Category Archives: Live Event

What Credentialing and Enrollment Mean for Acupuncture Practices

Credentialing and insurance enrollment can affect whether an acupuncture practice is able to participate in a health plan, appear in a provider directory, and submit claims under the correct provider and practice information. Although the terms are often used together, they describe related but distinct administrative processes. Understanding the difference helps practitioners plan ahead, reduce avoidable paperwork problems, and set realistic expectations about insurance participation.

In this American Acupuncture Council (AAC) presentation, credentialing specialist Brandy Brimhall discusses credentialing and enrollment in healthcare and why these processes matter. The practical takeaway for acupuncture practice owners is to treat payer onboarding as an ongoing administrative responsibility—not a one-time form submission.

Watch the AAC presentation

Transcript: Preserve and relink the transcript download attached to the existing AAC post. Confirm that the link opens the intended transcript before publishing this revival.

What is provider credentialing?

Provider credentialing is the process through which a health plan or credentialing organization reviews a clinician’s qualifications and professional information. Depending on the payer and provider type, this can include education, licensure, training, work history, professional liability coverage, disciplinary or sanctions information, and other supporting documentation.

Credentialing helps a payer determine whether a provider meets its applicable participation standards. The exact requirements are not universal: they depend on the payer, plan, jurisdiction, and type of practitioner. Acupuncturists should confirm the criteria directly with each plan rather than assume that a requirement used by one insurer applies to all others.

What is payer enrollment?

Enrollment is the administrative process of registering a provider, group, or practice with a payer or program so the relevant records and billing arrangements can be established. Depending on the arrangement, enrollment may involve a National Provider Identifier (NPI), tax identification information, practice locations, ownership details, billing relationships, and other payer-specific forms.

Credentialing and enrollment may overlap or be handled in a coordinated workflow, but approval in one part of the process does not necessarily mean every other step is complete. A practitioner should obtain written confirmation of the status and effective date applicable to the specific plan, provider, location, and billing arrangement.

For Medicare, enrollment is a program-specific process. The Centers for Medicare & Medicaid Services (CMS) directs eligible providers and suppliers to obtain an NPI and submit the appropriate enrollment application, commonly through the Provider Enrollment, Chain, and Ownership System (PECOS). Medicare rules and provider eligibility are not interchangeable with commercial insurance network requirements. Acupuncturists should verify current Medicare coverage and enrollment rules for their provider type and services before relying on any assumption about payment.

Credentialing, enrollment, and network participation: the difference

These terms are related but should not be treated as synonyms:

Credentialing: Review of professional qualifications and other required information.
Enrollment: Creation or maintenance of payer/program records and billing arrangements.
Network participation or contracting: The plan-specific agreement and status that determine whether a provider participates in a particular network, subject to the contract and plan rules.

A plan may use different terminology or combine steps. Ask the payer what has been approved, what remains outstanding, and when the approval becomes effective. Do not infer that a submitted application—or even a credentialing approval—automatically authorizes in-network billing.

Why these processes matter to acupuncture practices

1. They can affect claims and payment

Incorrect or incomplete provider records can create claim rejections, delays, or requests for additional information. Even when a practitioner has an active license and an NPI, payer records may still need to reflect the correct legal name, tax details, practice address, billing provider, rendering provider, and effective date.

Credentialing or enrollment does not guarantee that a particular service is covered or that a claim will be paid. Coverage, medical-necessity rules, patient eligibility, authorization requirements, coding, documentation, benefit limits, and contract terms can all affect payment.

2. They help keep provider information consistent

Inconsistent information across applications, payer portals, professional records, and claims can slow administrative processing. Establish a single source of truth for each clinician’s legal name, credentials, NPI, license information, tax details, practice locations, contact information, and liability coverage. Limit access to sensitive records and submit information through authorized channels.

3. They support practice planning

Payer onboarding can take time, and processing timelines vary. Before advertising participation or scheduling services on the assumption that a plan will pay, confirm the plan’s requirements and effective date. Explain any uncertainty to patients accurately and avoid promising coverage or reimbursement before it is verified.

A practical credentialing and enrollment checklist

Acupuncture practice owners can use this workflow as a starting point, adapting it to each payer:

Identify the payer and product. Confirm the exact insurance company, plan/network, and provider type; different products from the same insurer may have different participation rules.
Verify eligibility. Ask whether the plan accepts acupuncturists in your jurisdiction and what services or credentials are required.
Prepare documentation. Gather current licenses, NPI details, professional liability information, practice and billing addresses, tax information, ownership details where requested, and other payer-specific records.
Complete required profiles and applications. Some plans use third-party data platforms, such as the CAQH Provider Data Portal, to collect and share provider information. Confirm which profile fields, attestations, authorizations, and supporting documents each payer requires.
Track every submission. Record submission dates, confirmation numbers, outstanding requests, contact names, and follow-up dates. Respond promptly to requests for corrections or additional documents.
Obtain written confirmation. Confirm approval, effective date, network/product, provider identity, practice location, and billing arrangement. Clarify whether separate group, location, or individual steps remain.
Validate before billing. Confirm patient benefits and service coverage, authorization or referral rules, claim-submission instructions, and applicable contract terms.
Maintain records. Update payer records when relevant information changes and complete recredentialing, reattestation, revalidation, or renewal tasks by the applicable deadlines.

Common mistakes to avoid

Assuming a license or NPI alone establishes payer participation.
Treating credentialing approval as proof that enrollment and contracting are complete.
Using inconsistent legal names, tax details, NPIs, or addresses across records.
Failing to track payer requests, deadlines, effective dates, and confirmation notices.
Assuming one payer’s process or coverage policy applies to another.
Telling patients that a service is covered before verifying the specific plan and benefit.

When an application is delayed or a claim is denied, identify the precise issue before resubmitting documents. Ask whether the problem concerns credentials, enrollment status, network participation, effective dates, member benefits, authorization, coding, or claim data. The right correction depends on the actual cause.

