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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.
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.
News in Brief
NBCE Launches Computer-Based Testing Era; California Chiropractors Get Expanded DOT Exam Privileges; New Jeff Hays Documentary.
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.
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.
Improving Our Political Effectiveness
The November 2014 elections are right around the corner; members of Congress, governors and state legislators are all running. Now is a good time to talk frankly about our overall political involvement.
Let the Patient Tell Their Story
Often when a patient presents with an injury, they want to tell their story. People by nature like to talk about themselves, particularly when they're worried about their health.
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?
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.
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.
Medicalization and Mindfulness
The past several years have seen a veritable explosion of research on mindfulness. Research abstracts we've published in each issue of Health Insights Today under the heading "Mind-Body News" have increasingly reported on studies about mindfulness interventions.
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.
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.
Rethinking GMO: Less Panic, More Context
Some of you may have noticed that after writing parts 1 and 2 of “Genetic Modification of Organisms for Human Consumption” a while back [Nov. 15, 2013 and Jan. 1, 2014 issues], part 3 never appeared.
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.
Thoracolumbar Syndrome: The Great Mimic
The thoracolumbar junction is a common area of joint dysfunction. The most obvious cause is dysfunctional breathing or lack of diaphragmatic breathing. Treating this breathing problem will ultimately be the long-term cure for the syndrome.
Uncle Sam Needs You
Scrutiny into the Department of Veterans Affairs (DVA) continues to grow after efforts to reform the DVA by the former Secretary of Veterans Affairs, Eric Shinseki, were deemed "a stunning period of dysfunction" by Senate Minority Leader Mitch McConnell (R-Ky.).
A Commonly Missed Spinal Fixation: The Upper Lumbar Spine (Part 1)
When we think of lower back pain, we tend to think in terms of the lower lumbar spine and the SI joint. These joints and their discs are obviously important. However, we tend to miss fixations that occur just above – in the upper lumbar spine. Three questions come to mind: 1) Why is the upper lumbar spine so important? 2) Why do we miss the fixations here? 3) How can we adjust them?
If You Get a Request for Records, Respond!
In our previous two articles, we discussed two of the main reasons for denial when chiropractic records are reviewed by Medicare contractors.
Help Secure Our Future by Sharing It
The National Board of Chiropractic Examiners (NBCE) conducts one of the most comprehensive surveys of the U.S. chiropractic profession every 4-5 years.
The Problem With Prolonged Sitting
We need to constantly talk to our patients about spending less time sitting and about what can go wrong with poor sitting postures. The fact is we sit too long in repetitive malpositions.
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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