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Is There Value in ChatGPT for Acupuncturists? Michelle Grasek

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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.

Hi there. My name is Michelle Grasek and I’m the host of the Acupuncture Marketing School podcast. And today we’ll be talking about how to use AI to generate content for your marketing so you can save time and just generally make your life easier. And before we dive into the slides, I’d like to thank the American Acupuncture Council for the opportunity to be here with you today.

All right, let’s get started.

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Okay, so let’s talk about using AI for your marketing content creation. How can you use it to be much more efficient? So very quickly, what will we be talking about today? First, why use AI for this? How is it helpful? Is it really helpful? And I also want to talk about this concept of content creation and whether it still matters.

I know everyone is drowning in a sea of content. The answer is yes, but we’ll talk about that in a moment. We’ll also talk about how to use AI and what to use it for. What are the things that you can ask it to do for you? And specifically, when I’m saying AI, I’m referring to the free version of ChatGPT.

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We’ll talk about how to create effective prompts. This is one of the most important things you can learn about ChatGPT. The better prompts you ask, the better your results will be. Hands down. And I’ll give you some examples. Why use AI for content generation? The easiest answer, the simplest answer is that it will cut down the amount of time it takes you to create content by about one fourth, okay?

It is, it will just make the process so much more efficient, and we live in a world where we are expected for marketing. To do a ton of content creation and it can be very overwhelming. It’s a bit of a hamster wheel I’m sure you’re familiar and I personally think that one of the best ways to Retain your sanity in digital marketing is to use chat GPT or other AI to help you either generate content ideas or generate the content itself and to repurpose content, which you can see is the last bullet on this list.

chat GPT can help you with repurposing. Okay, and repurposing content simply means taking something that you’ve already created or written for one platform, like a blog post, and copying and pasting it, making it some tweaks, breaking it down into parts so that you can use it on other platforms, instagram captions or email newsletters. Those are the most common ones that acupuncturists are repurposing content for and Facebook, of course, other social media. But there’s this idea that. To retain your sanity in digital marketing, you do not need to keep writing similar content over and over. You can just repurpose what you’ve already created.

That saves time to begin with. And then, asking ChatGPT to do that for you drastically cuts down on the amount of time that you need. And of course, on top of that, asking AI to write the content or help you with ideas. Cuts down on that time yet again. Okay, so really to make content creation Reasonable and manageable in the world that we live in I think both of those things are essential chat GPT and repurposing content Okay, and sometimes people ask me does content still matter as I said earlier everybody’s drowning in content There’s more articles on the internet than any one person could ever read in their lifetime.

Like why should I contribute to that? Why should I keep adding? So something I want you to think about is Google and the way that it works for a search. So Google’s purpose is to provide the best possible experience for its users. So if you type a query into Google, it wants to give you the most relevant, best answer that it thinks answers your question that you will like.

Because Google wants you to keep using it. Do you remember Ask Jeeves? Yeah, I’m dating myself, right? Ask. No one uses it. It doesn’t even exist anymore. Because other search engines were better, okay? So Google never wants to become irrelevant like that. Its goal is to provide a good user experience. So you can help Google do that by writing content for your website.

So people always ask me, is blogging is old school. It’s dead, isn’t it? So I always say no for two reasons. One, every time you publish a blog post on your website, that’s another page on your website. Google likes websites that are updated regularly because it shows to Google that this business is still active.

And it’s still relevant compared to a business. Maybe the acupuncturist down the street from you who opened their doors 10 years ago, publish their website and has not touched their website in a decade. Clearly Google is going to think that your website where you’re publishing monthly or maybe every two months publishing a blog post, it’s more active.

It’s probably going to be a more relevant, better user experience and answer the person’s question better. than a website that’s been ignored for a decade. Okay, so that’s one reason. And two is that when you are publishing content on your website, whether it’s a blog post or a more formal page on your website, you are naturally including keywords that your ideal patient would be searching for.

So if you specialize in orthopedic acupuncture for runners, for helping them you know, recover from injuries and be able to do marathons, whatever it is, you could write a series of blog posts specific to that. Like I’m a marathon runner thinking about what are the questions that this person would put into Google if they need help, if they’ve got a knee injury, right?

How long after a knee injury can I, or before I start running again? with acupuncture. Think about what are they asking and then write blog posts about those topics so that all of those keywords are on your website and you just become so relevant to Google that it brings you up towards the top of the search because you are answering those questions and you are helping the person writing the query.

You’re the answer to that query. So I’m repeating myself, I’ll move on, but that really is why blogging and content creation is relevant for you as an individual with a brick and mortar local business. Because that’s what Google wants to send your way. But it needs you to help it do that. You have to establish your relevance on your website so that Google can crawl it and understand that relevance.

Yes, blogging and content creation are still important. And just in general creating educational content for your audience. It doesn’t matter if you only have a hundred followers on Instagram, teaching them about what you do and how acupuncture can help them is always going to be relevant. And it just falls under the name of content creation.

So one question that people always ask me about AI is they’re nervous about using it. They don’t know how to use it. They don’t know what its capabilities are, how far reaching it is, these sort of things. So I always tell people to use chat GPT to your comfort level. You could ask it to do brainstorming with you or to write you an outline for a blog post or an email newsletter.

You don’t have to ask it to write the entire content piece. You could ask it to write you the whole blog post, but you don’t have to. So use it to your comfort level. And you could also think about, AI from this perspective. I find this really helpful. And an AI professional that I met last year shared this idea with me that AI is like a really eager, enthusiastic assistant.

Imagine if you had a receptionist in your office who had free time and just loved to write and kept saying, let me help you write Instagram posts. Let me help you write blog content. What? Let me write your email newsletters. You’d have to teach that person a little bit about the tone. You want them to write the concepts that are important to include or things not to say.

And you would expect them to do an enormous amount of research, right? That is what ChatGPT is doing. It’s doing an enormous amount of research to find the answers. And when you write a prompt, that is the same as you explaining to your receptionist how you want them to put this content piece together.

You’re giving them instructions so that they write something that is relevant to your business, your community, your ideal patients, your specialty, etc. Including your tone of voice and all of the details. Okay, so Try to think about chat GPT in this really positive way where it’s a smart, enthusiastic assistant that just wants to lighten your load and make your job easier.

Okay. So what can you ask ChatGPT to help you with? Honestly, the sky’s the limit. Anything that you can think of. I would say that the major things that people tend to ask for are one, brainstorming or idea generation, two, writing outlines for content, or three, writing the content itself. So you could ask ChatGPT to write you a list of maybe Two blog posts.

Basically write me a content calendar outline for this year with two topics per month. Okay, so two blog posts. It’s just an easy place to start. Or two email newsletters per month. And what would their topics be for the whole year? So before you do this, in your prompt, It’s very important that you tell ChatGPT about your business, about your target market, about your specialty, if you have one.

Basically, give it as much information as you can so that it can give you relevant results. And we’ll talk more about things to include in your prompts in a little bit. But It helps enormously the more information you can give it. It could give you an outline for a blog post. Let’s say you really wanted to write that blog post about knee injuries and recovery with acupuncture for marathon runners.

And you just have writer’s block, and you just want to get it done so that you can repurpose it into an email newsletter and send it to your list. You could ask ChatGPT to write you an outline for this blog post, okay? And then you could write it yourself, or once you have that outline you could say, okay, this is great, please don’t include this bullet point, that’s not relevant.

