resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Multivitamin Supplement May Reduce Breast Cancer Recurrence
There is a great deal of controversy regarding the value of multiple vitamin supplements in cancer prevention.
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.
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."
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.
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.
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.
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
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.
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.
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.
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.
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.
An MD Who Understands the Opioid Epidemic
Doctors of chiropractic have an important role to play in ending the opioid epidemic and dealing with chronic pain by conservative means (see our top story in this issue) – but who's to blame for opioid dependence and abuse in the first place?
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.
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.
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.
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.
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.
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.
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.
November, 2010, Vol. 10, Issue 11
Insurance Fraud and Massage Therapists
By Vivian Madison-Mahoney, LMT
This is to inform all therapists who work for physicians, MDs, chiropractors, massage therapists or other providers who bill insurance for their services to be aware of possible fraud; it is your license and your reputation on the line if others are using you to their advantage.More and more, fraud and in some cases, organized crime, is taking place involving massage practitioners.
Abuse is most common among newly licensed or just out of school therapists where the therapist, though not involved in fraud and abuse themselves, is unaware of billing rules, legal and ethical documentation guidelines, correct coding and other insurance-related issues. Therefore, they are easy targets for those who hire them with intentions of making a lot of money by running insurance mills, or taking advantage of patients and their insurance.
Again, many therapists are not even aware that illegal or unethical activity is taking place nor of how serious the situation can become if the offices they work for come under question by authorities. This article is meant to help inform and protect you from activities that could eventually cause you to lose your license if not face possible prosecution, penalties and jail time.
You may be working for a "clinic" or other medical arrangement where you are asked to perform many procedures and modalities during a single patient visit, such as: hot/cold packs, manual therapy, massage therapy, neuromuscular re-education, ultrasound, electrical stimulation, therapeutic exercise, therapeutic activities, manual traction, mechanical traction, and other such procedures and modalities. Commonly, the office uses checklists and has the therapist check off the modalities and procedures performed. However, often times checkmarks are added after the therapist has submitted their paperwork, while the therapist is none the wiser.
It is not that some or all of those procedures and modalities are not in our scope of practice and training (depending on state licensure) but certainly, it is impossible to perform each of them within the normal treatment session of no more than one hour. Further, when there is a lack of thorough daily documentation (using just checkmarks is not thorough), it can lead to open-door fraudulent actions.
We are trained licensed practitioners and we should know not only our scope of practice but also what is within our legal, moral and ethical boundaries. Over-coding, over-billing and over-treating or documenting what is not provided are certainly not what we should be doing if we want to continue to build our professional image within the massage, medical and insurance communities.
I have received numerous calls over the past year or so from very concerned and frightened LMTs who have been caught-up in this sort of practice working for others. Sadly, there are still a whole lot of massage therapists who by choice, fear or intimidation are still working for this sort of practice. If you (or someone you know) is involved in such activities whereby you are told to perform many treatment modalities and procedures in one session, you might be involved in criminal activities.
The maximum in our industry standards is normally no more than four procedures and two modalities when noted on written prescription - not eight to 12 as some are performing. You might be involved in criminal activity if:
As insurance consultant for the Florida State Massage Therapy Association (FSMTA), I first presented this information in FSMTA's Massage Message magazine. Since, I have been requested by insurance fraud divisions, the FBI, police investigators, and attorneys to provide information about our scope of practice, coding, industry standards for massage billing and to review suspected massage therapists' billing forms and practices.
I would highly advise that you pay special attention to the services you are asked to provide, and the paperwork you are asked to sign. As a legitimate independent contractor you should be able to request any file or patient record that you have created. By learning how to accept and bill insurance (when and where it is feasible), you can avoid falling victim to fraud.
Know too that all medical providers are not dishonest and as always, it is the one bad apple that spoils the bushel. So forewarned is to be forearmed.
Author's note: I am not a legal advisor, CPA or accountant. Please be sure to consult with proper authorities if you have any questions or concerns that pertain to a medical facility that you work for.
Click here for more information about Vivian Madison-Mahoney, LMT.
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