Use authoritative sources and verify payer-specific rules

CMS provides current guidance for Medicare provider enrollment, including NPI and PECOS steps: https://www.cms.gov/medicare/enrollment-renewal/providers-suppliers

CAQH explains how its Provider Data Portal supports providers and practice managers in maintaining and sharing information for credentialing, directory updates, and enrollment: https://www.caqh.org/

For commercial plans, consult the payer’s provider manual, credentialing department, contract documents, and written application instructions. These resources are more authoritative for a specific network than general descriptions of credentialing.

Conclusion

Credentialing, enrollment, and network participation are connected but distinct parts of payer administration. Acupuncture practitioners can reduce avoidable disruption by understanding each stage, maintaining consistent records, tracking applications, confirming effective dates in writing, and verifying benefits and billing requirements before providing services under an insurance arrangement. Processes differ across payers, so use the current rules for the specific plan and provider type.

Learn more from the American Acupuncture Council. Visit the [AAC website](https://acupuncturecouncil.com/) for resources relevant to acupuncture professionals and practice owners.

Educational disclaimer: This article is for general educational purposes and is not legal, billing, coding, reimbursement, or payer-specific advice. Requirements vary by payer, plan, provider type, and jurisdiction and may change. Confirm requirements directly with the relevant payer and consult qualified professional advisers when needed.

Chinese Medicine for Insomnia: TCM Patterns, Formulas, and Clinical Safety

Insomnia can involve difficulty falling asleep, repeated awakenings, waking too early, or sleep that feels unrefreshing. In this American Acupuncture Council presentation, Moshe Heller discusses how practitioners may use traditional Chinese medicine (TCM) pattern differentiation to organize treatment strategies for sleep disturbances. The framework is educational, not a substitute for an individual assessment or evidence-based insomnia care.

Transcript: Read or download the original presentation transcript. AAC notes that the transcript may contain spelling, grammatical, and terminology errors; consult the video when interpreting the presentation.

How TCM pattern differentiation frames insomnia

Heller emphasizes distinguishing the main sleep complaint—difficulty initiating sleep, difficulty maintaining sleep, early waking, or vivid and disturbing dreams—and then assessing the full presentation rather than selecting a formula based on insomnia alone. The patterns below summarize the presentation’s traditional framework. They are TCM diagnostic concepts, not biomedical diagnoses or proof that a specific mechanism causes insomnia.

Heart–kidney disharmony and yin deficiency

In the presentation, frequent awakenings after initially falling asleep are associated with a pattern described as heart–kidney disharmony or yin deficiency with yang rising. Other traditional signs discussed include night sweats, dry mouth, palpitations, anxiety, a red tongue with little coating, and a thin, relatively rapid pulse. Heller identifies Tian Wang Bu Xin Dan as a formula traditionally considered in this pattern and mentions combinations such as Kidney 3, Heart 7, Heart 6, Kidney 7, and Spleen 6.

Heart and liver blood deficiency

Difficulty falling asleep and dream-disturbed sleep are discussed in relation to a traditional blood-deficiency pattern, with possible pallor and a pale tongue. Heller names Suan Zao Ren Tang and discusses Spleen 6 and Heart 7, with Stomach 36 as a possible supporting point in the TCM framework. He also highlights suan zao ren (Ziziphus seed) as an herb traditionally used in sleep formulas.

Heart qi and blood deficiency with unsettled shen

For a presentation involving palpitations, being easily startled, and unsettled sleep, Heller describes Hu Po Yang Xing Dan (also referred to in the talk as amber-nourishing-heart pill). He discusses Heart 7, Pericardium 6, Bladder 15, and sometimes Bladder 20. The talk also mentions children with attention and sleep concerns; this should not be interpreted as evidence that this formula treats ADHD or that it is appropriate for children without a qualified, individualized assessment.

Liver qi constraint with heat or fire

Heller describes a more agitated presentation, with irritability, anger, anxious rumination, and difficulty falling asleep, through the TCM concept of liver qi stagnation that may transform into heat or fire. He identifies Chai Hu Long Gu Mu Li Tang and mentions Liver 3, Gallbladder 34, and Heart 7 as examples of a traditional treatment strategy.

Phlegm or phlegm-heat disturbing the shen

Restless sleep, vivid or repetitive dreams, chest oppression, a sensation of phlegm in the throat, nausea, bitter or sweet taste, a slippery pulse, and a greasy tongue coating are discussed as possible signs within this traditional pattern. Heller mentions Wen Dan Tang and, when heat is prominent, Huang Lian Wen Dan Tang. Point examples include Pericardium 5, Stomach 40, and Heart 8 or Heart 7.

What does current evidence say?

Research on acupuncture and Chinese herbal medicine for insomnia is promising in some analyses, but limitations matter. The U.S. National Center for Complementary and Integrative Health (NCCIH) summarizes a 2021 review of 11 acupuncture studies involving 775 participants that suggested possible improvement, while noting that the studies were small, varied in methods, and generally low quality. NCCIH also reports that evidence reviews of auricular acupuncture have important quality limitations. These findings do not establish acupuncture as a replacement for recommended insomnia treatment.

A 2015 systematic review and meta-analysis of Chinese herbal medicine included 79 trials and 7,886 participants. It reported possible improvements in subjective sleep measures, but substantial heterogeneity and methodological weaknesses limited confidence in the size and generalizability of effects. A later network meta-analysis of Chinese herbal medicines also reported potentially favorable findings, but rankings across trials cannot establish that a particular formula is appropriate for an individual patient or prove superiority in routine practice.

For chronic insomnia in adults, the American Academy of Sleep Medicine strongly recommends multicomponent cognitive behavioral therapy for insomnia (CBT-I). Sleep hygiene can support a broader plan, but guidelines advise against using sleep hygiene alone as treatment for chronic insomnia. Acupuncture or TCM care, when appropriate, should be discussed as complementary care and coordinated with the patient’s medical team.