But please write this blog post for me and also make sure you answer the question, how many treatments do I need and why? Okay. And then it will give you the blog post. You can also, of course you can ask it to write social media captions as well. You can also take content that you already wrote, copy and paste it into chat GPT, and then ask it to repurpose that content into other formats.

So if you wrote an email newsletter, you could. put it into chat GPT and say, please repurpose this as a blog post incorporating these important keywords for my website, or please take this email newsletter and break it down into two Instagram captions. Okay. So you can ask it to do. or help you create ideas for just about anything.

You can also talk with ChatGPT. This this class is really for beginners, people who don’t have a ton of experience or maybe you’ve dipped your toe in and you didn’t get great results from ChatGPT, so we’ll talk about how to improve your prompts so you get better results. But I just want you to know, if you don’t have a lot of experience with ChatGPT, you talk to it like a person.

You ask for revisions, you can say, I like this part, but this part’s not relevant, and here’s why. And if you stay signed in, it will remember, okay, most of the things that you’re telling it. Sometimes you have to repeat, but that’s okay. For the most part, it’s going to remember important things.

If you are just dipping your toe in and you’ve never used it before, I would recommend beginning with repurposing content. So find a piece of content that you wrote that really represents your business, your ideal patient, your specialty, and copy and paste it into ChatGPT and ask it to use that as the basis for creating other kinds of content.

So if it was For example, a really great Instagram post caption that got a lot of engagement with your audience, got people asking questions, maybe you got new patients because people were asking you questions about it, and you felt like it really represented you know who you are and what you’re doing in your practice.

That’s a great place to start. So you could put it into chat GPT and say, can you please write up like repurpose this as a blog post and or as an email newsletter or based on this information, can you suggest other Instagram post topics or other topics that I could write about for my blog? So if you are new, Begin with repurposing content.

And I put that little note in the first bullet that says repurposing content can go in any direction because I often talk about starting with a blog post and then breaking that down and repurposing it into email newsletters and multiple Instagram or Facebook posts, et cetera. But you can go in the other direction.

As I just mentioned, if you have a great Instagram post or email newsletter that could become a blog post or a new page on your website. etc. So as I’ve been saying, the way that you ask ChatGPT for something is very important, and that’s called the prompt. So the more descriptive and specific you can be in your request, in your prompt, the better results you’ll need and the fewer revisions you’ll need to ask for.

Now, If you ask ChatGPT to write a whole piece of content for you, a blog post from start to finish, it’s normal to expect that you will need it, you will need it to do some revisions. And, you’ll probably still have to do some tweaks and edits, even after the revision, just to make sure it sounds like you, that it feels authentic, that you think it is really going to resonate with your ideal patients.

And that’s normal. Okay? But the better prompts you write, the less of that you will have to do. So what can you include in a prompt? Let’s go with the blog post example. That’s clearly my favorite. So you can tell first, tell chat GPT about your business, describe your ideal patient and your target market and your specialty, and then tell it.

Why you need this piece of content. What are you going to use it for? What’s its purpose? That’s important for chat GPT to know and then you can ask it to write this piece of content in a specific tone of voice for example warm, but professional or you could say friendly and warm and So let’s say you ask for professional.

Please write this blog post about XYZ in a professional tone of voice, and then you add all the other information about your business, your target market, and the purpose of the piece, and maybe it produces something that is very formal, way too professional, and you realize, oh, this is not the tone that I use on my website.

All you have to say is, actually, this is too formal in tone. Can you please write it in a more warm and friendly tone? Or you might have to use a the, excuse me, thesaurus, to figure out what are the descriptive words that you want to use until you hit on the right tone. Now, let’s say you finally land on tone that feels appropriate, right?

Like you nailed it. Write down those descriptive words that you put in your prompt so that if needed, you can ask for them again in the future. So you get a consistent tone. Okay. And you can also say to ChatGPT anything you definitely want it to include or not, okay? You can tell it how long you want something to be.

If you want an 800 word blog post, then say that. You can Take a piece of content you’ve already written. Let’s say you wrote something about acupuncture for fertility and you feel like it really represents, again, your specialty and your target market. And you can copy and paste that in there, but then give it instructions to write a different piece of content, maybe about acupuncture for PMS, and you can ask it to use that content example as a formatting.

For writing this new piece of content, okay? So that can substitute for giving it all these specific instructions about like tone of voice etc. So that it basically tries to write something like your previous piece. So you have that consistency. You can also give it specific numbers. If you have a blog post and you want Instagram to give you three, sorry if you have a blog post and you want chat GPT to give you three Instagram posts, then say so.

Okay. If you want it to give you six ideas for a subject line for an email, Ask for six. And again, don’t be afraid to ask for revisions because once chat GPT produces something for you, it will typically say, I hope this is what you’re looking for. Let me know if you need changes. And if you want changes, just say so it will do it.

instantly. And if you don’t like the changes, you can always go back and use the initial for further revisions. Okay. And lastly, I’ll say that you can use chat. You can ask chat GPT questions about itself so that you can learn how to use it better. For example, when I first started using chat GPT and I’m using the free version, so I’m not sure if this is possible in the paid version, but I had asked it, if I give you the, Web the hyperlink for a website.

Can you then read the webpage and summarize the page for me and it answered and said, no, I can’t do that from you giving me the link. But if you want to copy and paste the text on the page, then I can give you a summary. Okay? So you can basically ask chat GPT or tell it, here’s what I want, and then ask it.

What information do you need to create this for me? Okay, so you can really engage with it so that basically you’re going to learn to use it more effectively and efficiently so that it takes up less of your time and you get a better result and then you have to spend way less time on your marketing.

That’s our goal. So I really hope all of this is helpful. It’s definitely a crash course in using ChatGPT for marketing and content. I hope it inspires you just to dip your toe in if you’ve never used ChatGPT before. Try repurposing a piece of content and, if you used it in the past and got like weird or mediocre results, really practice.

your prompts and give it a lot more information and play around with it. And I think you’ll see that you get even better results. Okay. So as always, it’s a pleasure to be here with you. If you have questions about marketing, you are more than welcome to send me an email, michelle at michelleGrasek.

com. I clearly love talking about and teaching marketing. So I am more than happy to chat with you. Mhm. Mhm.

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You’re Undercharging & What To Do About It – Sam Collins

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Greetings, everyone. This is Sam Collins, the coding and billing expert for acupuncture for you, for the profession, for the American Acupuncture Council, and of course, for my AAC network members. Let’s talk about, have you really decided, how do I determine

Have you ever thought of what the costs are? As most acupuncturists, you’ve probably dealt mostly with cash and you’re charging one fee no matter what you’re doing. I want to start to do something that allows you to make more money in your practice by identifying your services and creating a true value to them.

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I can’t tell you how often I’ve had acupuncturists come to me and say, Charging a fee that is well below what people will accept. By example, if someone is willing to pay you 70 for a service, but you only charge 35, how much are they going to pay? 35 is what you charge. And I say this really from an insurance standpoint, because if an insurance is willing to pay you 70, but you only charge 30, they’re going to pay you 30.

