www.thebodyworker.com

One of my pet peeves in the massage profession has been this whole idea that medical massage is the future of the massage profession and that the massage profession should get involved with working with doctors and insurance companies as contracted providers. I am referring to working with HMO’s and PPO’s as a regular contracted provider and also some auto insurance companies who have joined networks. Medical Massage is not being defined by the massage profession itself so the insurance companies are doing it for us. Being in WA State where we are allowed to become contracted providers with insurance companies, I have been privileged to witness the demise of insurance billing in a few short years. This is what is happening here in WA and some reasons why we need to think twice about wanting to work with insurance companies.

1. The insurance companies are constantly reducing the allowable fee (what they pay you and that you accept when under contract with insurance companies.) When I first started in about 2000 accepting insurance one company paid me about $90 an hour which was a very acceptable rate. Within a few years they reduced that rate to less than $70 and it continued to be that same rate until this year when they gave us a $.40 raise - yes that is forty cents when the price of gas is sure to go over $4.00 a gallon.
2. The insurance companies are also constantly reducing their benefits in their policies with people. For example - one company who used to allow 45 sessions of massage and PT combined a year now only allows 14 sessions a year.
3. The insurance companies are constantly making it harder to get paid. One company in particular will ask that we prove medical necessity after 4-6 sessions of massage and then deny any further treatment no matter what it seems.
4. The insurance companies set the allowable fees and usually send out a rate chart in the beginning of the year or when you first contract with them. Although it hasn’t happened to me yet as a massage therapist, I have heard from a few chiropractors and an acupuncturist that they change their mind in the middle of the year and say they are paying too much and reduce the rates and MAKE YOU PAY BACK THE DIFFERENCE - yes I am yelling- and there is nothing that can be done except to pay them back or they will take it out of future payments. I do know of one Naturopath who almost went out of business because of it.
5. Out of network providers may often get paid more than in network providers- yes this is a fact too. There is one company doing just that. If you are out of network they only pay a percentage of the bill usually, but they pay contracted providers so poorly that even the percentage of the full bill which usually is about $132 (UCR) works out to be more than they pay contracted providers
6. One such health network includes a list of auto insurance companies who are using provider networks and rules to pay for services rendered. This means that you have to accept a reduced rate of pay.
7. Most of the companies have not increased their allowable fees since I started with them in 2000. So no raise for a contracted provider -not even to reflect a cost of living increase.
8. Insurance companies are also creating educational requirements for credentialing meaning they are saying what training and education is required to become a member with them. It doesn’t matter that we are licensed by the State Board of Health. The insurance profession is defining the massage profession.
9. Affinity networks are discount networks that some massage therapists unknowingly join thinking that they will get more clients not understanding that they are also taking a big cut in fees.

So does that make you still want to join a provider network and be able to bill insurance companies for your massage services?

See also the Insurance Billing Section on www.thebodyworker.com

2005 Guest editorial in Massage Magazine

Issues and Ethics in Billing Insurance Companies

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No other webhosting company helps you create a website that gets results - gets the site to the top of the search engines and gets the reader to make the ‘most wanted response’ -whether it is to click on an ad, buy an ebook, buy an affiliate product or sell your services.

Site Build it! is different and the focus is all about results.  They even keep track of what SBI! sites are getting results and have a running list of sites that are in the top 1%.   This year I made it to that list with my site www.massagetherapycareers.com !

My clinic site is also moving up quickly in the search engines since I started working on it more a few months ago when I became more committed to getting out of working with insurance companies.  There is a guy who I know locally who always was in the top listings who was a programmer in his past career and now my site is right up there on the first page of google results.  I am also writing more content for that site to help educate readers about just what it is that massage does.  I had a new client last week who never had a massage before in her life who came in and said after reading my website, I was the one she wanted for her first session!  My focus is about writing more than just the standard benefits of massage - which by the way I just found out - the big basic benefit that can be found on most everyone’s website or brochure - ‘Massage increases circulation’  - is not a scientifically proven benefit!  There is no research that supports that claim as I learned from Tracy Walton who is a prominent massage researcher. This makes having a website even more essential so that you can start talking about what massage really does and how it affects your clients and what you think it is that massage really does.  By providing more content about these things you can create a regular following of clients.  If you are unsure what to write about just start thinking about what you tell people on the phone or on the table about what that ‘knot’ is in their back or how that muscle contraction affects their posture and over all health.

My focus since last fall has just been creating content, getting links, adding to the look and feel of the site, using Content 2.0 to get readers to help me create pages and it has all paid off.  I now am being found for the keywords ‘massage therapy’ and ‘massage therapist’ right up there with massagetherapy.com (ABMP’s website)  I am getting an average of 400 visitors a day who are making on average 750 visits - which means people keep coming back.