Clinical application: assessment before formula selection

Characterize the sleep problem. Ask about onset, awakenings, early waking, duration, daytime impairment, schedule, and the patient’s goals. A sleep diary may help track patterns and response over time.
Screen for other causes and red flags. Consider sleep apnea, restless legs, pain, mood symptoms, medication or substance effects, shift work, and other medical contributors. Encourage medical evaluation for persistent symptoms, significant daytime impairment, breathing pauses, or other concerning features.
Use pattern differentiation as a clinical framework, not a shortcut. The patterns and formulas in the video are examples. They should not replace a comprehensive history, examination, individualized diagnosis, or follow-up.
Coordinate care. Do not advise patients to stop prescribed medication or delay evaluation. Consider referral to a clinician trained in CBT-I for chronic insomnia.

Herbal safety and scope of practice

Chinese herbal formulas can have adverse effects, interact with prescription and nonprescription medicines, and vary in quality and composition. NCCIH warns that some TCM products have been contaminated with toxic compounds, heavy metals, pesticides, or microorganisms, and that substitution or manufacturing errors have caused serious complications. Before recommending or dispensing herbs, review the patient’s medication list, allergies, pregnancy or breastfeeding status, relevant medical conditions, product quality, and applicable scope-of-practice requirements. Use reputable products and appropriate monitoring; consult a pharmacist or other qualified clinician when interaction risks are uncertain.

Acupuncture also requires appropriate training, clean-needle technique, and attention to anatomical safety. Patients should understand expected benefits, uncertainty, alternatives, and the need for medical evaluation when indicated.

Key takeaway

Heller’s presentation offers a traditional pattern-based way to think about sleep complaints and examples of associated formulas and acupuncture points. For contemporary practice, use that framework alongside careful assessment, transparent discussion of evidence limits, herbal safety screening, and coordination with evidence-based insomnia care. Chronic insomnia should not be managed with sleep-hygiene advice or a formula alone when further evaluation or CBT-I is indicated.

Continue learning with AAC

Explore more educational resources from the American Acupuncture Council blog, including Supporting Sleep with Chinese Medicine, Part 1 (confirm the target URL before publication). For information about professional liability coverage, visit the American Acupuncture Council website.

References

National Center for Complementary and Integrative Health. Mind and Body Practices for Sleep Disorders: What the Science Says.
National Center for Complementary and Integrative Health. Sleep Disorders and Complementary Health Approaches: Usefulness and Safety.
Edinger JD, Arnedt JT, Bertisch SM, et al. Behavioral and psychological treatments for chronic insomnia disorder in adults: an American Academy of Sleep Medicine clinical practice guideline. J Clin Sleep Med. 2021;17(2):255–262. Full text.
Ni X, Shergis JL, Guo X, et al. Updated clinical evidence of Chinese herbal medicine for insomnia: a systematic review and meta-analysis of randomized controlled trials. Sleep Med Rev. 2015. PubMed.
Chinese herbal medicine for insomnia: a systematic review and network meta-analysis. 2025. PubMed. Interpret comparative rankings cautiously in light of study limitations and clinical context.

Educational disclaimer: This article is for professional education and general information only. It does not provide individual medical advice, establish a diagnosis, or replace appropriate medical assessment and treatment. Clinical decisions must be based on the individual patient, practitioner qualifications, applicable law, current evidence, and professional judgment.

Facial Acupuncture Self-Care: Tools, Techniques and Safety

Facial Acupuncture Self-Care: What Practitioners Should Know

Facial acupuncture self-care interests acupuncturists who want to understand facial skin care, cosmetic techniques, and skin-stimulation tools. In this American Acupuncture Council presentation, Michelle Gellis shares her experience with facial self-care and discusses equipment used in personal routines and professional education.

However, learning about a technique does not establish that every device or method suits home use. Practitioners should therefore consider the available evidence, infection prevention, manufacturer instructions, and applicable professional requirements before using invasive skin-stimulation methods.

Watch the Facial Acupuncture Self-Care Presentation

Michelle Gellis — American Acupuncture Council

Presentation transcript: Download the original presentation transcript.

Editorial note: Retain the original AAC transcript disclaimer explaining that transcription may contain spelling, grammatical, or terminology errors.

What Does Facial Acupuncture Self-Care Involve?

During the presentation, Michelle Gellis describes her personal self-care practices and connects them to her teaching in cosmetic and facial acupuncture. Her educational materials cover several facial techniques, including cosmetic acupuncture, facial cupping, gua sha, microneedling, and approaches to neuromuscular facial conditions.

In particular, the presentation identifies several tools used in facial self-care:

Magnifying mirrors: These improve visibility when examining the face or performing detailed skin-care tasks.
Derma rollers: These handheld devices roll small needles or projections across the skin, depending on their design.
Microneedling pens: These devices use needle cartridges to create controlled punctures in the skin.
Serum-delivery devices: Gellis also demonstrates a device designed to stamp serum onto the skin.

Although these tools may appear similar in a cosmetic setting, their functions differ considerably. For example, a magnifying mirror does not penetrate the skin, whereas a microneedling device disrupts the skin barrier. Consequently, each product requires a separate assessment of its intended use, risks, and regulatory status.

Consider this presentation an educational introduction to facial self-care tools rather than a universal protocol for self-treatment.

Facial Acupuncture, Microneedling, and Skin Care Are Different

Facial acupuncture and microneedling may both involve fine needles. Nevertheless, they represent distinct procedures with different purposes and safety considerations.

Facial acupuncture involves inserting acupuncture needles at selected anatomical locations within an individualized treatment plan. Depending on the practitioner’s training and clinical context, practitioners may use facial acupuncture to address cosmetic goals or certain functional concerns.

By contrast, microneedling uses a device to create repeated punctures in the skin. Some devices penetrate deeper skin layers, and regulators authorize particular devices for specific indications. For example, the U.S. Food and Drug Administration (FDA) has authorized certain microneedling devices for uses that include improving the appearance of facial acne scars and wrinkles. However, that authorization does not automatically extend to every device, treatment area, technique, or claimed benefit.

