resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
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."
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.
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.
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.
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.
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?
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.
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.
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.
The Zen Art of "One Point"
We were always told in our Zen Shiatsu training (by Japanese and Japanese American instructors) that our ultimate aim was to to find that "One Point." To be so focused we could touch just one point to transform Qi throughout a client's body.
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.
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.
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?
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.
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?
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?"
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.
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.
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."
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.
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.
News in Brief
Call for Abstracts Announced - Parker Las Vegas 2016; Logan Adds Doctorate Degree; New Role for Dr. James Edwards.
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."
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.
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.
October, 2009, Vol. 9, Issue 10
An Issue of Reimbursement
By Vivian Madison-Mahoney, LMT
Most patients and massage therapists are not aware of the fact that "massage therapy" and/or "manual therapy techniques/myofascial release" is a covered service by most insurers, including Medicare and self-insured employer plans which fall under the Federal guidelines of ERISA (Employee Retirement Income Security Act).
However, there is a catch.
While insurance companies do pay for the services we perform, they do not directly reimburse us for our services. Instead insurers will pay PTs, MDs or DCs who have massage therapists on staff. (I might add at increased costs to employers and insurers.) Therefore, we are not faced with the issue of getting insurers to reimburse for our services; it is an issue of getting them to directly pay those who perform this hands-on, intensive, time-consuming work.
Patients typically must go through practitioners who have massage therapists on staff to receive full insurance coverage. But many practitioners do not have massage therapists/bodyworkers on their staff. In this case, a treating physician may write a prescription for medically necessary massage/manual services for the patient. However, because the patient is dealing with a referral (and a non-staff therapist), the patient will very likely have to pay out-of-pocket for the service. As a result, many patients will simply choose not to pay for the much-needed treatment.
I have no objections to physicians, chiropractors, etc. hiring massage therapists to perform work in their offices as an employee or independent contractor if this is what both parties prefer. However, more often than not, I hear that both the therapist and physician would rather work on a referral basis. Unfortunately, this is only possible now with liability type insurance and a few health insurance exceptions. Therefore, only very limited coverage is available to patients in comparison to what would be available if insurers provided coverage and direct reimbursement for all medical referrals to massage therapists.
The Time Is Right
Health insurance coverage is expanding as we educate insurers, legislators, employers and the public to the benefits of massage. Employers across the nation (including insurance companies) have massage therapists come to their offices to provide stress relief massage therapy to their employees and incorporate massage therapy in their wellness programs. They are beginning to understand and value the benefits of massage therapy when performed by those who are trained and licensed to provide this service. However, they do not yet realize the cost-effective savings of reimbursing massage therapists directly.
If insurers or employer group plans allowed direct reimbursement to state-licensed, certified or trained therapists to provide therapy for prescribed medical conditions through their health insurance programs, employees would be able to better stay on the job, return to work faster after injury, and be more productive. Reimbursing other practitioners for services provided by massage therapists only increases insurance companies' payments as they are paying a "middle-man", costing them more in the long run. If other health insurers, Medicare and the VA directly reimbursed state licensed and/or certified massage practitioners, their costs could be considerably reduced due to direct provider reimbursement. Direct reimbursement to those providing the services would also decrease patient's co-pays and in some cases, their deductibles.
As mentioned, most of us who have been accepting insurance cases have only been successful with liability type insurance cases such as auto, work, or slip-and-fall as well as some health insurance situations. When I began in this field in 1984 no one was billing insurance for massage. To my knowledge not many physicians knew about massage therapy as a benefit to their patients. Before I sold my practice, in one county alone, more than 172 physicians were referring patients to my office. Now they are doing it across the nation. They understand the benefits to their patients.
Now is the time to make insurance companies, self-insured employers, Medicare, VA and private health insurers understand the value of these services and savings to them as well.
I know, some are against direct reimbursement. Some worry that their fees will be lowered if insurance companies were able to reimburse them. But reimbursement would be an option; therapists would not be obligated to change their way of doing business or forced to accept insurance for reimbursement. We need to always protect our rights to choose as well.
But, I can say this: since 1984 when I began billing insurance and since 1990 when I began providing CE courses on insurance billing procedures, laws and rules to massage therapists, I haven't seen any massage therapist doing any worse because of it. If we were directly reimbursed by health insurance companies, working under the prescriptive orders of a physician and only able to make what the going Medicare or state workers' compensation fee schedules are, it would surely be more rewarding for those therapists losing business from out-of-pocket patient referrals.
I know for myself, we worked on volume, charging extremely low fees such as $58.50 and $65 per hour (or more), and built a massage practice earning a half million a year back in the late 80s and early 90s. There are many therapists who would be happy to make anything working in a field they love rather than wondering where the next dollar is coming from or searching for other forms of income as, sadly, I so often see these days. So if money were pretty much guaranteed, would it not be better to have the capability to accept or reject new clients/patients as your office (or hands) permitted?
When contacting an insurance company, many massage therapists hear the following: "We will reimburse a PT or MD to provide massage therapy or manual therapy services but not a massage therapist." "We do not allow massage therapists to become in-network or participating providers." While we may complain that this seems like discrimination, it will not change things as they are. We need to work together to change the way insurers reimburse for physician-prescribed services.
What's Your Take?
I realize reimbursement is not for every therapist. For those of you who command much higher fees, you may be concerned by this possibility. I want to hear from therapists on both sides of the issue.
As a health care advocate, I'm requesting feedback and possible future assistance from those interested in helping to reform the way health insurers, Medicare, VA and employer group plans reimburse for massage/manual therapy services.
Please email me at or send mail to: Massage Today/MPA Media, 5406 Bolsa Avenue, Huntington Beach, CA 92649.
Your input is welcome and appreciated!
Click here for more information about Vivian Madison-Mahoney, LMT.
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