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For massage therapists it is a great way to create a website for your massage practice and get a second site to develop into an online business where you can supplement your massage income so you don’t have to always feel so much pressure.  It can free you up to do what you do best- doing massage.

Working at home is also becoming more important because of the challenges we are faced with concerning our environment and economy.  As the price of gas increases and more families are affected by the housing crisis, it is more imperative to have additional sources of income.  Working from home a few days a week can reduce the carbon emissions and the amount of gas being used by the country dramatically.

What you get with a subscription is really the blueprint for taking your massage business online or a business plan for creating an online business.

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One of the things about having a website that works is about creating an additional source of income. Since I started talking about making money with Google Adsense, I have seen many massage therapists with Adsense ads on their home page as well as many other pages. There are pros and cons of having these on your site. The ads actually take visitors (potential clients) away from your site to others sites and most like those who are your competition. The thing is that you won’t be a match for everyone and Ken Evoy of Site Build it! recommends that you use the ads to make money from every visitor. I put a few on my clinic site last year but they never really did anything. I also didn’t have much traffic (under 50 people a day) because I wasn’t promoting my massage practice. To make Google Adsense work for you, you will have to test various ad formats and placement of ads and also test what pages work the best. I do think that putting ads on pages that are just general articles about massage could be beneficial, but I also think that it will work best when you have a few hundred visitors a day.

The other way to make money with your website while you are busy doing massage is to sell products through an affiliate program. Affiliate programs are programs that you can promote for others and make money by promoting their products. I use Amazon.com to promote a few massage products that I have found to work well for myself and clients like Traumeel homeopathic gel for inflammation, the Theracane for home massage treatments and a few highly recommended books on health and health related topics.

To find other affiliate programs to participate in just do a search for ‘massage affiliate programs’.

The best product to promote are ones that you have used yourself. The best way to promote products is to write about how you use them and how they have helped you and/or your clients. I don’t promote things that I haven’t used or tried myself for the most part.

Some of my best affiliate programs are the Emotional Freedom Technique, The Science of Getting Rich, The Science of Being Well and a Vision Improvement program and Site Build it!  While I don’t make tons of money from one program, I do make a little with each program and added together it still isn’t tons but it helps keep me going.

To learn more about making money with affiliate programs you can read this Free Ebook- “Affiliate Masters Course” from Ken Evoy of Site Build it! and apply the principles to any website.

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The two best ways to get the clients you need to keep your massage business booming are getting referrals from current clients, physicians and other health care providers and Search Engine Optimization for your website.

Getting referrals from others is about learning to ask for what you need. Lynn Grodzki of Private Practice Success speaks of it this way:

But in a small business, letting other people know about your business needs is a necessary interaction. As business people, we need a way to communicate our legitimate business needs, such as our need for referrals (the life blood of our business), in a way that matches our sensibilities and ethics.

The best way for people to find a massage therapist is to go on referrals from their friends, neighbors, coworkers, physicians and other health care providers - or just about anyone. There seems to be some hesitancy with massage therapists to ask for referrals from clients or others because they don’t want to be seen as being salesey or pushy yet they continue to say they don’t have enough clients to make ends meet. There are a few ways you can go about getting referrals from clients such as creating an incentive program for people to refer to you - like if they refer 3 people or something like that they would get a free half hour massage. I think that works for some, but I actually think the best way to get referrals for your massage business is to just do the best massage of your life with each client. When people go back to work or home or wherever they are off to and are feeling their best- it will show and they will be talking about how good they do feel. That is the best kind of referral.

Getting physicians or other health care providers to refer to you requires that you build a reputation for yourself. The best way is to actually find a someone that you would want to go to yourself or refer others to. You don’t just want any old person referring to you. You need to get referrals from people who understand and match your values and philosophy on healing otherwise there will be too many possibilities for misunderstandings. I used to get referrals from a chiropractor who wanted people to come in 2x a day -5 days a week. I just didn’t agree with this type of service. He only did it with people who were in car accidents who had insurance companies with open pockets waiting to pay him. I would tell people that they just have to go by what they feel and most would want to leave his care causing some difficulties between us. So it is important to find someone who works in a similar manner to you. Would you send your mother to this person or would you go yourself? That is the litmus test.

Also once you find someone you trust - go to them for care. This is the best way to find out more about what they do and tell them about what you do. Actually you may not even have to tell them anything more than you are a massage therapist down the street from them. This is the way I build most of my practice when I first started. I started seeing a chiropractor and the next thing I know his whole family was coming to me and then he started referring all his patients.

The key to asking for what you want is to build relationships with others just based on wanting to create a relationship -not just about asking for referrals.

The other way to get a constant stream of clients is by having a website that gets you new clients every week. That means you have to have one that search engines find and that people click on. To do this you need to create pages that are optimized for the search engines using the most popular keywords (most likely some variation of ‘massage, your city’). To create a page that is optimized you also have to know how to create file names with the keywords as well as metatags -descriptions and keywords. I have a page on my website about formatting pages to help you get an idea of what it is about.