Basic skin care follows a different approach. Cleansing, moisturizing, and sun protection, for instance, do not require intentional skin puncture.

For practitioners, the essential distinction concerns the procedure itself, not simply whether a company markets a tool as a cosmetic device. Therefore, evaluate every technique according to its intended use, limitations, and potential complications.

What Does the Evidence Say About Facial Self-Care?

A technique’s popularity does not establish its clinical effectiveness or guarantee a cosmetic outcome.

According to the FDA, microneedling may improve the appearance of certain scars and wrinkles when practitioners use appropriately authorized devices for their specified indications. However, results vary, treatment may require multiple sessions, and improvements may be temporary. These findings do not establish equivalent benefits for every consumer roller, serum-delivery tool, or facial acupuncture technique.

Similarly, evidence supporting acupuncture for particular health conditions does not automatically demonstrate that facial acupuncture improves skin appearance or reverses visible aging. To assess cosmetic claims responsibly, examine studies that directly evaluate the procedure, population, comparison group, and outcome in question.

Traditional Chinese medicine also offers diagnostic frameworks and explanations for treatment choices. Practitioners may draw on these frameworks in clinical practice. Nevertheless, they should distinguish traditional theory from modern clinical evidence when explaining treatment rationale and expected outcomes.

Ultimately, realistic expectations protect both patients and practitioners. No facial procedure should promise a particular aesthetic result without adequate supporting evidence.

Safety Considerations Before Using Facial Devices

Facial skin requires careful handling, especially when a procedure creates punctures. The FDA identifies several potential microneedling complications, including redness, bruising, bleeding, infection, pigment changes, and reactivation of cold sores.

1. Understand the device and its intended use

First, read the manufacturer’s instructions and identify the device’s intended purpose. Next, verify its regulatory status and authorized indications where applicable. A product’s availability online does not establish FDA authorization for a particular procedure.

2. Prevent infection and cross-contamination

Follow the manufacturer’s cleaning and disinfection instructions, and never share personal microneedling tools. For applicable medical microneedling devices, the FDA emphasizes using a new needle cartridge for each treatment session. Cleaning does not make a used cartridge suitable for reuse.

Likewise, acupuncture needles used in clinical practice must meet applicable sterile, single-use requirements. However, practitioners should not treat microneedling equipment and acupuncture needles as equivalent products.

3. Screen for potential contraindications

Microneedling may not suit everyone. For example, active skin infections, certain inflammatory skin conditions, impaired immune function, bleeding disorders, and relevant medication-related risks may affect a person’s suitability.

Therefore, a qualified healthcare professional should assess individual circumstances rather than relying solely on a general online demonstration.

4. Use appropriate products

Never assume that a serum, cosmetic, or topical medication is safe to introduce through punctured skin. The FDA has not authorized microneedling devices to deliver cosmetics or topical medications into the skin. Accordingly, practitioners should verify product compatibility, intended use, and applicable requirements before recommending a device-assisted application.

5. Recognize complications and arrange appropriate care

Monitor for persistent or worsening pain, spreading redness, swelling, discharge, significant skin changes, or other concerning symptoms. If these problems occur, stop the procedure and arrange prompt clinical assessment as appropriate.

Practical Implications for Acupuncture Practice Owners

Acupuncturists interested in facial services should distinguish personal self-care techniques from professional treatment offerings. Each setting raises different questions about training, patient safety, and professional responsibility.

For professional practice, training should address facial anatomy, infection prevention, device handling, patient selection, informed consent, realistic outcome discussions, and adverse-event recognition. In addition, practitioners must confirm that their training, professional scope, and applicable state requirements permit the proposed procedure.

Before adding microneedling or another device-based service, review the equipment documentation and manufacturer instructions. Also examine relevant insurance terms, regulatory requirements, and professional obligations. An acupuncture license alone does not necessarily authorize every cosmetic procedure.

Clear documentation supports responsible care. When applicable, record the treatment rationale, informed consent, relevant screening, equipment and products used, aftercare instructions, and any complications. For consequential scope-of-practice or coverage questions, consult the appropriate licensing authority, insurer, or qualified advisor.

Continue Learning About Facial Acupuncture

The American Acupuncture Council offers additional educational presentations on facial acupuncture and related clinical topics. Explore these resources to continue your professional learning:

These presentations provide additional educational perspectives. Even so, practitioners should evaluate each technique against current evidence, training requirements, individual patient needs, and applicable safety standards.

Conclusion

Michelle Gellis’s presentation introduces facial acupuncture self-care through practical examples of mirrors, rollers, microneedling pens, and serum-delivery devices. For acupuncturists, the central lesson is to distinguish personal routines from professional procedures and assess each technique independently.

Safe practice depends on appropriate training, equipment-specific precautions, realistic expectations, and an understanding of the available evidence. With these principles in mind, practitioners can explore facial self-care without assuming that every tool suits every user or that all techniques deliver established cosmetic benefits.

Continue your professional education with the American Acupuncture Council. Explore the related presentations above and consult authoritative safety guidance before incorporating new procedures into your practice.

References

U.S. Food and Drug Administration. Microneedling Devices: Getting to the Point on Benefits, Risks and Safety.
U.S. Food and Drug Administration. Microneedling Devices.
National Center for Complementary and Integrative Health. Acupuncture: Effectiveness and Safety.
American Acupuncture Council. Facial Acupuncture Self-Care – Michelle Gellis.

Educational disclaimer: This article provides professional education and general information, not medical advice, diagnosis, or an individualized treatment protocol. Acupuncturists should base clinical decisions on each patient’s circumstances, current evidence, appropriate training, professional scope, and applicable laws and regulations. Only appropriately qualified practitioners should perform skin-penetrating procedures, and they must comply with all applicable requirements.

ICD10 Diagnosis 2027 Should You Care?

Realize when it comes to diagnosis, best practice coding for an acupuncturist, pain. Don’t get fancy. Pain works.

Click here to download the transcript.