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So have you ever really taken some time to look through your fee schedule to understand the value and what we’re going to focus in on what’s called relative value units. So let’s go to the slides. Let’s talk about that. Every single service. In CPT, any service you can provide as a licensed acupuncturist to a patient, that service has a value.

And that value is just to compare one service to another. By example, if one service has a value of 1 and another service has a value of 1. 5, It tells you the one that’s 1. 5 would be 50 percent higher than the other. So what I want you to do with this is start to really use just your fee for acupuncture.

If you tell me what you’re charging for your first set, I will tell you what the relative price should be for everything else you should do. And I’m going to implore my network members, in particular those that are viewing this, Make sure if you haven’t reached out to me this year to do so we can go through with you on a one on one Zoom on Establishing and understanding a fee schedule that’s specific to your area.

There isn’t generic across the United States It depends on your area. So I’d like to start this though with all of you taking a look at what is your current charge? Have you ever really thought what do I charge for stuff? I want you to write this down. What is your charge? For the first set, an additional set of acupuncture.

We’ll just choose manual for now. Keep it simple. What is your charge for a 99203? A simple mid level new patient exam. As well as 97124. Just simple massage. Nothing fancy. So acupuncture. mid level new patient exam and massage. How did you choose the fees? How do you know what one should be to another? What we’re going to focus in on is the relationship of one to the other.

Now, what we’re going to start with is what is your fee for 97810? Now you may think how do I come up with that? There’s things to do there. And again, network members can contact me about that, but I’m going to just keep it simple. What do you currently charge? If you tell me what you charge for a 97810, I will tell you what the other fees will be and what an insurance will pay.

Give me what an insurance pays for one code, and I’ll tell you what they’ll pay for any. Now I want to keep in mind, a lot of your managed care contracts don’t necessarily follow this. But, this is one of the reasons I don’t like managed care, but things that don’t. By example, workers comp, personal injury.

Even the VA follows this because I will tell you the VA and Medicare rates are much higher than what you would get from American Specialty Health in a lot of these. So I want something that’s going to make sense. So what this is about though is understanding the value of services. So on this page I’ve given some examples of the relative value units for common codes and you’ll see right in the middle I’ve included the acupuncture codes.

And you’ll notice 97810, 97811 all have relative values from one to the other. To make this the simplest way to think of it, if you charge 138 for the first set, I’m just making it an obvious example, what should be the cost of a second set? 80. Now you may think, wow, that’s a big, yeah, there is more than a 50 percent difference.

between the first set and the additional set. The first set includes more of the initial part of the visit, all the exam part. That’s why it’s a little bit more. And I’m going to warn everyone, this has gone up 20 percent this year. If you’re not aware, and you’ve probably seen it within the VA for those that are billing, there is a 20 percent increase in the relative value.

RVU’s updated substantially because I think they really looked at the cost. and value of acupuncture in relation to other services. So 97810 and 97813 both increased 20%. So if you have not increased your value of 97810, I’m going to let you know you’re losing money. Now, the value differences of 11 and 97814 did not change, but those two increased substantially.

By example, on a Medicare slash VA patient, That is literally 10 to $15 more per code. And remember that’s based on a $40 rate. The $40 rate for 9 8 9 4 0, which was fairly common, is now 50 plus in most areas. So start to look at that. But what this also does though, is give the relative values of other services by example.

Notice simple heat, infrared heat, 9 7 0 2 6. It has a value of 0.2. So if you think in relation to a 9, 7, 8, 1 0, you’re gonna think my goodness. That’s literally around 15 percent of that. So if you want to know the relative value of a heat lamp, it’s about 15 percent of the price of your acupuncture, which means that’s why it’s worth like 10.

I, in addition here, though, I have other codes, 99203, 3. 37. Now here’s something to look at notice 97810 is 1. 38. 99203 is 3. 37. Now, this is not exact, but what we all see here, that’s close to, if not quite, three times that rate. I’d say about 2. 6. What you want to start to think of is, what should be my price of a mid level new patient exam?

Two and a half to maybe 2. 75? Of the value of the acupuncture code. So if I’m charging, say 60 for a 97810, my price for a 99203 is going to be 160, 170, somewhere in that range. What I find often is a great deal of undervaluing. of the services. So here’s how we’re going to do this. Let’s talk about what you charge.

Let’s just make it simple. What if we were to charge 75 for a first set of acupuncture? I’m just using this as a random number, so that’s what your fee is. Great. I take 75 and I divide it by its relative value. So I take 75, divide by 1. 38, and it gives me this conversion, which is 54. This conversion number then is what we multiply any other code by.

To tell me it’s relative price. So if my first set of acupuncture is 75, notice the additional set 5434 times 0. 79 means 42. Now I’d probably round that up to probably 43, but needless to say, you can see here. Oh, okay. It’s not going to be the same price. I’ll give an example. I had an office that was charging 60 for every set, and they were paying in full for each one.

They’re thinking, this is great, Sam. You know what that told me? If they’re willing to pay you 60 for an additional set, do you think you have undervalued the primary set? You bet you have. So I want you realizing that this swings both ways, that you really want to start to have a reason behind the fees.

And again, with network members, I want to push you that. Let’s start to set this up, because here’s what I’ve learned. Most acupuncturists bill roughly 8 to maybe 10 codes on a regular basis. Exam codes, acupuncture codes, a handful of therapies. I find of that, usually more than half are undervalued. Which means Half of the codes you bill, you’re getting less money than you should.

So by example, look at the exam price. Now again, remember I said it’s about 2 point whatever above, but notice 54. 34, 183. So again, not quite three times, but you can see the range. But notice for massage. Massage has a higher value than the additional cent. Hence why that one is going to be 49. 99 or again I’d round up to 50.

Now to show you how this works, here is the fee schedule for Arizona. And I just picked Arizona. Obviously this is going across the U. S. and I have network members everywhere. Network members contact me, we’ll go over what’s in your state. But this is always a good starting place. This is the Medicare rates.

for the state of Arizona. And every state has this same breakdown. Now what I’m showing here though is the Medicare rates notice for the acupuncture codes, exam codes, but let’s do the math here to show you how RVUs work. Notice the value in Arizona Medicare is 43. 86. By the way, last year that was like 35.

It’s gone up substantially. So I take 43. 86, I divide by 1. 38. It gives me a conversion of 31. 78. I then take that number, 31. 78, multiplied by any other codes RVU to give me the price. Now notice how this works. 31. 78 times 79 is 25. 10. Do you notice the fee for 97810? 25. 17. I know it’s off a few pennies, but you get it’s in that range.

Notice 3178 times 3. 37 for 99203, 10710. Notice 99203, 10695. Again, within 15 cents. 3178 times 0. 92, the value of a massage, 2923. Notice the value of massage. So you may want to start to realize that, oh, this is exactly how insurances do look at fees, particularly when it comes to personal injury and non managed care.

Now here’s what’s further interesting. My general rule is An office probably wants to be maybe twice the Medicare rates as a typical fee. Now, I’m not saying necessarily that high But that’s a starting point. I would say maybe even 1. 5 But here’s where I bring this up in Arizona for workers compensation and let’s face it.

Would anyone say? Oh, yes, the workers compensation fee the mandated fee is the highest fee in the state No, it’s not but notice the conversion in Arizona is 68 So instead of being 3178, it’s 68. So think of it 97810 has a value of 1. 19. If 68 is your first, or you’re going to use 68 conversion, the worker’s comp rate is going to be, oh wait, 68 times 1.

