March 23rd, 2007 Julie Onofrio
After attending a seminar put on by the AMTA WA and two attorneys John Pieck and John Conniff, I was shocked and awed with the amount of information and mis- information that is prevalent in the massage profession.
While they said that they would be putting out a book and creating a website with this information, I am posting my take on it here with the hope of creating discussions and awareness of these issues that face us as massage therapists. The big difference for massage therapists in WA State is that we are licensed as health care practitioners and have rules to follow under that category as well as our massage licensing requirements.
The main points of the seminar included:
- it it illegal to charge different clients different fees (no matter what you think might validate your reason for doing so, you have to be able to prove it)
- it is illegal to get paid a % when working for someone as it violated kickback laws
- it is illegal to talk about fees, talk about issues that may influence whether or not someone signs a contract with an insurance company and it is illegal to organize a group to fight insurance companies unless it is an association or union.
- When you sign a contract with an insurance company make sure you understand what you are responsible for. Read all of the contract, the addendum’s and other materials put out by the insurance company and make sure you have all of those papers - sometimes they don’t send these to you.
- doing business with insurance companies is a risk. Make sure you know what you are getting into and make an informed decision. I highly recommend taking this class by the attorneys at Peick and Conniff that is offered occasionally through AMTA WA.
Resources from Peick and Conniff:
Discounting fees for health care services - newsletter
Am I an Independent Contractor or Employee?
Provider Agreement Analysis Sheet
Business side of caring
Laws and Statuates:
Insurance Fraud : RCW 48.80.030
Federal Fraud and abuse lawsÂ
HIPAA Fraud : 42 USC 1320a-7c
False Claims 31 USC 3729
False Statements: 18 USC 1035
Posted in Insurance Billing | No Comments »
March 21st, 2007 Julie Onofrio
One of my latest sites, www.workless-playmore.com that I am working on using Sitebuildit! is already getting an average of 50 visitors a day and I have only had it up since January.
I have also started two new SBI! adventures that are just starting out but I wanted you to be able to see the progress. www.moving-through-menopause.com and www.learn-the-law-of-attraction-secret.com.
I just started those last month but already have them live so they can start attracting traffic. I have set up the rss system in them so the search engines will start knowing that they are there and I still have to complete the google and yahoo sitemaps.
While I am still doing massage 2 days a week, my plan is to be making a more on websites by the end of the year and hopefully a great living by next year. It does take a lot of work, but once you get it all set up you don’t have to do much - just add a page or two. I probably could stop now and still have a residual income of about $1000-1500 in Google Adsense income alone as long as the program continues. (Please note: I don’t use adsense on my sites where I am selling my services such as my clinic website www.massageseattle.net and my new site to promote SBI -www.workless-playmore.com. I don’t have it on my new sites yet as it is better to wait until you have 100 visitors a day.
Doing massage never seemed like work until I started dealing with insurance companies. I guess that is why I get so riled up about them. Making websites lets me stay in the creating zone that they talk about in “law of attraction” which is my new passion. While I don’t have it all worked out, I think I am getting a better picture of how to live and be ‘the law of attraction’.
If you haven’t seen the movie “The Secret” yet, it will give you a good start on the whole process but you have to remember there is much more too it than the 3 simple steps. It is about discovering or uncovering your dreams and desires and learning to allow them to happen. It is learning to get out of your own way. It is about working less, playing more.
Posted in Websites for Massage therapists | 2 Comments »
March 20th, 2007 Julie Onofrio
Medical massage is already being defined by insurance companies. If we don’t step up and define it someone else will do it for us. It is evident in the laws too regarding massage therapy as I see from the research I have been doing for my site www.massagetherapycareers.com.
This is from an application form from American Whole Health Network credentialing application for therapists in WA State.
“Clinical Massage Practitioner Application”
Application Checklist for
Clinical Massage Practitioner
Applicants may qualify as a Clinical Massage Practitioner, with the
following documentation:
X Valid State or local license as Massage Therapist/Practitioner
X Entry level certification by the National Certification Board for
Therapeutic Massage and Bodywork, or
equivalent State Exam *
X Attestation to at least 60 hours of documented continuing education
course work in massage in past 4 years
X Copy of certificate of completion of at least one advanced massage
training program of 25 contact hours or
more
X Documentation of at least two calendar years in active clinical
practice
X Two Professional Reference Evaluations from health professionals
attesting to personal and clinical practice
characteristics, at least one of which must be from a referring or
supervising MD, DO, DC, PT, RN or from
an AWHN credentialed clinical massage practitioner who has supervised
your practice.