Disclaimer: The following is an actual transcript. We do our best to make sure the transcript is as accurate as possible, however, it may contain spelling or grammatical errors. Due to the unique language of acupuncture, there will be errors, so we suggest you watch the video while reading the transcript.

Hey, greetings to my acupuncture providers. It’s Sam Collins, the coding and billing expert for you acupuncturists, and of course, the American Acupuncture Council and our network. As always, I wanna make sure you’re up to date. Hey, it is the 1st of September. What’s gonna be changing? Oh, diagnosis codes will update October 1st.

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So let’s talk about it. Let’s go to the slides. Let’s look at what’s going on for 2027, what’s changing. The one thing we’re always careful with, we’re not big on hyperbole. We always wanna make sure we understand the coding, the codes that are important to your profession, and I’m always gonna be a little acu-centric.

Realize when it comes to diagnosis, best practice coding for an acupuncturist, pain. Don’t get fancy. Pain works. Realize you can have lots of diagnosis for the back, spondylosis, disc degeneration, on and on it can go, but yet it still comes back to pain. That’s the beauty and the genius. Realize that pain, symptoms, or neuromusculoskeletal diagnosis are always gonna be the most common payable codes.

There are certainly a lot of programs now that do pay for others, and I want you to be aware, but I wanna focus in on making sure are we getting paid? Do we have the right code? Of course, as is every year, there’s updates to diagnosis codes. This year is no different. So the 2027 diagnosis codes actually begin October 1st.

So here’s a good sort of riddle you can have. When do the 2027 diagnosis codes begin? And of course, most people would say 2027.” Technically, no. They begin October 1st. Now, as always, I’m going to be very acu-centric. You know what I care about? How does it affect us in the acupuncture field? Of course, there’s almost 75,000 codes.

You’re thinking, “Whoa. Are you ever gonna use that many?” Nah. You’re probably gonna use probably on a regular basis 10, and maybe occasionally a few more, with 5 of them being most often. So what I care about is the ones that affect us. We could look and say wait a minute” There’s 190 new codes, 30 deletions, four revisions.

Does that make a difference? Let’s take a look at the overview. There are gonna be changes to infectious diseases. Metabolic conditions, injuries or toxic effects, and this is ingesting things. Pregnancy-related, but pregnancy-related for more obstetrics, if you will. Oncology codes, but not related to what we would do ever, even though it might be pain, and then pelvic conditions, again, unrelated.

So the truth is, no significant changes except one, plantar fasciitis, and I’m not saying you can’t code plantar fasciitis. You can, but you might be coding foot pain anyway. So I will tell you, there’s no changes for high volume pain or neuromusculoskeletal codes. However, I wanna focus on, do I have the best codes?

Let’s look at the changes. The old code, or if you will, the code that’s being deleted, M72.2 plantar fascial fibromatosis, is the code that’s current. So if someone has plantar fasciitis now, that’s the code we use. Beginning October 1st, we’re gonna switch to the new codes, and you notice there’s three.

One says, plantar fascia, plantar fascial fibromatosis, unspecified foot. Let me tell you, never gonna use that code because can you imagine saying they’ve got it, but I don’t know which foot”? Of course you know. Is it the right or the left? Notice the code ends in one is the right, one that ends in two is the left.

Bottom line, keep it simple. If they have it in both feet, put both codes. If they have it in one, put that one code. Now, I have some acupuncturists say Sam, I’m not even gonna code that. Could I just code foot pain?” Technically, you could. Remember, pain is always gonna be a fallback. So here’s the new codes.

You’ll see here we’ve updated them. This is a list, and what I have here is a big list. I’m not showing the whole thing, but a big list of the common codes payable to acupuncture. I’m gonna give you an opportunity for all of you to get it because what this list is the list of payable codes by insurance.

Now, I will warn you, it is a big list. It’s about nine pages. It’s gonna have codes that are payable by insurance, but I’m gonna argue, or not argue, but I will state to you All the codes are payable by insurance, but not all are payable by all insurance. So you do wanna have a little bit of nuance there.

That’s one of the things our seminars note. But you wanna make sure if you’re gonna choose a code to bill insurance, I’m gonna suggest pick from this list because this is the list that there’s references to every carrier. So I’m just highlighting here, this is part of the extremities with the plantar fasciitis, but notice there’s other codes on the list, such as chronic pain, acute pain, and so on.

So to get that list, here’s what you do. Pull out your phone, use this QR code. I’ll leave it up for a moment. What you’re gonna get is a quick bounce back just asking for some information, and off it’ll come to you. It’ll be a nice PDF that you can use on your phone or also on your desktop. What it is, though, is a usable format that actually you could search.

Remember, if you go to the little magnifying glass, click in the click on that, type in a keyword, it’ll bring up every time that code is there. So if you wanna look up cervical, type cervical, and all the codes that have cervical will come up, or lumbar, whatever the case may be. What I wanna make sure is that you should be choosing codes that are specific and come from a reference as opposed to thinking, “Oh, I’m not sure.”

Now, again, always defaulting to pain is still fine, but I’m gonna say a little bit more specificity always can be helpful. What I do wanna talk about, though, a little bit more beyond that is just some recent things about the state of the profession. Here’s what I’m excited about, and I wanna show you something Acupuncture utilization has more than doubled in the last 20 years.

Now, we still treat a small part of the population, but I’m excited about that. Part of the reason, commercial plans now include the benefit. In fact, how many are familiar that Aetna now has mandatory acupuncture if it’s a commercial plan? Medicare Advantage plans, the Part C, have acupuncture. And what about complementary care networks?

They’re out there. Now, here’s something, and I want to show you where I got this. The American Journal of Managed Care from February of this year, this is a group that’s a, support group for the managed care industry that talks about how to position their business. And it says, “The most successful acupuncture providers will likely be those who combine clinical specialization, measurable outcomes, payer knowledge, and strong referral.”

This tells me where we should be looking. Specialization. You cer- deal with certain things. You’re focused on outcomes, and you understand what the payers allow. It says, “The market is moving toward greater acceptance, but payers are also becoming more focused on authorization,” meaning understanding diagnosis restrictions, utilization, and proof of functional improvement.

