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Billing Timed Services
Q: I do not always use physical medicine services but in my state I do have a scope of practice that allows me to provide many of these services. I am trying to understand what "direct one-on-one patient contact" means in relation to physical medicine services.
In This Current Age of Anxiety
Anxiety, also referred to angst or hysteria, goes by many names. One, popularized by the sagacious Zhang Zhong Jing, who many practitioners of Chinese Medicine may be familiar with, is known as Restless Zang/Fu disorder.
Discovery: Finding Insights and Each Other in Different Disciplines
Recently I've been thinking about all sorts of things which are hidden from our daily direct experience. That general category is what links nearly everything that catches my attention and then demands some kind of investigation.
The Need for Standards
ISO-TC-249: You may look at these letters and numbers and wonder what they are and what they might mean. They turn into: International Standards Organization- Technical Committee – 249. There is a global organization called The International Organization for Standardization.
News in Brief
NYCC Aggregates Degree Programs in New School; Palmer Chancellor Receives Education Award From ICA; Oklahaven Announces "Have a Heart" Winners.
Transforming Las Vegas
On a warm spring day in Las Vegas, Sonia Kim, clinic front desk staff, is busy preparing for a full day of intern shifts at Wongu Health Center. She greets patients, makes sure documents are properly signed, and lets the interns know that their patients have arrived.
Building Bridges with Discipline
As practitioners of traditional Chinese herbal medicine, our role is to educate patients and medical practitioners about the various safety aspects of our medicine. Medical doctors that embrace Chinese medicine want to collaborate and include Chinese herbal medicine in more aspects of clinical care to support their patients.
Understanding Levels of Evidence
The concept of levels of evidence is a cornerstone of research literacy and a great starting point for understanding basic principles of how research works.
How to Reach Your World With the Chiropractic Message
My latest effort to share chiropractic occurred in mid-May while I was sitting at an introductory parent information night for high schoolers. The IT instructor informed us that each student would be receiving a computer for all their studies.
A Different Way of Looking at It
The way you and your chiropractic colleagues access information has changed over the past decade. According to a recent survey conducted by Dynamic Chiropractic, almost half (48 percent) of DCs read online articles on their personal computer or laptop daily.
Finger (Pad) Pointing: Repetitive-Use Injury Waiting to Happen
"My wrist and hand hurt. I spend all day working on computers and then I come home and spend more time on a computer, usually playing video games."
Hip Flexor Contractures & LBP in Above-the-Knee Amputations
Patients with above-the-knee amputations (AK or AKA) are particularly prone to developing hip flexor contractures. Not to be confused with muscle tightness, contractures are a permanent shortening of tissues which cause deformity or distortion.
Prostate Cancer Risk
A large study published in January 2016 in the American Journal of Clinical Nutrition showed that men who are vegans had a 35% lower risk of developing prostate cancer compared to non-vegan men. The study followed more than 26,346 men who are part of the Adventists Health Study-2.
With Low-Back Pain, Sometimes Little Things Matter
Typical treatments for low back pain involve large muscles like the quadratus lumborum, iliopsoas, and piriformis. However, there are situations when a very small muscle, the multifidus, can play a significant role in the diagnosis and treatment of low back muscular or spinal injury.
Billing One-on-One, Direct Patient Contact
This is often misunderstood and leads to trepidation when documenting and subsequently billing timed services.
Living Well: Lessons From Our Oldest Old
Aging is a significant public health problem, important to chiropractors in practice and important to DCs who teach students training to become chiropractors.
Sleepless nights, anxiety, mood swings, euphoric energy bursts, obsessive thinking, and a strange feeling in his chest. That is what Matt was experiencing when he first entered my practice. Rather than being concerned, he was loving every minute of it.
Constructing Our Reality, Part 2
My last article discussed perception and its relationship to the primary channels. Before we get to the channels most commonly used to treat sensory disturbances, the small intestine and triple heater, we should first talk about the bladder channel.
Keeping Malpractice Allegations at Bay
It has been suggested that in the litigious environment in which we live, the practice of chiropractic should be defensive and practitioners should constantly be watching their backs. An element of defensive practice is a good idea.
Holistic Skin Care and Modern Technology
Anti-aging is a concept that we hear in reference to skin rejuvenation and growing older on a daily basis. Aging begins as soon as we are born; therefore "pro-aging" is embracing all stages of life gracefully, with vitality, wisdom, joy, and gratitude as the goal.
Streamline Your Front Desk
Your front office can be your greatest source of efficiency or it can be a constant bottleneck. Increasing the productivity of this area, while not sacrificing the quality of patient interaction, can be a little tricky. However, with some focused effort and intention, your front desk can keep your practice running smoothly.
Low Fat vs. Low Carb & the Power of Protein
A science-based website recently posted a nice summary of 23 randomized, controlled trials from peer-reviewed journals pitting low-carb diets against low-fat diets.
Parker University Embraces New Era
Change is in the air at Parker University, which recently announced the selection of both a new president and a new consultant for its seminar program.
