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Deciphering the New CMS-1500 Claim Form
Q: I am confused about how and when to use the new 1500 form, particularly block 14 and block 15. What is required and how do I properly fill out these fields? And do I actually have to use this new form or may I continue using the old version?
"Doctor ... Always Do the Right Thing"
So says "Da Mayor" in the iconic Spike Lee movie. As a fresh grad questioning in-network versus out-of-network, it struck me that some doctors have explicitly skirted the issue, while others have argued adamantly for the latter and "sticking it to the man."
Home Sweet Medical Home
While the Affordable Care Act (ACA) has received its fair share of praise and criticism since its adoption, few question the value of its emphasis on collaborative, patient-centered health care.
Shared Mechanisms Between Computer-Assisted Mechanical Adjusting and Contemporary Acupuncture?
Can contemporary acupuncture provide clues to the mechanisms responsible for pain relief provided by computer-assisted mechanical adjusting instruments, and clarify whether certain mechanical frequency combinations are superior to others for modulation of acute peripheral pain?
The Importance of Knowing Mainstream Lingo
There is a secret lingo within mainstream medicine of which the vast majority of acupuncturists and Chinese medical professionals are unaware.
The Boston Benevolent Chiropractic Clinic: Standing Up for the Needy
Our chiropractic assistant, Bridget, greeted an arriving patient at the Emmanuel Church in downtown Boston. She said, "Hi, Michael, good to see you. It's been awhile. Have a seat and Dr. Ken will see you soon."
Changes in Herbal Medicines from Ancient Times to the Present
The classical literature of Chinese medicine remains highly relevant in the modern era, as many of the basic theories and herbal combinations emphasized in clinical practice were first established in texts that are nearly 2000 years old.
Don't Trust What a Patient Says
When a patient presents to the office for care, they typically have a specific complaint in mind – lower back pain, whiplash, sinus congestion, sciatica, etc.
Medial Knee Pain: 11 Potential Causes (and Corrections)
We have all seen patients with medial knee pain that either has no traumatic origin or lasts well beyond when it should be resolved. How can we help these patients? Here is an overview of clinical scenarios and how we can provide conservative care.
CRREW Rallies for Ongoing Acupuncture Relief Effort in the Philippines
On November 8, 2013, Typhoon Yolanda (Haiyan) made her way through the Philippine Islands, leaving in her wake at least 7,000 people dead, millions homeless and complete communities destroyed.
News in Brief
D'Youville Vet Program Gets High Praise; A Moment of Silence for Dr. Paul Reginald ("Reg") Hug.
Halt Allergies With Moxibustion Therapy
An allergy is an immune system disorder in which the body is hypersensitive to normally harmless substances in the environment.
Employers Need Chiropractic First and Sooner
From the Journal of Occupational and Environmental Medicine comes a study that gives excellent direction to employers (and insurers) regarding the management of low back problems (LBP).
The Search for the Origin of the Wiggle Technique
When Bob had adjusted me previously, most of the time I knew what he was doing. But this time, he had me lie on the treatment table in the usual side-posture position, and he "wiggled" my sacroiliac with the fingers of both hands, while stabilizing my pelvis with his forearm.
Medical Qigong for the Heart: Part I
According to the Center for Disease Control and Prevention, heart disease is the leading cause of death in the United States, affecting people of all ages and backgrounds. Coronary heart disease, in just the United States alone, costs close to 109 billion dollars a year.
New Leadership Era at the WFC
The World Federation of Chiropractic recently announced not only a new president, as is customary every two years, but also an incoming secretary-general, marking the first time since the WFC's inception in 1988 that someone other than David Chapman-Smith, Esq., will serve in that capacity.
Vibrational Medicine: Frequency Micro-Current and Color Acupuncture
Vibrational medicine involves the application of various forms of energy frequencies to the body for pain relief, healing and rejuvenation. Vibrational medicine will become a major growing trend in our medical systems for the following reasons:
Working With The Yuan-Source Level: Resonance and the Extraordinary Vessels
How do we stay fresh with our medicine? As healers, how do we balance our medical selves with creative artistry? Chinese Medicine is not a fixed dogmatic entity, but a living system, reliant on a mysterious force called "resonance."
Replenishing and Restoring Jing
I learned an important principle from my great Taoist Master Sun Hak. He taught me that all people "leak" Jing, and that we can mitigate or stop this leaking, and as a result strengthen our life force, develop enhanced adaptability and lengthen our life.
Wellness: A New Buzzword at the Aging in America Conference
Aging in America is "the nation's largest gathering of a diverse, multidisciplinary community of professionals in healthcare, social service, government, business and philanthropy with expertise in providing services and products for older adults."
Don't Trust What Your Patients Say
When a patient presents to the office for care, they typically have a specific complaint – lower back pain, whiplash, sinus congestion, sciatica, etc. They are often not interested or engaged in what they consider "unrelated" personal health history.