It then goes on to talk about, according to the CC, CDC, opioid prescribing is declining. If you think about why is the VA beginning to use acupuncture, it reduces the need for opioids 50%. It’s showing, “Our findings indicate,” and again, this is the Journal of Managed Care, “a large commercial insurer is increasingly covering acupuncture for its beneficiaries.

Unlike Medicare Part B, which limits coverage for chronic low back pain, these insurers are reimbursing acupuncture for a more myriad of conditions.” Think of for those of you in Massachusetts, they cover any diagnosis. And it says here, look at this, “Insurers should consider systemic reviews, meta-analysis, and other rigorous studies when expanding acucover, acupuncture coverage to new indications.”

Why is that? Their business strategy will be one that if they include more acupuncture, they will get more insurance. It says, “The greatest growth opportunity for acupuncture is not simply expanding the number of services offered. It’s positioning acupuncture as a measurable, evidence-informed component of conservative pain management in integrated healthcare.

Providers who understand payer requirements, document objective fun- functional improvement, and build strong referral relationships will be the best positioned for growth.” These are insurance companies that are then dictating how they’re going to do it. I want you to get on board. Doesn’t mean you have to bill all insurances, but I would certainly say I would cherry-pick a few.

Remember, though cash is king, I get that, you always wanna make sure, am I there to make sure I understand the insurance side? What I will tell all of you is I wish you really well. I hope you do fantastic. If you’ve never been to one of the HJ- or excuse me, American Acupuncture Council seminars, we’re here for you to help.

We’re always a support. Our network is there for you as well. And that’s more than just insurance. Diagnosis coding, small update this year, not a big deal. But make sure that if you need information or help, AAC is always there for you, and of course, I am as well. Until next time, my friends.

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Supporting Sleep with Chinese Medicine Part 1 – Moshe Heller

today we were, are going to talk about how do we support sleep in Chinese medicine.

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Hello. My name is Moshe Heller, and I’m from the Moshen Center in New York and also representing the Moshen Herbs which is a company that produces formulas. And I’d like to first thank the Acupuncture Council for letting me present today. And today I’ll be speaking about supporting sleep with Chinese medicine part one.

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So let’s go to the slides, and we can start. So a- as I said, today we were, are going to talk about how do we support sleep in Chinese medicine. And we’re going to talk about in part one about the ma- mechanisms and and how can we look at sleep from a Chinese medical perspective and support it.

And then in part two, we’re going to talk about patterns and formulas and points for the treatment of sleep disorders So I think there are two important substances that we need to discuss or remind everybody when we talk about the physiology of sleep and those are blood and yin. And so these are two important aspects of maintaining sleep.

The first of all b- in– The w- first of them, blood is the one that governs falling asleep. So blood as a substance in Chinese medicine is understood not only that it is the red fluid that travels in your arteries and veins, but also your ability to transition from an active mode to a more relaxed mode.

Therefore, for example, when if we have blood deficiency, then we tend to have muscle spasms because one, the transition between activity and relaxation is not smooth, so you get muscle cramps. The same way goes with sleep. If we have abundant blood, then the transition between being awake and going into sleep is smooth, and we will fall asleep easily.

In general, blood is this– the enables the transition from a yang state of being, from an active state of being, to a yin state of bl- b- being, so it lets us relax into sleep. Whereas yin, on the our other aspect, is actually supporting the staying asleep. So it’s about enabling us to maintain or stay asleep or go into deeper sleep.

This is the yin aspect of our th- that is in charge of that. So in fact, if we have a yin vacuity but not necessarily a blood vacuity, we’ll fall asleep easily and then we’ll wake up frequently during the sleep or not go into a deep sleep. So yin enables us to easily or stay asleep and then and go into deeper states of sleep, and we’ll see why in a second.

The generally speaking, we’re saying here, what we’re saying is that falling asleep easily but waking frequently usually points to a yin vacuity. But if we are having difficulty falling asleep but then we sleep better, then that’s more of a blood vacuity. So that’s a clinical clue for us to always remember.

So the blood has actually two roles in its ability to sleep, and it has to do with it, its relationship with two organs. One is the heart and the other one is the liver. In the first part, the blood enables relaxation into sleep, meaning it it enables us to relax into sleep, as I said in the previous slide.

But it also has this ability to house or enables the housing of the shen in the heart and then, and the housing of the hun in the liver. So when blood is full and abundant, it allows the shen and hun to rest peacefully in their relative organs. And therefore, if we have deficiency or issues with blood, liver blood or heart blood, then we will have either a difficulty of the shen to rest peacefully or the difficulty of the hun to rest peacefully, and that will look slightly different.

If so we’ll… And we’ll talk about that in a second There’s another point that I have to point out, which is very important. Sleep is part of a rhythmic aspect of our qi circulation, and we always need to take care of this or try to remember that qi circulation is part of this awakening and going to sleep rhythm.

So as we know in the Ling Shu it says that the wei qi circulates 25 times on the surface mainly through the jing jingjin sinews channels and maintains muscle tone and mobility. And in the evening, it penetrates the body at the ankle tran-transitioning from the surface to the interior, and at night it circulates 25 times through the zangfu organs following the Ke cycle and then it emerges in bladder one jing ming at the corner of the eye, allowing for the eyes to open.

So this wei qi circulation is really an important aspect that we need to remember and see if there’s blockages anywhere in that process and which allow– will allow us to understand how to treat it better. And so we can see a reflection of that wei qi circulation with our body temperature as we see here that during activity when we wake up, our body temperature usually goes down, but as we fall asleep towards the evening, then the body temperature will will be reduced and as we s- we sleep at a lower body temperature and that also reflects the yin yang activity.

So when we have more yang, we have higher temperature. When we are in a more yin state, we will have lower temperature. So there is also this ability for the blood to help us with this mental relaxation, the spiritual aspect of that. And and, during sleep, we say that the Shen retires into the blood.