19 is about 120 percent of that. You’re thinking that first set then is going to be around 80. Yeah, what would the additional set be? 68 times 79 or 80 percent of that take off about 13. Again, right about 52 or 53. Please be careful of undervaluing. If you are billing 50, And a carrier is willing to pay 80, but you bill 50, you’re going to get 50.

So be mindful that if someone ever says, how did you come up with a fee schedule? Have a real reason Not based on what my friends have been doing. We don’t know what your friends are doing. We’re right. Your mom told you that Did you ever get away with it when you said that’s what Johnny did, mom.

Mom’s not going for that. We don’t care what Johnny does, what we do at my house. So network members, I’m mom right now. I want to know, what are you charging? We can go through it. Make sure you set up a zoom for that. I want you to really start to realize, make a competent fee schedule, not a guessing fee schedule.

And that’s what too many of you do. And that’s why a lot of acupuncture struggle. I want to end that struggle. By setting up a good sound fee schedule now bear in mind when you sign a contract With an insurance company you’re accepting the pay less. That’s why they like you to sign up By example, if you sign up with UnitedHealthcare, what do you get?

About 60 a visit. What if you don’t sign up with UnitedHealthcare, what do you get generally? About 100. Same might apply with Cigna. Now ones that are HMOs, maybe we want to, but others you may want to rethink it. So to help you do that, what I’d like you to do is take a moment, and this is, this is not just for my network members, obviously this is for everyone, Use this QR code.

Go in here. You’re going to send us some information of what is your fee for 97810, where they’re going to send you back the calculations of the codes that we just showed you based on your fee for 97810. See if it makes sense, but I’m going to warn everyone. Be careful if you have not increased the value of your 97810 this year, you have flat out lost money because it went up 20%.

That doesn’t mean all managed care, but for everything else. As always, we want to make sure that your practice does well. Network members especially, I’m going to emphasize, if we haven’t done our meeting this year on fee schedules, get in contact with me. Let’s get moving. For everyone else, make this a good starting point.

Maybe I’ll see you in the fall for a seminar to make sure you really can make sense of it. Or how about this? Join the network. Make me part of your staff. Let’s work one on one. As always, everyone, I’m going to say thank you for taking some time with me. We always want you to be successful because your strength is ours.

Take care all.

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Treating TMJ with a Multifaceted Approach Part 2 – Michelle Gellis

And today I am doing part two of a two part lecture on treating TMJ with motor points, scalp acupuncture, and submuscular needling.

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Hi, my name is Michelle Gellis. I’m an acupuncture physician and I teach cosmetic and facial acupuncture classes internationally. And today I am doing part two of a two part lecture on treating TMJ with motor points, scalp acupuncture, and submuscular needling. So if you can go to the first slide,

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I previously was a former, I’m a former faculty member and clinic supervisor at the University, Maryland University of Integrative Health. I was there for almost 20 years and I’m currently on the doctoral faculty at Yoson University. I’ve writtenly written. I’ve recently written a book on treating the face.

It is a comprehensive guide, covering everything from the five element treatment of the face to cosmetic acupuncture, treating neuromuscular facial conditions, facial cupping, gua sha, microneedling, red light therapy, and many other. So you might want to check that out. So last time I spoke about TMJ and its etiology, its symptoms, treatments.

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As far as some Western medicine theory and TCM theory, and today I am going to go over a multifaceted approach to treating TMJ because it is a very common condition that we will see in our patients. The underlying theory in my treatment protocol is that neuromuscular facial conditions such as Bell’s palsy, TMJ, myasthenia gravis, and others can best be treated using a multifaceted approach.

So today we are going to talk about three of those. Scalp acupuncture, Facial motor points and submuscular needling. Scalp acupuncture is actually a fairly modern technique in our medicine. It’s only been around since the 1950s and really became popular in the 1970s. And we use our needles to stimulate different areas of the scalp, which stimulate different areas of the brain, which control different parts of our body.

And it is not based on acupuncture points. It is based on neuroanatomy and it makes it Very beneficial for treating the face because frequently when people have certain conditions that are very painful, it’s hard to do localized treatment. But by treating the scalp, we can affect. the face. So there’s three main areas that we would look at when thinking about treating, using scalp acupuncture to treat the face.

And that would be the motor area, the sensory area, and the foot motor sensory area. And depending on the condition, whether it’s more motor function or sensory meaning pain or neuropathy, you would choose the particular area. So again, it’s based on neuroanatomy. Basically, on the homunculus.

So looking at this, the face takes up a really large section of the brain area. So this is motor and this is sensory. And you are going to be needling horizontally through this loose connective tissue. So we have the scalp, the clo, the skin rather, the close connective tissue, the aponeurosis. And then we have the loose connective tissue, which is where we would be.

needling. So the landmarks that we’re going to be looking for are the glabella and the occipital protuberance. So we need to measure the scalp and we usually do that with two hands. And so you would look at the glabella and the occipital protuberance, and then you would draw an imaginary line between the two, and when you find the midpoint, you go back 0.

5 centimeters, and that is going to give you your your vertical line this way, and When you’re deciding on your horizontal line, you want to start at the midpoint of the eyebrow. So you are going from the midpoint of the eyebrow to the occipital protuberance. That is going to be you’re starting here 0.

5 centimeters back and you go right to the hairline when you measure from the midpoint of the eyebrow to the occipital protuberance. So this is the motor area and the bottom two fifths. So we have five fifths. The top one fifth is your lower extremities. So we’re not concerned about that middle two fifth, the upper extremities.

And so that would be the hands and the arms, and then the face and the head would be the right here, this section right here. That is the bottom two steps.

Another technique that we can use is submuscular needling. Submuscular needling is a technique that we use when we need to or want to relax an atrophied muscle or overly tense muscle and it is really beneficial for long term paralysis or if someone has a lot of tension in an area and there are several muscles on the face and head that we can use submuscular needling for, but TMJ, the ones that we’re going to focus on are the temporalis and the masseter.

So here you can see the temporalis and the masseter. And what you would do is you would take. half inch acupuncture needles and you would thread them around the edge of the temporalis and underneath or through, if you can’t get underneath the masseteer. And by doing this, it brings blood and qi flow to this area.

So here’s another close up of what that might look like. It doesn’t really matter what direction the needles are going. As long as you stay right on the edge of the muscle and the easiest way to find the border is you bite down and where you have your patient bite down and you can feel the front of the edge.

of the temporalis, and then you are just going to, once you find the front edge, then you can follow it around on the temporal fossa, and this will go all the way back behind the ear, and you would just thread the needles all around horizontally along the edge of the muscle. And it looks something like this.

And then for the masseter, the easiest way to find it is ask your patient to bite down and it will pop out. And then you are going to place needles right underneath from the origin to the insertion. Right underneath the muscle and some people the muscles very thick and you might be going right through the muscle and it looks like this

some additional ancillary treatments that you could add in are to use some points to help relax your patient like Shen Men, you can also In the auricular area there’s a TMJ point that you can use and lower jaw, so you would look those up on an auricular acupuncture chart and for if they’re having sensory issues like pain, you would do both sides for scalp acupuncture.

