resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
A Conversation With Dr. Betty Edmond
This month's column is an exclusive interview with Betty Edmond MD, newly elected CEO/President of the AOMA Graduate School of Integrative Medicine in Austin, Texas.
Qigong for Substance Abuse
It is commonly believed that substance abuse, in addition to harming one’s physiological state, hurts the spirit. There is also a belief that one’s spirit does not weaken due to substance abuse, but rather, the person finds solace in addiction due to an already weak spirit.
Low Back Pain in Running Athletes
After 7 million years of adapting to upright postures, the lumbar spine and pelvis have become remarkably adept at managing ground-reactive forces associated with running.
We Get Letters & Email
Our Country Needs Us Between Elections, Too; Continuing Care: We Aren't There Yet; Our Associations Need to Do More.
An Opportunity & a Responsibility
Nearly 80 Americans die from an opioid-related overdose every day, and spine-related pain is one of the principle drivers of opioid use. This unfortunate situation creates both an opportunity and a responsibility.
True Practice Mobility for the Chiropractic Profession
When natural disasters occur, chiropractors can literally travel to the other side of the world to offer humanitarian relief in less than a day. The chiropractor's license to legally practice, however, can't make it past the state line.
News in Brief
Updated Neck Pain & Whiplash Guideline; Attention, IHS DCs; New VP of Institutional Advancement At Palmer; N.J. DC Interns At U.S. Olympic Training Center; Chiropractic Society Of R.I. On The Front Lines.
Prepare for the End, From the Beginning: Wealth Building and Retirement with the Tao
Yin and yang flow into and out from one another continually. Beginnings become endings and endings become beginnings again. Wholeness and cycles are the nature of Tao.
Five Branches University Has First Hospital TCM Residency
Established in 1984, Five Branches University (FBU) has campuses in Santa Cruz and San Jose, Calif., which serve the communities of Santa Cruz, the Monterey Bay, and Silicon Valley.
Anti-Aging With Dr. Ping Zhang
Jennifer Waters, TCM practitioner and writer of the Acupuncture Today column, "Talking With the Masters" sat down with Dr. Ping Zhang to discuss aniti-aging with acupuncture.
Shoulder Rehab: Start With the Scapula
The scapula is an incredible display of elegance and movement within the biomechanics of human motion. It's evolved for mobility and stability in the scapulo-thoracic region, giving us the ability to do things that are uniquely human, such as throwing with accuracy.
Scar Reduction With Acupuncture & Microneedling (Part 2)
Protocols & treatment Timing
Flirting With Alternative Therapies
There are about as many adjunct therapies being marketed to acupuncturists as there are acupuncturists. While some may remain purist in their application of traditional Chinese medicine, others choose to explore new horizons of treatment.
The Acupuncture Channel System (Part 1)
The earliest Chinese reference to channels is in the Mawangdui Medical Manuscripts,1 which are dated to the Warring States period of the Zhou Dynasty (475 BC-221 AD). The text presents 11 channels. There are no acupuncture points listed in those channels.
The Case Report: A Valuable Tool
Case reports are a valuable form of descriptive research. The most basic form of practice-based research, a case report is a detailed account of the history, presenting symptoms, assessment, observations, treatment and follow-up of an individual patient, discussed in the context of prior and potential future research.
Another Step Forward for Chiropractic
Chiropractic is now available to 86,000-plus Latter-Day Saints missionaries and you are invited to become a provider. LDS membership in not required; our only concern is that our missionaries get the best quality care available.
Crow Like the Rooster
As we welcome in the Year of the Rooster, we look at some of its major characteristics: confidence and communication, which suits the image we have of the Rooster...strutting in the farmyard, crowing to the others that it's time to wake up.
Let's Clear Up the Collection Confusion
This is an often-misunderstood practice swirling with misinformation. First, a few basics: Insurance is a contract between the patient and the insurance company. The insurance company is simply making a payment for services or care on behalf of the patient.
A New Year and Vision for the ACA
Inadequate pain management coupled with the epidemic of prescription opioid overuse and abuse has taken a severe toll on the lives of millions of people in the United States. Every day, more than 1,000 people are treated in the ER for misusing prescription opioids.
The winter season is upon us and offers unique challenges for the clinician and patient alike. To effectively navigate through the winter season there are two main TCM medicinals, Huang Qi and Gan Jiang, to consider, as well as two important formulas which feature these two TCM treasures.
An Education in Gluten Sensitivity
A relatively new syndrome officially documented as non-celiac gluten sensitivity (NCGS) or gluten sensitivity (GS) was officially recognized and published in the new list of gluten-related disorders in 2012.
Nutrition for Menopause: Front-Line Therapy for All Phases
Of all the changes women experience during their reproductive life, there is no doubt the most dreaded are the three phases of menopause. This is not surprising since all of the symptoms associated with menopause are replete with unpleasantness.
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 previous articles by Vivian Madison-Mahoney, LMT.
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