If the sh- the blood is not full, then we will have a Shen not being able to rest quietly, as I mentioned before. Whereas also this kind of waking or ability to wake is managed by this kind of liver qi regulation of the circulation of qi throughout the body, including the Wei Qi’s circulation.

And so when we are having movement in the muscles when we’re trying to sleep, we should definitely look at this kind of relationship between qi circulation, the liver, and what we might call liver qi constraint, and the, in order to resolve that disturbance. This is really important to remember the relationship between the liver, the blood, the Shen, and the Hun so generally speaking, we also say that there is a lot of relationship between the Hun and dreams.

So the Hun, when the Hun moves inward drawing Qi away from the mind, then it hel-helps us or it will allow for, or it will create these dreams and the Hun wanders that’s when we c- what we might call when the Hun wanders it produces dreams and observes it’s observed as rapid eye movement or REM sleep.

Dreaming is necessary for health, for our healthy both la- function of our body. This really REM sleep is considered a very important part of not only sleeping and getting deep sleep, but also helping the body reje- rejuvenate and heal itself. When we talk about blood vacuity the heart blood is causing…

When the heart blood is deficient, this is causes what we might call fun or vexation, or when the liver blood is deficient, we might call it as restlessness and we call that jiao or agitation. So those are two different aspects of blood vacuity

So we also have to remember that our relationship between the different Zang organs and the eMoshens, and so how they the, the eMoshens affect the organs and when the organs can imbalances in the organs can affect our eMoshen. When we have too much heat or in, in the heart that might cause a lot of irri- a- anxiety and anxiousness.

Whereas when we have some disturbance in the liver, that can cause anger and and, a- and stress. And worry of course also affects the spleen, but then it can also affect the heart blood. And then when we have fear and fright, that is usually a relationship between the heart and kidney, and a lot of that is more than fright, it’s very

It’s fear and irritability, and that is associated with the kidney and heart balance. This is, summarizes very quickly what we are talking about or what different aspects that we need to look at when we look at insomnia. We have to look at what the issue is, where it’s l- the issue is located.

Is it falling asleep? Is it staying asleep? What are the eMoshens associated with it? The flow of qi and circulation, which we can assess by feeling the pulse and palpating different points, and therefore we can create a, a more clear picture of what needs to be done. So this ends part one and in part two we’ll talk about different formulas and patterns that are associated with insomnia.

But I wanted to thank again the American Acupuncture Council for letting me speak today, and I hope that we will, I will see you soon in part two. Thank you very much.

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The Personal Injury Success System – Michael Coates

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Hi, I’m Michael Coates, president of Personal Injury Made Easy, or pimadeeasy.com, and we’re continuing with the six-part series about personal injury. And what we’re really getting into is I know you’re all great healers. What I want you to all be is a great business operator or owner. So to do that, the first thing I wanna mention today is that it starts with mindset.

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And for mindset, realize that you are a pro, you’re a professional. And I think a lot of times, whether it’s chiropractic or acupuncture, that you think of yourself less than whether it is even the MDs or certainly dealing with an attorney, or you’re dealing with the court system, and it’s just not true.

All professionals are on an equal plane. You’re no better, you’re no less. So you’ve gotta grab that mindset, and then realize that you’re no better than anybody else, but you also deserve the same as everybody else. And the second thing is, again, realizing that you’re not just a great healer, but you need to be a better business operator.

So I really want you to grab onto those two hats. And the third part about mindset is to, something I talk about a lot is whether you are a fox or a lion. So the fox has to outsmart things. It could be a problem you’ve gotta kinda MacGyver around it, or it could be someone you’re dealing with, someone that’s trying to, whether they’re taking advantage of you, it could be someone that’s a staffer, could be a patient, could be an attorney in PI, about anything.

You gotta be a fox, right? ‘Cause no one outsmarts a fox. But at the same time, you may have to be a lion, and the lion is about strength. And you have to be strong for your patients, your staff, your family, your business, and also for yourself. So when someone says you need to be a fox or a lion, I say you need to be both to succeed in business.

You’ve gotta have both the ability to outfox those that are around you, and you also gotta be strong to stand up for what’s right and the people that matter to you So that’s the first part. The second part is I want to get into what is the success formula, and it’s a three-part form- formula, and I always think that when you get into things that they’re too complicated, it’s just too hard to implement.

It’s too hard to even get set in your head because we like to put things in buckets. So I’m gonna give you three barrels, so to speak, to put things in, or three buckets, and the first one is processes because we need proven processes to make things more efficient and more effective. And you all know about processes.

You cannot have a medical office or medical practice without being really efficient in processes. How many patients do you see in a day? It’s done because you’ve got a process for how you flow from at the lobby and intake, putting them in the room, when you’re doing treatment, and when they’re even exiting.

It’s just to realize that in personal injury, you’re gonna have all these nuances that are unique to PI, and you’ve got to learn to master those, to identify the ones that really have a great impact and to put those in place, and then you can tweak it and modify it for your practice. But if you don’t do that, you’re going to have gaps in the timeframe.

You’re going to be missing all kinds of ability to value drive. And when I say value driving through processes, there are things that you can do through processes, from intake, the forms you use, when you use them, to the documentation that you do, how you do your documentation, that literally can drive the value that you bring to a personal injury case for your patient and also for their attorney, even for your peers So if you think about it this way, you’ve got the insurance companies that are all trying to drive down PI case value, and you are remaining as this neutral, ethically bound medical provider.

You are all about just the patient’s health. You’re not about the liability or outcome of the PI case, because that’s just not your role and you have no control over it. But what you are is an avid healthcare advocate. You are there for your patient. Remember, you see that patient far more than an attorney ever sees their own client.

So because of that, you’re at this ground level to pain and suffering. That’s when you get into storytelling documentation that I’ve referred to before, and I’ll refer many times, which is about the ADLs, the activities of daily living. That’s life that you’re living. Then it’s about the duties under duress, those that affect the workplace, and then the loss of enjoyment, the LOE.

