resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
What's Chiropractic Research Worth to You?
The Palmer Center for Chiropractic Research (PCCR), in celebration of its 20th anniversary, has announced it is spearheading a fundraising campaign to support chiropractic research.
An Acupuncturist's View of Medicinal Marijuana
The use of cannabis for medical purposes is very controversial. Use as a panacea by physicians uninitiated to the proper application of herbal medicine, as well as an excuse for recreational use have greatly confused the issue.
More Chiropractors Required
An intriguing study published in the Journal of the American Board of Family Medicine examines how "chiropractic care affects use of primary care physician (PCP) services."
The Food Conversation: Nutrition and Your Practice
It's morning and your first patient rolls in with a triple espresso steaming in one hand and a frazzled, desperate look in her eye. "You gotta help me, doc, I am constipated unless I drink one of these, and I am exhausted and anxious all the time."
Practicing with Authenticity
To extrapolate from the above quote, patients love healthcare providers they can trust. One way to earn the trust of your patients is by practicing with authenticity. What does that mean, exactly?
Practice Policy (Gone Bad): The Sign
Every once in a while, you see something and think to yourself, That's a really bad idea. Case in point: I went to see my medical doctor the other day. Just after being "roomed," as they say, the nurse checked my vital signs. Then she left.
Modernization of Chinese Medicine
Language – written, spoken, signed, or otherwise is learned as a means to express our individualized perceptions about the world around us. Language is designed to communicate our personal experiences.
Oriental Medicine on the World Stage
"Let me win. But if I cannot win, let me be brave in the attempt." This simple, yet powerful statement was lived out time and time again by so many of the athletes from around the world during the Special Olympics World Games in Los Angeles.
The New Age of Communication
In the age of technology, everyone, including the patient, is seeking faster, easier ways to communicate. With a wealth of social media, blogs, websites and videos, we are constantly barraged with information – to the point of overload.
Help: A Need at Every Level
One of the great gifts of training in acupuncture is the ability to take good care of oneself. I recently had a bout of frozen shoulder — an inflammatory syndrome which can be debilitatingly painful and take years to resolve.
Acupuncture Rising: From Acupuncture Anesthesia to Assisted-IVF, Part 1
Acupuncture's cultural and historical roots go back to the emergence of Chinese civilization. For more than 2,000 years, acupuncture needling has been continuously practiced on the largest population in the world.
News in Brief
Call for Abstracts Announced - Parker Las Vegas 2016; Logan Adds Doctorate Degree; New Role for Dr. James Edwards.
Nuts Reduce Risk of Heart Disease, Cancer and Other Health Problems
Several recent studies suggest regular consumption of nuts may provide a significant degree of protection against certain types of cancer, heart disease, possibly type 2 diabetes and some neurodegenerative diseases.
Fertility and Poly-Unsaturated Fatty Acids
Starting or expanding one's family is a major milestone. It's something that more and more people seek out health care advice and support for.
Change Lives by Supporting Chiropractic Research: Are You In?
The Palmer Center for Chiropractic Research (PCCR), in celebration of its 20th anniversary, has announced it is spearheading a fund-raising campaign to support chiropractic research.
Getting a YES: An Effective Strategy for Overcoming Patient Objections
Patients make more excuses for declining care from an acupuncturist than perhaps any other type of doctor. Various reasons hold them back from making a commitment to care.
Dorsiflexion Dysfunction: Evaluation & Manipulation Techniques
Almost every condition from the foot to the hip can be attributed to the inability to dorsiflex the ankle mortice and other joints that participate in dorsiflexion. Let's start by understanding normal versus abnormal dorsiflexion.
Surprising Reasons for Orthotic Efficacy
Clinical outcome studies show orthotics are effective in the management of a wide range of injuries, including plantar fasciitis, Achilles tendinitis and patellofemoral pain syndrome.
The Short Leg Dilemma
When evaluating a new patient, it is common to note a relative shortening of one leg to the other. Some patients will even tell you they have one, and then pull out the store-bought heel lift they read about online.
Fish Oil: A Key Component of Positive Clinical Outcomes
Patients seem to be presenting with more complex problems, and many are responding to care more slowly or have completely unexpected results. Why?
Harvard Health References Flawed AHA Position Paper
In its special health report, "Stroke: Diagnosing, Treating, and Recovering From a 'Brain Attack,'" Harvard Health Publications includes information from the American Heart Association's 2014 position statement on cervical manipulation and cervical dissection – a statement the American Chiropractic Association emphasized in a letter to Harvard Health mixes "scientific facts with half-truths."
A Chiropractor's Guide to Yoga
"Doctor, can I continue to do yoga while undergoing your care?" "Is it OK for me to go back to yoga while I'm getting my back treated?" "It is safe to start my yoga classes again after my neck pain improves?"
Healing Trauma: Cultivating Resilience and Presence Through Mindfulness, Part 2
In the last issue of Acupuncture Today, the first part of this article introduced the topic of trauma and resilience, and their relationship to the autonomic nervous system response and the concept of the spirit being grounded in the body, and suggested the importance of mindfulness as a tool for healing.
Improving Communication Between AOM and Biomedical Providers
How comfortable do you feel talking to Western medical providers? If you are like me, you may not feel as comfortable as you would like. Some of my interactions with MD's haven't been the fruitful steps toward integrative medicine for which I had hoped.
Patient-Centered Care vs. Payer Restrictions: Your Ethical Obligation
Do you have an ethical obligation to evaluate your patients, make a diagnosis and provide evidence-based, patient-centered health care, irrelevant to the payer restrictions?
Do Some Good and Grow Your Business with Cause Marketing
Cause marketing is truly one of the best ways that you can promote your services as a acupuncture professional. Cause marketing refers to a type of marketing where a business partners with a non-profit organization to help bring awareness to a charitable cause.
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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