PLUS
X Certification by a recognized national advanced clinical massage
certification exam
OR
X Documentation of supervised contact hours** performing clinical
massage
500 contact hours required for applicants with only a basic 500-hour
massage education
OR
250 contact hours required for applicants with 1000 hour basic
massage education that includes clinical assessment,
clinical pathology, and clinical charting,
OR
Postgraduate clinical training equivalent to 250 contact hours after
their basic 500-hour education
With submission of verification documents for any postgraduate
course, fellowship, preceptorship, or
clinically supervised practice
Please submit the following materials (obtain the forms at
www.wholehealthpro.com):
X Completed AWHN network covered benefit and discount contract with
signed agreement to business and financial
contract terms. If you are employed by an institution or group, your
employer must contract for you as an associate.
X Completed AWHN credentialing or recredentialing application for
clinical massage, this includes your online profile
listing for the AWHN web directories***
X Applicable credentialing fee
X Copy of your Published Fee Schedule
X Copy of your current professional liability (malpractice) policy
face sheet
(At least $200/500,000 limits are required, GHC contracted
practitioners must have 1Million/3Million)
X Copy of your current unrestricted state license and/or NCBTMB
certificate
X Copy of the AWHN Attestation for Specialty Training and Experience
form with supporting documents
X Send the Professional Reference Evaluation forms to your
professional references to submit directly to AWHN, note
the names of the professional references on your credentialing
application
* States with equivalent exams:
AL,AK,CT,DE,DC,FL,IL,IA,KY,LA,ME,MD,MS,MO,NE,NH,NJ,NM,NC,OR,RI,SC,TN,
UT,VA,WV,WA,WI
** Supervised clinical experience means a) session hours treating
persons presenting with clinical problems in a setting
involving some combination of assessment, treatment planning,
documentation of status and progress notes, and b) the
availability of mentoring and clinical supervision by one or more
experienced massage, physical therapy, medical, or
chiropractic practitioners. Can include practice sessions during
advanced training or preceptorship/apprentice programs.
Documentation includes affidavit by practitioner and/or statement of
completion by employer/supervisor/referring
practitioner.
***If you are listing other professional health services outside of
the scope of massage practice, you must have an AWHN
contract covering the licensed profession involved and meet AWHN
credentialing standards.
Please call the AWHN Network Development office if you have other
questions or need assistance in the
application process.
Posted in Insurance Billing | 1 Comment »
March 19th, 2007 Julie Onofrio
After attending a seminar on doing business with third party payers (insurance companies) I have become inspired to start searching for answers for the profession.
What is going on is that for the most part we are all uninformed as to what we are responsible for in doing business with the insurance companies. The contracts are so complex and not easily understood that we need an attorney to decipher the details. Without being properly informed the risk of committing insurance fraud is such a great risk. Insurance fraud is a Class C felony punishable by 5 years in prison and $5000 fine for each count not to mention the cost of hiring an attorney to defend yourself.
In that seminar I also learned that the only way to be able to work with these companies to make changes is to work through an association or union. While we do have a few associations, they are not strong enough or united enough to provide the support and knowledge that we need to be efficiently informed particularly when doing business with insurance companies.
What needs to happen from what I see right now is that we need to define medical massage and define it so that all types of massage therapy are included - reiki, polarity, structural integration, trager, swedish massage, reflexology, shiatsu, acupressure, therapeutic touch…every single type of modality has it’s place in medical massage.
I have thought at various times that we needed a type of organization to do just that and I myself do not know much about what it takes to create such an organization. But from what I have just learned we are powerless without it and the insurance companies will continue to walk all over us.
The other part of this has to do with a massage therapists ability to build a cash practice and how the insurance companies make us “fix” people and ignore healing. It also has to do with how we value ourselves as individuals and as profession. Are massage therapists turning to insurance companies when they can’t make a sustainable living with cash clients? What will it take to educate the public about the benefits of massage enough so that they understand that they have to take responsibility for their health and leaving it up to insurance companies who’s sole reason for being is to make a profit?
I don’t know the answers to these issues but the one thing is that we need to start thinking about these things and set aside our excuses and differences and decide what it is that we want for massage as a profession.
Posted in Insurance Billing | No Comments »
March 18th, 2007 Julie Onofrio
San Franciso passed an interesting law regulating massage therapists. I am still trying to figure out what it all really means.
This article in “Massage Today” explains it like this:
“In December 2003, former San Francisco Mayor Willie Brown passed the ordinance, which, among other things, shifts massage permit authority from the San Francisco Police Department to the Department of Public Health (DPH), and creates a two-tiered massage permit system that recognizes “therapeutic massage practitioners” on the one hand, and “adult entertainment massage workers” on the other. “
What the heck is “adult entertainment massage”? Who gets a massage for entertainment? Is this another word for prostitution? Is prostitution legal in SF?
I am still trying to figure out what this law really means and who supported it. If you have more information, please post it here or contact me through one of my websites contact forms -www.massagetherapycareers.com, www.thebodyworker.com
The Coalition for Responsible Massage supported and created this legislation.
Posted in Licensing and Legislation, News | 1 Comment »