That’s about life. And so all those have this incredible impact, and it’s the impact that trauma has on our lives and on your patient’s life. So the processes that you do help to pu- and documentation help to pull that out. Now, we’re going to get much deeper into that in the next session when we really dive deeper into processes.

But I want to give you a little flavor for it, because when you do these things, it so positions you well. And let’s talk about positioning a little bit more. So when you talk about processes, that goes also the documents you use to protect your bill. So we’ll talk about a number of them in the next session, but it includes things that you have the patient sign, and it’s not just a medical lien agreement or even a letter of protection.

But there are other forms that you can do that helps to stop when the attorneys want to throw things at you. And again, it’s positioning you to be better at the time it comes to be paid. So all those processes, which include when you’ve even discharged a patient, what process do you have to follow up on a PI case?

Who do you follow up with? When do you follow up? And what are you asking when you follow up? So again, we’re going to hit that in the next session, but I just want you to realize how important processes are. Everything else flows from that. So that’s the first area of the success formula. The second area is profits Right?

It takes money to do the mission, as we’ve talked about, and your mission is to heal. And the more money you make, the more healing you can do. So I wanna really see you ramp up the profit. And for profit, remember, it’s not how much money you make, it’s how much you keep in your pocket at the end of the day.

It’s that net profit that allows you to give increases to staff on bonuses, hire more staff, do more things for your family. So profits is such an important area, and we’ll dive deeper into the two weeks from now when we get into that session, we’re gonna hit profits, and we’ll talk about MedPay and PIP.

We’ll talk about how you negotiate with law firms. The negotiation method that I have come up with and I’ve refined over the last 15 years that literally has providers owning law firms because the leverage is on your side. You just gotta learn how to identify the leverage, how to apply it, and that’s what the method that I’m gonna talk about in that session is all about.

And then there’s the third area. We talked about processes, we talked about profits, and there’s a third area that every business must do, and if it doesn’t, it cannot succeed, and it’s growth. You have to be able to scale. But what is growth? I think that I find that people think different aspects of growth.

Growth doesn’t have to mean you’ve got to have 15 offices, okay? Growth can simply be that you are maximizing your patient flow for if you’re the solo provider, you’re maximizing that out. You might have a multidisciplinary practice, though. You may have another office, a second or a third. So growth can mean different things to different people.

So when you’re scaling, it could be scaling up just your one office to maximize your potential so you’ve got the flow you want, you’re not overworked, but you are maximizing your patient mix and your patient numbers. It could be because you’re thinking of the exit strategy, like where you wanna end up, what kind of life you wanna lead.

You might want more offices. So then you gotta think about growth that way, which again, if you have processes down, that prevents a brush fire turning into a forest fire when you’ve got a number of offices. It’s why it becomes refining those processes early so important and why profiting matters, because the more you profit, the easier it is to expand And so think about how this works together.

Processes, profits, and growth. It’s a simple formula, but you cannot have any success, whether it’s personal injury or a medical practice or, to be honest, any business, unless you’ve got all three. Any of those three pillars, like a tripod that is off and goes, the tripod’s gonna fall down because it’s only got two legs.

It’s gone. It’s over. So this path that we’re talking about is to help you understand through the next sessions each of those silos, each of those buckets, because it’s all about one thing: helping you to be more successful, and you’ve earned it, and you deserve it. So again, think about that formula, think about how easy it is, because when things get too complicated, we find ways to stop ourselves.

And I have a lot of providers that come and talk to me, and they say they just want to focus on one. Michael, I just want to grow,” because they think they’re doing the processes right or they think they’re making enough. And when I dive in and talk to them, and because data doesn’t lie, and I find out the forms they’re using, the process they have, or I find out how much they’re actually getting paid by the trusted attorneys and even more what they’re getting paid by the difficult for attorneys, I found out it’s not what they thought.

So what they’re growing is is not profit. Sometimes they’re growing losses, and you never want, of course, to do that, right? So when someone says, Michael, I just want to focus on processes,” by the way, that is the best thing to start with. There is an order to things. So I do love when someone’s never done PI before, and when they say, “Mike, what’s the first thing I should be doing?”

And I say, “It’s processes.” Think of it like a, a house, and you’ve got that solid foundation in the house, and you want to have the great processes are part of that foundation, but they also get into the curb appeal, right? So that’s like the documentation. We talked about that the the last segment.

So when you build this really great house that has this great curb appeal, that’s when you can really thrive as a business, where you become a value driver to personal injury attorneys, to your patients, to your peers, to yourself And then that allows you to also not only profit more, but to grow. So I hope that gives you a little bit of a start and sets the stage for what we’re gonna talk about these next three really important weeks.

Because once you understand it’s about processes, profits, and growth, and that you need all three, I would say as we go through the next few weeks, I want you to identify one, two, or three things that I talk about that you will implement right away. So maybe you might do one thing in each of those silos or those buckets and put them in this month, okay?

Or next month when we talk about it. I think that’s gonna help you. In fact, when we talk about processes, try to pick out three things and implement that. When we talk about profits, try to pick about three things and implement that. When we talk about growth, try to pick out three things and im- implement that.

That means each month you’ll be doing more, and at the end, if you’re still, maybe you put this aside, you didn’t hit this like you wanted to, don’t stress yourself out. It’s about your life and your practice. Sometimes we’ve gotta take a step back to move forward. That’s what I’m gonna tell you instead of picking three things, pick one.

It’s still stepping forward, and stepping forward is what perfection is. Perfection doesn’t exist in this world at all. So I always say that progress is perfection. And again, if you wanna live well, you gotta build it well. So that’s what we’re gonna be doing through the rest of this series. We’re going to build it so that you can live well.

So again, as Michael Coates, I wanna give you how to contact me if you need any help on anything from me or my team. That’s, my website is pimadeeasy.com, and my email address is michael@pimadeeasy.com. And we’re here to help, so please don’t hesitate to reach out. And I want you to start compiling your questions, because I think that’s gonna really help to get things focused on what matters to you, because you matter to me.

I’ll see you at the next session.