A Whole-Body Approach to Chronic Tension Headaches
Nearly every day in our practices, we see patients with chronic headaches that have not responded to traditional treatment. They present in our offices with a feeble hope that "maybe" a chiropractor can help.
One of the most common trends to see in clinical medical practice and public health is the cycles of health "buzzwords." These come and go depending upon the current cultural zeitgeist. One year, "parasites" are causing all the issues, and the next year it's "candida."
Distal Style Treatment of Neurogenic Pain
Treat locally or distally? This question has frequented my thoughts for the treatment of pain throughout my acupuncture career. Each style has strengths and weaknesses, thus the versatile practitioner would do well to forgo dogmatic adherence to any one style in deference to the needs of the individual patient.
February, 2012, Vol. 12, Issue 02
Re-Framing the Idea of Referring New Clients to Other LMT's
By Cary Bayer
Recently, I called a licensed massage therapist to find out about the possibility of getting a session. If I liked her work, I told her, I'd be interested in working with her as my regular LMT.The first thing she said was that she wasn't doing massage now. I was disappointed. Then she said was she could refer me to a working therapist. I was less disappointed, because she said this therapist was terrific. Then, as I was about to hang up and call the therapist, to whom she referred me, she said something else. If I gave you a hundred guesses what this non-working LMT then told me, you couldn't possibly guess what it was. That's when she said ... drum roll please ... that she'd be working again in three weeks time. WHAT????
You heard me right. So, why didn't she answer my original questions about her work and book me in three weeks? I never told her I needed a massage in the next three weeks; she just assumed I did. As the business coach for massage therapists, I've seen some really weird attitudes, speech and actions from ungrounded LMTs, but this one took the proverbial cake. Talk about ruining an opportunity! I hope you can see the craziness in "assuming" your prospective client's needs without first checking with them. Promise never to repeat such behavior.
But there's an even more subtle massage marketing tip contained in that phone call. As a business coach for massage therapists, I've seen far too many booked LMTs refer prospective clients to other therapist friends. That's incredibly thoughtful. That's incredibly generous. And that's incredibly dumb. Let me explain
Suppose that your limit is 20 sessions per week - four sessions daily, five days per week. Suppose when you do number 21, your wrist begins to ache and you've promised yourself that you won't do more than 20. Let's further suppose that it's Monday, and you're already completely booked for the week. But you get a call from a new person who wants to work with you. Since you've read the first few paragraphs of this article, you won't assume this person wants their session this week or they will work with someone else. So you try to book them for next week. But suppose they really need to see you this week, what do you do?
You can be incredibly generous, like most therapists, and give them the name of a friend of yours whose work is excellent. The caller is happy, your friend is happy, and you don't have to hurt your wrists. But you might be hurting your bank account a great deal more. Let me explain.
Because the therapist you're referring is great, there's a strong chance this therapist will become their therapist. Good for them but not good for you. Why do I say that? Let's do the math. Suppose that they becomes a regular client, seeing the therapist twice a month for $75 per session. That means they will spend $150 per month with someone else for massage. If you multiply that by 12, you get their annual expenditure on massage: $1,800. That doesn't take into account gift certificates they might purchase, or clients they refer to your friend.
Then, suppose that the client and your friend develop a working relationship that lasts six years. That means they will have paid $10,800 over the course of their work together. That's good for them and, again, not good for you because that $10,800 could have been yours. But it wasn't yours because you were too busy to take them on as a new client. I'm not suggesting you should have taken them on if your schedule is full. You have to protect your body for the long run, and avoid injuries that prevent you from doing any sessions the following week. So what am I suggesting?
It's very simple: bring in a second therapist to work for you to handle your overflow and design a compensation program with them. My recommendation is to pay between 50 and 60 percent of the sessions they do for your clients. But make sure that you're paid first, and then give them the commission on a periodic basis (like weekly) if they do a lot of treatments, or monthly, if they do fewer. It's important that you're paid first — otherwise, there can be some resentment on their part if they have to surrender the full amount of the treatment to you and then get their cut.
If, on the other hand, you're like so many of the massage therapists I've encountered and don't want to have another therapist working for you — for whatever reason that might be — then develop a compensation program with an outside therapist who doesn't work for you, but pays you a commission for clients you refer. How that compensation is structured is clearly between the two of you, but here's a guideline: have them pay you between 30 and 40 percent of each session they give the client you referred to them.
They need to keep good records and could easily send you a monthly check based on how much revenue they gained from the client or clients you sent their way. If you get 40 percent of those treatment fees, and we refer back to the $1,800 that the new client pays them each year, you're looking at $720 in passive income that year for making a single phone call. Multiply that by the six years of their association and you have $4,320 in passive income from a single phone call.
Now that's prosperity consciousness. And that's quite different from just giving that new client your friend's phone number and all you wind up with is a thank you. Thank you's don't pay $4,320 in bills. In this economy, four thousand dollars is nothing to sneeze at.
Click here for more information about Cary Bayer.
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