-participating providers. Policyholders or subscribers of the policy or plan most often must pay higher co-pays and deductibles.
Florida Blue Cross requires an LMT to obtain a provider number mostly for identification purposes but does not allow in-network or participating-provider participation. Blue Cross Blue Shield does not directly reimburse massage therapists in most states at this time. Do not confuse this with affinity or discount programs where they require you to be credentialed to be a "provider" in their programs. These programs most often do not offer payment directly by insurance companies for medically necessary and prescribed treatment. They only require that you give a discount to subscribers/policyholders. Their premise is that if you provide discounts, you will increase your client/patient load from subscribers of the insurance plans with which they are contracted.
My personal thoughts on this are that you have shown the insurance company just how low you are willing to drop your rates. I have yet to see where someone is able to significantly increase their income by participating in this type of program. However, I personally have seen where this type of participation has caused thousands of dollars to be lost when a company such as this crossed over and provided your discounted contract to other insurance companies, thereby causing several insurers who previously paid your fees to suddenly and without notice cut all payments by .25 percent for a full year.
2. Do I have to be a "certified medical massage therapist" to bill insurance?
No, it's your licensure/certification and the insurance company, policy or plan itself that makes the difference, not whether or not you are certified in any particular technique or program. Certification programs provide certificates to prove you have had additional training in a subject. Certifications and additional training are imperative to your learning skills, which in turn creates more clients and referrals. However, at this time they do not make the difference in whether or not you are reimbursed by insurance companies.
3. Can I bill Medicare?
Absolutely not! Please go to www.coalitiontopreservepatientaccess.org for more complete information on this subject.
4. Do I need a prescription to bill insurance?
Yes, you need a prescription because insurance companies do not pay for services that are not medically necessary. To prove medical necessity, the treating physician must diagnose a patient's medical condition because diagnosing is out of our scope of practice.
A physician must prescribe your services for a diagnosed condition on a written prescription for you to be reimbursed by an insurer. There are exceptions per some insurance company requirements, but they are few and far between.
5. Do all insurance companies pay for massage therapy?
Possibly. Almost all insurers reimburse for massage therapy services. The most upsetting part is that most will pay for massage therapy services but will not pay the provider most qualified and trained to perform massage. They WILL pay for massage therapy services when provided by a doctor or a physical therapist. This is about as uneducated as one can get.
However, this leaves us with an open-door opportunity where we need to get busy training the insurance adjusters, employers and the powers that be about what massage therapy really is, how it can save them money and how it most benefits the patient. They also want to know about massage therapists as professionals in the health care arena. How about making this the year to get busy with this project?
6. If most insurance companies will not reimburse a massage therapist directly, why would I want to consider accepting insurance for reimbursement?
You might want to accept insurance for reimbursement because those companies, policies and types of cases that will reimburse you are extremely valuable to your increased income levels. Another reason is because you will be increasing the number of patients you can be helping who could otherwise not receive your services.
Even if the insurance were to not reimburse your services, or if the patient's benefits become exhausted, these patients are coming to you by referral and are learning how effective massage therapy is for their health and overall well-being. They get excited to be able to receive services from someone who takes time with them, listens to them, consoles them and makes them feel better. Guess what? They go back and tell their physicians what a great therapist you are, what a great session they had and how much they were helped. Then guess what?
Their physician - happy that they have pleased their patient - refers more patients, some of whom have insurance that WILL reimburse you. Do you get these types of referrals from your non-medical, time-of-service, paying clients? Even if their insurance does not reimburse, you have "advertised" where it counts. Some will even continue to return while also referring friends, family and co-workers.
Had you not been willing to accept insurance for reimbursement, whether or not you are paid on specific cases, these physician-referred patients would have never known of your services. They would never have told their physicians how great your service is. We are keeping our profession alive within the insurance industry, constantly showing them and causing them to acknowledge (whether they admit or not) the need for our services in the medical field.
Look at insurance as a game: take it one step at a time, learn the rules, play to win, win some and lose some, cut your losses and keep moving forward.
Click here for more information about Vivian Madison-Mahoney, LMT.
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