And if it’s just one side, if it’s motor issues, you would just do one side and then cupping and Gua Sha can also be very beneficial. and submuscular needling of the massetere, temporalis and there’s also some auricular muscles that you can see right here in this picture. These are the auricular muscles.

You could also needle under those and in some individuals that is very beneficial. Why does it keep doing this

and also the motor points for the masseteer and the temporalis. So the facial motor points, the motor point for the temporalis is just anterior to gallbladder a. Okay. And it is on the temporalis muscle and you would just go anterior to that and you can needle that and stimulate it a little bit. And then there are two motor points for the masseter and one is stomach six is a motor point.

And then just below stomach seven, in line with the earlobe, there is another motor point. And you could needle both of those on the affected side or on both sides and stimulate those. And all of these used in combination can really be very beneficial to helping to relax the face, relax the jaw, relax your patient.

If they have TMJI cover this in great detail in my classes and there is my website, facial acupuncture classes.com. And you can also follow me on Facebook, Instagram, TikTok. I have I have a Facebook group with over 8,000 acupuncturists in it. There’s always a lot of conversation going on and I. Teach classes internationally so you can check out my schedule.

Thank you so much.

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United Health Care Non-covered Services for Acupuncture Providers

Let’s talk about what is going on with UnitedHealthcare. I’m sure many of you have received or have seen the letter that indicated about what changes you have to make.

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Hey, greetings everyone. It’s Sam Collins, the coding and billing expert. American Acupuncture Council and specifically the American Acupuncture Council network members. And I’m really appealing out to you as well. Not just that we’re not sending it to everyone, but I wanted to keep you updated on what’s new and changing.

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As we always promise, we want to make sure you get the information first, have the right information, can use it. I know a lot of you have probably gotten the UnitedHealthcare information about, we have to build differently and put the GA modifier. I wanted to help attempt to make this simpler, more easy to understand, and kind of.

Boil it down a little bit. So let’s go to the slides. Let’s talk about what is going on with UnitedHealthcare. I’m sure many of you have received or have seen the letter that indicated about what changes you have to make. I want to make it even that much simpler. Here’s what’s happening. Beginning February 1st.

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So starting this month, they want all acupuncture providers must bill UnitedHealthcare for all services they’re providing, even if the services aren’t covered. Now, for the most part, let’s be realistic. Probably you’re billing out mostly acupuncture. There isn’t a lot of services that you’re doing that aren’t covered.

But let’s just say there are services that you’re doing that’s not covered. They’re saying now they want it to be billed. So they want these non covered services to be billed, even if they’re not payable. And this will make an added step from what you normally have been doing. Now, keep in mind, the added step is just you’re going to add it.

The reality is, the No Surprises Act, as a lot of you are familiar with, which has been a couple of years, requires that all providers make patients aware of what their costs are. I think acupuncturists have always done an excellent job of that because that’s the number one question every has is how much is it going to cost?

So what this means is you’re going to make sure not only to do that with patients, make sure what they know, the cost are what’s covered and not covered. But more importantly, what’s not covered. We have to make sure the patient’s aware, like by example, if you’re doing cupping or moxibustion, you want to make sure to let them know, okay, this cupping service is not covered.

And therefore, it’s 25, whatever you charge. So again, think of it now, if it’s a therapy, therapies are for the most part covered, so it’s going to be the services that are not covered. Remember, contract and so forth will come into place. If you’re contracted and it’s bundled, it will be. So again, this is going to be services that they normally do.

Do not cover and the patient will be liable for it’s not going to be very many, but there may be instances where this come up. Realistically, this is should be something you’re already doing. Of course, every patient should be aware of, okay, if your insurance is going to cover, what is it going to cover, but also what is it not going to cover?

So therefore the patient understands what they’re having to pay. That’s again, part of your financial agreement. I hope you’re all already doing that to some extent. Now, what does this mean for non covered services though? I’m going to tell you for the most part, I’m going to look at things that are unusual.

Obviously, massage, manual therapy, exercise, heat, those are all covered. But services that aren’t covered, I’m going to put in cupping and moxibustion as being the most likely. Those are ones we’re going to have to outline. Now, by chance, let’s say the policy doesn’t cover therapies. They’re not bundled, then you would include therapies as well.

But for the most part, I’d say they’re covering therapy. So again, non covered services. And what does this apply? And this is where people are confused because it says commercial plans. So you’re wondering what’s a commercial plan? You know what a commercial plan is one that a person buys or they get through their job for the most part, you know, they get as part of their employment.

The only place that doesn’t apply is ones that are called self insured that are just managed by United healthcare. These would be. big giant employers, you know, large union groups and so forth, which aren’t that typical though. Obviously, if you work with a lot of people in those, you might run and cross it, but it’s going to be generally the commercial plans.

One patient’s purchase themselves, get through their job and Medicare advantage plans, but it doesn’t include if it’s self insured. So it is worth asking when you’re verifying. Is this a self insured plan? Because if it is, then you don’t have to do any of this. Again, I don’t see this as very hard. What do we need to do?

We need, oh, did I hit the wrong button here? I apologize. What we need to do is to make sure a few things. Number one, when verifying UnitedHealthcare, inquire if the plan is a commercial or Medicare Advantage. If it is, we have to do this. Now, again, I’m going to emphasize, this should be something you’re already doing.

You should already be making the patients aware of cost and what services aren’t covered But this is now something they want a little bit more detail for them You’re going to complete a financial understanding with the patient with an estimate of cost which means your cost So let’s say you charge 25 for cupping you would indicate this cupping service is not covered and you would indicate something as simple as It’s not covered because it’s not part of your plan.

Your plan may not consider it medically necessary, but anything like that, the bottom line is make the patient aware it’s not covered and they’re paying out of pocket because in order to hold them liable, the plan now is saying their requirements to do that. It says there identify if any. If any are not covered and include a statement.

So some services are going to be covered. Your acupuncture is covered, but services that are not identified and simply again, state it’s not covered or may not be covered. What you’re doing is making clear. You’re not promising them that it’s going to get paid. It is non covered. Now this brings up, what if you’re doing acupuncture and the acupuncture is not covered, you would do the same for that.

I don’t believe we’re billing too many like that, but just in case, then what you’re going to do is bill for those services. Now in the past. We’re pretty much never required to bill for services. They weren’t going to cover. They’re just liable to the patient now What they’re wanting is that we do bill those services to the insurance What we have to do uniquely though is bill it and then put modifier G a so that’s G as an apple Or excuse me G as in George a as an apple and what you’re doing with that is simply indicating that the patient has signed a waiver meaning that financial agreement where they’ve agreed They’re responsible.

What this is really doing is putting in place that patients are never going to be surprised They know what it’s going to cost in addition the insurance now when you bill in this way They’re going to send the EOB back to the patient indicating what they’ve paid for But that service such as cupping like nine seven zero three nine or one three nine would indicate as patient Responsibility and at the fee you’ve charged and remember that fee is the fee you want to charge It’s up to you.

That’s your cash rate. Whatever your fee is and the patient’s paying. That’s all you’re putting there So is this a little bit of a hassle? Yeah, I think so Um, it’s only a hassle in that we need to bill it. Everything else is the same You still have to inform patients you’re doing a service not covered You start to make sure they understand the cost of it.

