“Practitioner Pissed off system”
I am going to be writing all week about the seminar that was put on by AMTA WA by two attorneys Pieck and Conniff, who specialize in working with insurance companies and providers.
One of the phrases that John Conniff used was very telling of the massage profession - he called it the “practitioner pissed off system” of working with insurance companies - meaning that massage therapists who were doing things like charging more for their insurance clients than there cash clients were only doing so because they were pissed off. What are they pissed off about? I think it goes much deeper than the issues of having to deal with insurance companies. I think massage therapists are starting to depend on the insurance companies for their income. I think massage therapists are not able to build cash practices and have enough income from cash clients that they are pissed off when they get involved with insurance companies and they expect just because the insurance company is this rich conglomerate that they should be paid fairly.
When you start blaming others such as the insurance companies and you lack of cash clients as the reason for not being successful, you are setting yourself up as a victim and not taking the necessary responsibility. Taking responsibility is a very humbling experience as it is that moment that you finally admit that you are in charge of your destiny - your thoughts, feelings and action. You and you alone are responsible for your success or lack of success - not anything and insurance company does or the economy or the lack of cash clients or your boss, or whatever other excuse you try to use to explain why your practice isn’t doing as well as you would like. It is a hard thing to swallow.
After attending the seminar more than ever I believe we need to focus on building cash practices because the risk of doing business with insurance companies is too great in my opinion. The penalty for insurance fraud which is a Class C Felony is punishable by 5 years in prison and $5000 in penalties for every count -which I think means every date of service or it may be every client- either way the cost of defense it too great for most massage therapists and not worth the risk. The other thing is that the only way that the insurance companies will ever change and start paying our regular fees and paying for wellness massage is if we focus on building our cash practices.
March 25th, 2007 at 4:41 pm
Hi Julie,
Well, it boils down to this uncomfortable Dual Truth:
1.) To get paid well, you must provide a service that is above and beyond the competition. And since massage therapy is becoming a commodity service in many areas of the country, it is imperative that therapists who do not want to be paid a lower wage must get trained to a higher level than is provided in most basic massage trainings.
2.) Becaue there are so many commodity level (average skills) therapists out there, one must get VERY into marketing — which could mean being a great networker and stimulator of word-of-mouth referrrals — and good at it.
I spent many years thinking if I only worked hard enough and helped enough people that everything I needed and wanted would come to me. My large number of far more than satisfied clients kept wondering why I was not super-wealthy, or why someone had not handed me big bucks to start a healing arts center or something. But that is not usually the way it works. Only occasionally does someone get the right contacts at the right time without a lot of groundwork, marketing, netowrking, and effort. So we must become experts at letting people know we exist and why they should come to us rather than someone else.
For those who think this is too “competitive”, the word competition etymologically means “To seek together.” What is being sought is the right quality at the right price for the right consumer. That is what the Free-Market provides: the right quality at the right price for the right consumer. All these so-called insurance plans are actually scams that fraudulently interfere with the quality/price/availability/consumer equation.
If one understands the realities of TRUE insurance, there is NO WAY insurance can pay for everyones preventive health care. What all these therapists are hoping for is that the laws of economics can be over-ruled and what theya re really asking for is to be welfare recipients.
I’m sorry, but if they examine the underlying structure of such things, that is the way it is. If anyone wants clarification on that, I will be happy to provide a summary of the whole thing.
Alternatively, your approach of helping therapists use the internet for educating the public and bringing them in the door for effective treatment is absolutely invaluable for those who are willing to face the Truth. — They also need to learn to be a higher level of practitioner than what is being turned out by the average basic massage program now-a-days. –
They also need to learn the laws of economics, politics and social evolution — and marketing — to be a true positive force in society with their skills.
Take Care,
David Scott Lynn
March 26th, 2007 at 1:15 pm
Julie, Many years ago when I was first starting out, I read a great article in the massage therapy journal warning about “getting into bed with Insurance companies”. It was very clear about the eventual trap this leads to.
But after years of trying to get up and growing on cash clients alone in a time when Massage was generally thought of as a luxury, I took the bait. I got on with Regence and then others.
For a while it was great, built in and growning referrals a greatly increased income and not that much more work. The billing after a short learning curve was clear and relatively simple. But then after a few years things started to change, the Ins. Companies started with holding payments, auditing every patient account, it became a nightmare. I was spending twice as much time on paperwork and phone calls as I was on treatment. Finally I gave up and cancelled with the Ins. companies; became a non-preferred provider and saw my practice shrivel. I was back at the beginning again, huslting for clients though I had 14 years of experience.
The article had spelled it all out in black and white, but sometimes we choose to learn the hard way.
Keep up the great writing!
May 24th, 2007 at 12:19 pm
That is a great shame that massage therapists would choose to go down a road of being “pissed off”. I used to do a lot of insurance billing and learned from David Luther the founder of the AMMTA, that we do actually bill more for insurance clients than we do for cash clients as they are billed within the medical system of using 15 min. codes for service. The reality is that, for example, 97250 myofascial release, was one of the highest grossing codes available, so it was most often used by physical therapy clinics. In my experience, and in talking with the various therapists at these P.T. clinics less than 5% had ever taken even the entry level MFR course, yet because they have a degree behind them, and are higher on the medical chain of command, they are not questioned about their billing. I would be surprised to find out that massage therapists would be more likley to overbill for treatment. In my experience, massage therapist tend to undervalue their treatment.
I will tell you that we no longer do insurance billing. Primarily because Arnold, our beloved governator, decided to pass a bill in jan. that stated that only, doctors, chiros, pt’s can perform massage for work comp. Of course, if you have been in this business for any length of time, you know that P.T’s, chiros and especially md’s do not do massage. So, basically, they just wanted to make sure that the previous mentioned medical practitioners can hire m.t’s to do the work for them(under their license of course, even if they are not there) and they can take care of the billing for the m.t’s. Maybe it is because the M.t’s out there are “pissed off” at insurance billing? Ha.
I will say that I own and run two succesful massage companies, one is a medical and sports massage clinic http://www.cassidysclinic.com and the other is a mobile day spa http://www.sandiegospa2go.com
I think the key is just being able to constantly adjust and I would love to see the massage therapits take their profession more seriously. If we would like to be respected by the medical community then we must welcome continued, expanded, and more intense training. We could lean a lot from our neighbors to the north.
Success to all!
Chris Cassidy, President/CEO
Active Wellness, Inc
DBA http://www.cassidysclinic.com
dba http://www.sandiegospa2go.com