resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
VF Works / DMX Works Epilogue: Almost Two Decades Later, the Lawsuits Continue
An article in the March 8, 1999 edition of Dynamic Chiropractic examined whether then-VF Works / Nu-Best Franchising was selling its franchises illegally to doctors of chiropractic.
Gather & Grow
I recently attended a faculty seminar held by one of the acupuncture schools. There was a facilitator who led us through some very interesting experiences. The attendees were a diverse group with varying opinions.
Near-Infrared Therapy for Diabetic Neuropathy
The pain experienced by people with diabetes is a symptom of diabetic neuropathy. The impact on quality of life is significant. Pain makes walking difficult, sleep troublesome, and eventually contributes to a decrease in social interaction.
TCM & the Caregiving Population: Treatment Considerations & Our Vital Role
Informal caregiving is increasingly a reality for many Americans who find themselves providing unpaid care for a loved one or a family member with a long-term, terminal, or chronic illness.
The Large Intestine Official
The large intestine (AKA colon) is the great eliminator, or as J.R. Worsley called it, "The Drainer of the Dregs." Dregs are defined as the remnants of liquid with its sediment left in a container, or the basest, least valuable portion of anything.
A Brief History of Acupuncture and Oriental Medicine Doctoral Programs
A doctorate in acupuncture and Oriental medicine has been a goal of the profession since its beginnings in the late 1970s. At that time, however, the maturity of the educational institutions and the regulatory environment made it a goal with only a distant completion date.
Reader Beware: Consider the Source
The aftermath of last year's presidential elections brought a running conversation on the role played by "fake news" that was largely presented via social media.
House Calls With Dad
My father was a chiropractor and he did house calls. On Wednesday nights, while my mother attended the weekly women's meeting at the Odd Fellows and Rebekahs hall in our small town, dad loaded up the portable adjusting table, fired up the Pontiac and drove off to treat a few patients in their homes. I went with him.
Spiritual Initiation: Opening Your Higher Healing Abilities
People drawn to the field of acupuncture and Oriental Medicine tend to be those who march to the beat of a different drummer.
Getting Unstuck: Healing From Trauma With TCM, Qigong & Movement
We all come into this world vulnerable, with seeds to grow into our strength. Some of us — through a combination of good fortune (i.e., family and culture we are born into, constitutional inheritance, or ability to learn) grow with minimal interruption from traumatic injuries and experiences.
Advancing the "Whole Organ" Spine Model
Historically, the human spine has been organized by body region utilizing specific anatomical landmarks and transition zones.
Correcting Rib Dysfunction: Improve Patients' Pain, Posture and Breathing
As chiropractors, we tend to focus on the spine, and rightly so. Many problems our patients face can be corrected by manipulating the correct spinal level.
Chiropractic in Texas Is Under Attack
The profession of chiropractic faces an unprecedented challenge in Texas, an attack that is more aggressive, sustained and dangerous than anything previously seen. The medical lobby has launched a coordinated, multi-front assault.
AOM Residency at NUNM
Imagine you're a recent acupuncture graduate, worried about making enough income as you forge your new career and seek more in-depth training in a particular treatment style.
The Acupuncture Channel System (Part 2)
The primary channels (main channels) are introduced in chapter 10 of the Ling Shu, these channels are referenced in many chapters throughout the Su Wen and the Ling Shu. The primary channels have become the main channel system used in TCM.
Helping Patients With Parkinson's Disease
Parkinson's disease (PD), a long-term degenerative disorder of the central nervous system that mainly affects motor function, has a slow onset over time.
ICA Goes on the Vaccine Offensive
Have you watched the vaccination documentary, "Vaxxed: From Cover-Up to Catastrophe," by Andrew Wakefield MD, director, and Del Bigtree, producer? This is the documentary Robert DeNiro was pressured to remove from his Tribeca Film Festival.
Treating the Lower Pelvis (Pt. 2): Midline Structures and Fascia
My previous article [October 2016 issue] outlined evaluation and treatment of pelvic issues involving the sacrotuberous ligament and the pubic symphysis. Now let's discuss two case studies that illustrate how to address additional problematic areas of the pelvis.
Paperwork Done Wrong, Done Right
I was visiting a doctor's office recently and a member of his staff brought a stack of forms to his private office and laid them on the doctor's desk. She informed him he needed to complete the forms for patients and a few third parties.
Latest Cassidy Study on Stroke Risk Published
The latest study to investigate whether a unique association between chiropractic manipulation and risk of cervical artery dissection / stroke exists has yielded similar encouraging findings, with the authors noting "no excess risk of carotid artery stroke after chiropractic care" and no significant risk difference between patients receiving care from a DC or a primary care medical provider.
Waist Circumference: A Conversation Starter
New estimates suggest more than two-thirds of Americans are either overweight or obese. The medical significance of this statistic is astounding.
4 Things Every DC Should Know About Levels of Care & Prevention
As health practitioners, we help people with their health problems and assist them with health promotion and disease prevention.
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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