Now the only difference is that we also have to put it on the claim and when we do so just put it with the GA. So let’s say it’s a therapy this this plan doesn’t cover a therapy. Okay, we would indicate that therapy with modifier GA. Keep in mind it’s not required for services they pay for. This is only for services they’re not going to be paying for.

So they’ll process it and then they’ll indicate patient responsibility. So let’s kind of get back at synopsis here. Let’s go, what’s going on? UnitedHealthcare commercial policies for acupuncture. You are now to make sure a patient is fully aware of services that they’re going to cover, but also not cover.

That’s not different. We’re to make them aware of the cost of the services, whether they it’s covered or non covered, which is also not different. So therefore that’s all going to be the same. That’s something I think acupuncturists do a good job of. Haven’t you always made sure your patients know the cost?

This is just making sure it’s memorialized, if you will, the patient signing it. And now we’re going to bill it. With a GA, if it’s a non covered service. So just a GA. Now you might be saying, well, what type of form do I have to have? It’s going to be a pretty straightforward, simple financial agreement.

Where you would indicate, these are the services we’re being provided. This is the amounts. And here’s the cost. And also indicate if it’s non covered. Now if you’re a network member with me, AAC Network, just contact me. We do have some samples. If you’re not a member, I apologize, but that’s not available to you.

That’s why we do the service. At least you’re getting the information. But for those that are members. get in contact with. We have a couple of examples. It’s not that complicated, but want a straightforward statement that the patients know it’s not covered. Here’s the point. It protects us. Therefore, a patient can’t come and say, I thought it was gonna pay.

You’re gonna point out. No, we said that at the beginning, and so I think it eliminates a lot of that issue. However, there is an extra step. Yes, you’re gonna now have to put everything on the claim. Part of what United Healthcare is stating they want to see the services that are being provided. What my hope is is that they start noticing that, wow, this cupping service is popular, moxibustion, maybe it should be something that we’re covering.

At least that’s what I would think. So, that’s the change. Non covered services, make sure patients are aware they’re not covered, the cost, put them on the bill. Patient still responsible. Nothing crazier than that. Again, if you’re a network member, get in contact with me. If you’re not a network member, the whole reason I’m doing this is to get this out to our network members, though it’s going to everyone contact me, let’s get you started on into the network.

We’ll give you a lot more help. In addition to that, though, we can give you a day to day help as well as forms and other things. We’re here to help. So for all of you, I greet you and say thank you for listening for a few minutes. I hope to see you at a future program as well. Take care.

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Engaging the Jueyin Channels with Therapeutic Exercise

We’re going to look at a club exercise today. It can be used for a patient exercise or maybe for your own practice, but particularly we’re going to look at shoulder girdle mobilization. And ribcage mobilization.

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Hi, I’m Brian Lau and I’d like to thank American Acupuncture Council for having me back. We’re going to look at a club exercise today. It can be used for a patient exercise or maybe for your own practice, but particularly we’re going to look at shoulder girdle mobilization. And ribcage mobilization.

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So we’re going to be working with the Zhui Yin channels, the liver and pericardium channel. Why don’t we start by just a quick review of those channels, particularly the sinew channels. And then we can look a little bit at the anatomy and apply that to the exercise. So I’m going to put the presentation up and we’ll start looking at that information.

So this will be, again, a focus on the Zhui Yin channels. First of all, just quick review of the primary channels. We have on the left, we have the liver channel. Liver channel starts at the inner space between the first and second metatarsal, comes up the medial leg and thigh. This isn’t as much of what we’re going to be looking at today.

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Comes up into the groin and circles the genitals, and then this part will be a little more important as it traverses up the abdomen We’ll look at how it follows the line of the external obliques to liver 13, the motor entry point for the external obliques. So it’s a major innervation site for the external obliques.

It encircles the stomach when it comes internal. We’ll glance at that real briefly. The rest of the external channel goes to liver 14. Also in the external oblique muscle. And then the internal branch kind of connects in through the throat and the head. And we’ll leave that for another time.

Pericardium channel goes on the midline of the anterior part of the arm. Follows the median nerve. But then it comes up into the chest, also links to the side of the chest I guess you could say to the breast for women, but I would really consider it more in the soft tissue like the serratus anterior.

So with that in mind, let’s go to the Sinew channels. Sinew channels for the liver sinew channel really ends at the groin, but I extend it a little bit further. We’ll see this softer color one is really more of an internal portion that goes a little deep into the deeper musculature of the psoas, iliacus, and the quadratus lumborum.

But then they’re also, it also links with those external obliques, which is going to be a major component of rotation, which we’re looking at today. And it connects then with the paired pericardium channel, serratus anterior, also the lower costal fibers of the pec major and down into the arm. But we’ll notice as we look at a better anatomy picture that this, Serratus anterior branch is going to wrap around the back.

This is a way that I extend it and it’ll connect in the back with the rhomboids. It creates a sling with the rhomboids rhomboids in the serratus anterior. So let’s look at that anatomy. First of all, on the far left, we have that liver sinew channel ending at the groin, but it’s on that same myofascial plane.

As the iliacus and the psoas, iliacus then connects with the quadratus lumborum. Quadratus lumborum takes us to the twelfth rib, it’s between the ilium and the twelfth rib, and links with the diaphragm. We’ll see a lot of the movement we’re doing today is going to move the lower rib cage and mobilize that area of the diaphragm and the liver, which sits right under the diaphragm.

So we’ll note that anatomy there internally. But on the outside, we have the serratus anterior from the pericardium channel. interdigitates with the external oblique and creates a sling that wraps from one side all the way to the groin of the other side. If we follow the pericardium channel around, the serratus anterior goes under the scapula, attaches to the medial border of the scapula, but really it links fascially, seamlessly with the rhomboids.

When we do Dissection with the Sports Medicine Acupuncture Program, we look at this rhomboceretis sling. And sometimes you can take some time and actually tease those away from the bone and see that they’re continuous sling of tissue. That’ll link into this spleniosurfaces and capitis on the other side, so the opposite side neck.

So from one side of the neck, in this case, in the image, the left side. It’ll wrap around the right ribcage, link with the liver channel, continue along the right torso to the left groin. So it creates a sling around the body, very similar for those who know anatomy trains to the spiral line that Tom Myers talks about in his book.

If you’re not familiar with that, I wouldn’t worry too much about it. But it’s a very similar anatomy to that, though I take it a little bit slight alteration of how he organizes it. But the important thing to note today is it’s a spiral. It’s a spiral that facilitates rotation. And when we’re working with patients who have rotation type postural issues or discrepancies from the left and right, these channels would be largely involved.

The liver itself has a range of motion. It has a movement in the frontal plane follows if it stabilizes along this ligament, it’s called the triangular ligament, but if it stabilizes along a particular ligament that attaches to the diaphragm, The liver can move up and down more on the right side.

So it has a movement on the frontal plane. It has a movement in the transverse plane, and it has a movement in the sagittal plane. We’ll look at those, maybe I’ll demo those real quickly when we come out of the PowerPoint. Bottom line for now is if we’re going to mobilize this lower ribcage, we’re also going to be moving and massaging the liver and moving the diaphragm.

So diaphragm movement, liver movement, I guess spleen movement on the opposite side, but the liver is our thought for the day. And then the pericardium. Pericardium has attachments to the sternum, to the ribs, to the spine in the back. So we’re going to be moving the shoulder girdle. It’s going to pull on the thoracic spine, move the thoracic spine.