Low Melatonin Linked to Risk of Advanced Prostate Cancer
Epidemiological and experimental studies suggest the hormone melatonin, which plays a role in regulating the sleep-wake cycle, may play a role in the development of prostate cancer, as lower melatonin levels have been associated with an increased risk of prostate (and breast) cancer.
News In Brief
Pacific College of Oriental Medicine obtains grant funding from NIH; Yo San University of Traditional Chinese Medicine Announces New President; Kentucky Gets Licensed; PCOM Receives Approval from WASC to Offer FPD.
June, 2013, Vol. 13, Issue 06
Judge Lifts Stay of Florida PIP Injunction
By Kathryn Feather, Senior Associate Editor
Circuit Court Judge Terry P. Lewis lifted an automatic stay of a temporary injunction against the Florida Personal Injury Protection law, putting a halt to the portion of the law that requires a finding of an emergency medical condition (EMC) as a prerequisite for payment of full PIP benefits and that prohibits the service of massage therapy and acupuncture treatments, no matter who provides it, and payment for services provided by massage therapists, acupuncturists and chiropractors.According to Massage Today columnist and insurance expert, Vivian Madison-Mahoney, the injunction means massage therapists can now return to accepting auto cases and billing PIP for their services as long as the injunction is in place. However, Madison-Mahoney warns that all of the pre-2012 PIP rules remain in place.
"Will we have more battles? Yes, Florida Legislators are in the process of doing away with no-fault altogether to replace it with bodily injury (BI) because they are so upset that Judge Lewis issued the injunction in March," said Madison-Mahoney. "Yes, the State has already filed another motion with the District Court of Appeals, which has been legally responded to by attorneys Luke Lirot and Adam Levine. And it's back to work again until we find out how the appeals court rules."
"As it stands now, we are in the enviable position of fighting for Florida's citizens while legislators and the Governor are fighting for the insurance companies. As consumers, Luke and I are thankful for the few people like Vivian (and Kevin Johnson at Advanced Diagnostic Imaging) who have taken a stand and fought for all our rights. We are amazed at the general malaise and apathy that appears to overwhelm all Floridians - we cannot figure out how anyone could find it a good deal when the government requires that you purchase $10,000 in coverage from an insurance company and then allow that same insurance company to only provide $2,500 in benefits - seemingly at their own discretion," said Attorney Adam Levine.
A group of Florida massage therapists were hoping to close out 2012 with some positive momentum in their fight against HB119, which prohibits the state's massage therapists and acupuncturists from billing automobile personal injury insurance. The Florida PIP Defense Fund, a group assembled specifically to fight this bill and consisting of attorneys Luke Lirot, Adam Levine, the United Practitioners Organization, Inc. and Advanced Diagnostic Group, learned in the waning days of 2012 that the federal court canceled its hearing scheduled for December 27, 2012, and issued an order denying its motion for a preliminary injunction.
Attorney's Lirot and Levine then filed a motion to reconsider and they are also filed a response to defendant Kevin McCarty's request for dismissal on the day the case was due to be heard in Federal Court. Lirot and Levine explained that, "we believed that the provisions of this act violated the rights of acupuncturists, licensed massage therapists and chiropractors in Florida. Specifically, we believed that these health care provider's rights, which are protected to due process and equal protection, were violated when Florida determined that in order to prevent fraud, all licensed massage therapists and acupuncturists should no longer be permitted to provide care to those injured as a result of a motor vehicle collision."
According to an earlier release from the Florida PIP Defense Fund, Constitutional attorney Luke Lirot filed a complaint for declaratory and injunctive relief against Kevin N. McCarty in his official capacity as Commissioner of the Florida Office of Insurance Regulation. The complaint states that "the challenged legislation is invalid on a vast number of bases, generally summarized:
In an article from the September 2012 issue of Massage Today, "Florida Legislative Update," Lirot said, "While Insurance companies might be able to pick and choose medical providers, treatments and so forth, the State cannot. If, as the Governor alleges, the high costs to insurers is due to fraud in the PIP system, why then eliminate an entire field of medical providers? Why not go specifically to the fraudulent activity and attack the ones perpetrating the fraud? It is totally unreasonable, unjustifiable, arbitrary and overreaching to eliminate a whole profession of medical providers. Was it just because massage therapists and acupuncturists were the easiest to target?"
For additional information about the Florida law suit or a history of this legislation, see "Legislative Changes in Several States" from the April 2012 issue, "Lawsuit Filed Against FL PIP Ruling" from the December 2012 issue, "Florida PIP Update" from the March 2013 issue and "Temporary Injunction Granted in Florida PIP Case" from the May 2013 issue. For the latest information or to join the fight, visit www.flpipdefensefund.com. Massage Today will continue to monitor this lawsuit as it makes its way through the legal process.
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