Some other ways of getting your site found are to just create as many pages as you can writing about what you do. Have a separate page for each technique to explain it in detail and share your experiences with this technique or method. Share why you trained in it and what you feel you can do with it. The more content the better for search engines and your readers.

Getting others to link to your site also helps create traffic. There are many ways to do this but the first thing is to get health care providers that you refer to to link to your site by first giving a link to them! I have written more about creating links on my website www.workless-playmore.com

Keeping yourself focused on what you can do for yourself and your practice rather than just complaining that you don’t have enough clients is to keep focused on these two things. What can you do today to take one step towards getting a referral or building a website? If you don’t have the money for a website makes me wonder just how committed you are to being successful.

I of course use and recommend Site Build it! for webhosting because it is much more than just a webhost. It takes you through a process of thinking about your business and creating a plan for success. While I have talked about SBI! extensively in all of my websites and forums, it can be very overwhelming. It took me 2 years of hearing about it before I took the leap and created my first site. I did start out with a free webhost and then moved up to Front Page. It wasn’t as scary taking the leap to SBI! So even if you can’t start with an SBI! site start with what you can do. Create a free site or use another template driven site. Do whatever you have to do. You can start with this Free Manual from SBI! about taking your Service Business online and apply it in any way you can.

I also am available to help you create a website for your massage practice. I charge $600 for an 8 page website (in addition to the $299 hosting fee with SBI!)which is more than half of what you would be charged by a SBI! webmaster. The reason why I am charging so much less is that I know the massage business and I want massage therapists to be successful and be able to get the clients that they need.

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I don’t know if it is just me or if it’s my writing or my sites, but I can’t tell you the number of struggling massage therapists who contact me telling me how much they are struggling to build a massage practice. I know I struggled for most of my career until I started writing and creating websites and making money from doing that.

With so much information out there like all of the books and programs and articles and resources - how couls anyone really be struggling? What is it that makes the difference between someone who struggles along day to day as a massage therapist and one who is highly successful? And then I hear so many massage therapist saying this unbelieveable statement

It isn’t about the money

So why are you then driving yourself around and around in circles, beating yourself up because you don’t have enough clients to make ends meet? If money isn’t important why are you working two jobs in addition to trying to build a practice and working for free or working low paying jobs in massage therapy just to pay the rent? If money wasn’t so important why are you charging for your massages at all?

And then there are those massage therapists complaining about things like “our school didn’t have an externship - that would have guaranteed me a job in massage’ or ‘the insurance industry isn’t paying me what I was told they would’ or my employer just takes advantage of me and only pays me $15 an hour when I deserve so much more. Then there are the “I told them everything I knew about massage and they still wouldn’t get a massage or I gave them all the exercises to do and they didn’t want to do them.”

The reason why so many massage therapist fail to build a successful business has more to do with their beliefs and the ego. Your ego is the unconscious part of you - it is all of your beliefs that are really running the show and creating the struggle for you. Your ego is telling you that you aren’t worthy of charging what you are worth. It is the one who keeps complaining of all of the things outside of yourself- it’s the school’s fault, it’s the economy’s fault - it isn’t your fault! Actually it isn’t really your fault. It is a result of your early childhood upbringing where your beliefs about yourself were created. While it isn’t about blaming parents and caregivers - it is about becoming more conscious of these beliefs that were created at such an early age. The way to get in touch with your beliefs is about getting in touch with what you are feeling. What are you actually feeling the second before you complain about something else as the cause of your struggling? That is where the heart of getting out of the struggling lies! In feeling the pain, grief, saddness. Those are the feelings of the ego. Whenever you are feeling anything but love, joy and happiness you can know it is the work of the ego.

So how does one release the hold the ego has on you ? Just acknowledging the fact that you know it is your ego is the first part. But sometimes it takes time to realize that. It may be a few days later and you can say “oh there is was the other day when I was complaining that I didn’t have any clients”. The more you can become aware of the fact and practice becoming aware then one day you will be about to complain or try to give someone advice and you’ll notice that it is the ego trying to cover up a feeling and you may even be able to just feel the feeling first without having to act on it.

If we are complaining that our businesses are slow because of the economy or because we think that people just don’t want to take responsibility for themselves we can know it is the ego sending us a message. We can begin to challenge our beliefs about ourselves and learn that what we see in others or complain about is really a reflection of a part of ourselves. Somewhere inside what you see in others is really what is going on inside of you. Is it true? is what Byron Katie asks in her book “Loving What is: Four Questions that can change your life”. Is it true that it is the economy to blame for your slow business? 100% true beyond a doubt, beyond anything else and is your business slow totally 100% because of the economy? (or could it be because you didn’t market your business or do the things you need to do?)

For more resources:

Why we fail?

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