That’ll have some massaging. immobilization for the pericardium organ. So let’s look at that sort of on me. It’s easier to see it on a person than it is on the slides, but at least you have a view of the anatomy. So first of all, I have this club. I’m gonna grab this in a second. I’m just gonna put it down for now.

The liver itself, when we’re doing this movement, we want to be able to move that liver so it can move in the transverse plane, wrapping around with the ribcage, wrapping around with the ribcage, so we’ll notice that motion. We’re not going to have as much of this frontal plane motion.

That’s not going to be as big of a part of the exercise I’m doing today, but we might have a little bit of that sagittal plane motion. But primarily, we’re going to be looking at that transverse plane motion because as I swing the club, it’s going to pull the ribcage open. There’s also going to be a lot of movement in the shoulder girdle, thoracic spine, so that’s going to be moving the pericardium.

So that’s it. We’re going to use a club. It’s a really good way to work with this rotation. We’ll do a little bit of a progression. If you’re doing this yourself, you can start off with the first easier version and then progress up. If you’re working with patients who have shoulder issues, you just have to know when to give them the next level.

I’ll give some thoughts on that. A couple thoughts on the clubs themselves. I do have some variation of clubs here. I have some solid metal ones. 15 pounds, 10 pounds, and 5 pounds, even that little small one on the farthest away from me is a 5 pound, but it’s solid metal. So it looks very similar to this plastic one with metal filling, which is 2 pounds.

2 pounds is probably a really good place to start. These clubs are top heavy, purposely. So they can tip very easily and if people aren’t doing good motion they can wing their shoulder in a position that’s not particularly helpful. I have a three pound for the day’s demo. I usually use a five or a ten pound for these swings depending on what I’m trying to accomplish.

But start light, find the pathway, you don’t want to hurt yourself. So it’s better to start light. It’s a lot more, three pounds is a lot more than it seems when you’re swinging. that club around and throwing it. So if you have a good pathway, it’s an efficient movement, but you don’t want to start too high.

All right, so first progression. First progression, we’re not going to swing it overhead. We’re just going to go forward, back, forward, back. I want you to notice the ribcage. As I swing back, pulls the ribcage. open. I want to let it pull the ribcage open. So a couple things first, if you’re following along with this, I want to highlight something, is when I swing back, I’m turning my palm out.

So my hand, if it didn’t have the club, would be facing out. I don’t want to go back with my arm internally rotated. That’s going to put my shoulder in not a good position. Particularly if I had shoulder problems, that would be very aggravating. So as it goes along the midline, I want to turn out. In, out, in, out.

Let it pull the ribcage. Pelvis is stabilized. So I’m letting the movement move the shoulders. in the ribcage, massaging the liver, so back and forth, comfortable, just letting that movement mobilize the ribcage. If you’re

working with a patient with shoulder injury, maybe they do a smaller arc. You have to start small and then work towards that full range of motion. And one last hint before we look at the next portion is don’t let the pelvis kind of drag along. I have to stabilize so that I can move ribcage and shoulder girdle.

All right, next part. Overhead, I’m gonna place it just on the spine. I’m gonna let it touch my back for this first part. I’m gonna work with the shoulder mobility, shoulder girdle mobility. I want to let the club drop down like I’m trying to scratch my back low down. Lift the elbow, and make an arc, bring the elbow in, that pulls the shoulder blade around.

Lift the elbow, drop the club, bring the elbow back. Lift the elbow, drop the club, bring the elbow forward. Lift the elbow, drop the club, elbow back. So this works on the flexibility of the shoulder joint and the shoulder girdle.

Up, around, it’s okay at this phase to help yourself. I can push up, or the big range of motion issue people have is to pull the elbow in. Up, let the club drop, elbow out. Up, let the club drop, elbow in. I’m making an arc.

Patients, or if you’re new to this, sometimes when the elbow lifts, especially if the tricep flexibility isn’t there, the club lifts. But I don’t want to do that. I want to lift the elbow. drop the club. So again, you can help yourself with the other hand at this phase and just work, take your time to get that flexibility.

Next part, I’m going to lift the club away from the back and do the same thing, but the club moves. So you notice the club points to my same shoulder corner. The club points to the opposite shoulder. Same shoulder, opposite shoulder. It’s like it makes a pendulum type motion. It swings.

Once that gets comfortable, final phase, throw the club. Swings down, throw. I’m using my ribcage, shoulder.

Same thing, I don’t want the pelvis to go too wild, so I’m stable, letting the ribcage move.

Okay, that’s forward throws for back. I want to come over the same shoulder, I have to turn my torso to the opposite side, over the same shoulder, pendulum along the back, swing out.

Open the ribcage. Open the chest, open the ribcage.

All right, so we’ll do that again on the other side, but I want to highlight a couple things just from working with people on this a lot. That I give this to patients, maybe not the full movement or maybe portions of it. And I progressed them through the whole thing. I also do it in a Zoom Qigong class. I work with a lot of people that way.

We do it in Tai Chi class sometimes and we apply some Tai Chi drills to it. But working with a lot of people with this, there’s some common mistakes. The first one is the club can get horizontal and that kind of loses the trajectory. I don’t do that. When the club swings back, it points back up and then it’s like tucking.

a arrow into a quiver. It swings around in pendulums and out. And again, you see the clubs up and forward. So I don’t want to let the club get horizontal. I don’t want that top heavy portion to throw me around and then I lose control. It’s a very clean pathway. Point up, in, throw. Up, in, throw. Same thing as I go back.

Club points up, in, throw. You can see there’s a moment in time where my elbow’s down, tip of the club is up, and then it comes through.

All right, so we’ll go through those progressions on the other side. So first one, I’m gonna let the shoulder warm up and the ribcage start to mobilize. Palm turns in, palm turns out. In, Out ribcage moves. So maybe more of the spleen being massaged on me now, but it’s still that region of the liver channel in the sinews of the liver channel,

ribcage mobilization, diaphragm mobilizes,

and I’m ready for the next one. I’m going to take the club. Onto the back, elbow up, club drops down, elbow in, elbow up, club drops down, elbow out. I’m making an arc with my elbow. I can help myself if I want to work on the range of motion.

Take the club away from the back, pendulum. So it points towards the side I’m holding the club on, pull points towards the corner. of the opposite side, it makes a pendulum.

And then when I’m ready, I’m going to take that pendulum into a throw. In, throw. In, throw.

Other direction, turn, throw.

So let the whole torso open, pull back, chest opens. out, relax down. So it’s a full core movement.

Okay. Forward again, throw.

All right. So that gives the basics of it. I would start slow, start with getting control of the club and the swinging. Start with the range of motion before you start worrying too much about throwing, but I do want to show it once from the back. So you can see that. pendulum. Because that pendulum is what makes the club a little bit more weightless.

The idea is no matter how much weight you are, you’re controlling the weight, but you’re also using the momentum to throw. So let’s look at that pendulum from the back. I’m going to turn around. So we’ll go with the forward throws. I’ll go slow with this. So it tucks in. You can see that angle.

Swings around, and then through. Swings around, through.

So it’s a pendulum type motion as I pull my elbow to the corner.

Okay, when I go back, same thing. It’s gonna be in the opposite direction. Over the shoulder, pendulum around, throw.

Alright, YouTube channel that goes through it a little bit different, but same idea. That’s Jing Jin movement training, so if you want a little extra resources but you can also watch this video, I would recommend maybe practicing along with the video a few times. To get the angles, again, start with a lower weight, two pounds, one pound if you have a history of shoulder problems, before going up to something like five pounds, or even heavier once you get comfortable with it, ten pounds.

It can be a good way of doing strength training, but you don’t want to injure your shoulder, so you want to start slow and get the pathway. Who would be benefiting from this? Obviously people who want to increase the mobility of their shoulder girdle. So people who have shoulder problems, if they have a painful arc and it’s extremely painful to get the shoulder.

up. Maybe not quite appropriate for those patients, but they could start with using it to help swing and increase that range of motion at a lower capacity. And then as they get a little more comfortable, they can let that arc become a little bigger. But then I would definitely want to start with them once they’re ready here, getting that range of motion a little higher, dropping the club a little bit more before they start throwing weight around, because it is more.

Weight than you would think when it’s away from the body but also working with back pain, especially when there’s thoracolumbar junction type pain that might radiate down to the radi to the sacroiliac joint or the hip. This motion of the torso and that flexibility of the ribcage and diaphragm can be very helpful for that.

Internal problems, liver T stagnation or any TCM patterns that involve the liver, it would be a nice way to massage the liver and create a little more suppleness. And circulation, increase that circulation around the diaphragm and liver region. So it doesn’t have to be musculoskeletal problems, it could be digestive issues, a whole bunch of things where there’s a component of liver disharmonies.

So be creative with it, there’s a lot of things you can do with it, it’s an enjoyable exercise and it’s something patients can do on their own or if it’s something you’re doing for yourself, it’s something you can do on your own. Alright, I think that’ll wrap it up for today, so again, I would like to thank American Acupuncture Council.

Maybe we’ll do a follow up to this and look at some Tai Chi drills with the club, it’s a really great tool.

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Why HIPAA Matters in an Acupuncture Office

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Hi, everybody. Good morning. Good afternoon. My name is Dr. Perry Barnhill, and welcome to the Fearless Acupuncturist. First, I want to thank the AAC Info Network for having us here to discuss with you the importance of HIPAA and how it relates to your office. Slides, please. Why HIPAA matters in the acupuncturist’s office, protecting your practice and protecting your patients.

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Again, my name is Perry Barnhill. I have certifications in coding, certified medical auditing, certified professional compliance, and certified HIPAA privacy and security. Meaning, I can see what the HIPAA auditors are looking for. And this is why we’ve designed HIPAA program for you acupuncturists because we live in a world where we take care of patients as well.

So in regards to HIPAA, what is it that most of us think? A lot of us think that it’s talking, not talking about rather patients outside of the office. It’s not leaving patients names or their files or their charts in plain sight. We don’t discuss their diagnoses or their conditions out loud.

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What about sign in sheets? A lot of us think that we don’t have a sign in sheet that’s visible for everybody to see. So maybe we’re good. Or maybe you have a manual. And it’s on the shelf. It’s getting dust all over it. And we’ve never touched it. Some people think that, hey, if we have a manual, if it’s filled out, we’re good to go.

Or sometimes we think, hey, listen, I already have an appointed compliance officer. They’re doing everything they’re supposed to. Actually, you hope where they’re doing everything they’re supposed to. And so that means I’m good. So what does compliance HIPAA compliance specifically mean? What it means is this a compliance program.

It’s a continuous living breathing program. It’s something that has to be implemented upon, meaning we have to act upon it. We can’t just, like I said earlier, have it, fill it out and deal with it once and then just leave it alone. It’s not cookie cutter. It can be customized to each individual office, depending on how you do things.

Again, it must be routinely referenced, and it doesn’t matter, even if you spend a ton of money on it. 3, 000, some people spend money on these things. Even if it was an expensive manual, it still has to be filled out, it has to be acted upon, and we have to make sure we’re doing the things that we’re supposed to be doing.

Is compliance mandatory? This is a question that I get all the time. A lot of providers or acupuncturists are only doing cash. A lot of you don’t participate in any insurance company. A lot of you don’t do any kind of Medicare at all, but it’s still mandatory. HIPAA compliance mandatory, even if you’re full cash, even if you have nothing to do with insurance, and even if you have nothing to do with Medicare.

A lot of times we wonder with the HIPAA audits, what is a HIPAA audit all about? How does it come about as well? They can be random. And guess what? Recently the OCR, you’ll hear me refer to the office of civil rights, the acronym OCR. Those are the police of HIPAA. And they literally just recently announced that they are going to really start ramping up random audits and offices.

So again, this is another reason we’re going to really need to be on our toes and make sure. that we’re doing the things that we’re supposed to be doing because it’s not worth the risk by not doing them, which we will talk about here in just a moment. Another way that we get audited from HIPAA or the OCR is complaints from patients.

Sometimes, if a patient complains, they have to investigate by law and they will. We can have staff members, usually it’s a former staff member, someone who’s not happy with things, calls and complains about something, and here comes the OCR. Other providers, other doctors in the community, it can be a variety of healthcare providers that may call and complain for you, on to you, for whatever reason that may be.

Usually though, most HIPAA audits are the result of breaches and we’ve all heard about cyber attacks. It can be the phishing attacks that we have. You’ve heard about hackers, we’ve heard about ransomware. Ransomware meaning that they steal, these hackers steal all the stuff from your computer, hijack it, and then they ask for large amounts of money for you to regain all that information you had in your computer system.

The PHI, the protected health information. Sometimes providers get themselves in big trouble because of physical thefts, theft. Somebody walks away with a file, you lose a file, something happens. That’s a breach too. That’s something where we would have to by law report. And then again, if we don’t have our ducks in a rope, we don’t have a manual, if it’s not filled out, we’re not doing that ongoing training, we could potentially be in big trouble.

And then we have business associates, these third party vendors that a lot of issues that have access to protected health information like a lot of you may use outside billing people or billing companies. Those folks have to also be HIPAA compliant. And if they’re not, you could potentially be liable too for any mistakes or breaches that they may have.

Years ago, the OCR knew that providers were not doing what they were supposed to be doing. So guess what? They implemented a audit program where they were going to start doing Random audits. And again, it began a long time ago and guess what? Big surprise, right? Covered entities such as yourselves.

Didn’t do so well as with many other providers out there in the healthcare industry. Most of them, in fact, all of them didn’t do that good. The results were not good. So then of course, they did another phase and they got the same and similar results. And ironically, recently within the last month or so, they’ve implemented more random audits as well.

They basically said, Hey, listen, we know people are not doing what they’re supposed to be doing. So we’re going to increase the amount of random audits. Again, another reason you need to make sure you have these things. Going in the right place in the right direction, having your manuals, and it’s not as complicated as it has to be, and I’m going to talk to you about that here in just a second.

Here’s the number one reason for finding penalties, and they’re all the same thing. They’re basically the risk assessments and analysis, the lack of doing them for lack of a better way to explain it. We’re not doing our security risk and assessments. We’re not having these physical safeguards that we’re taking care of and making sure are in place.

technical safeguards, the computer side of things or the administrative safeguards, the things that we have with our staff or what they refer to as the ICER, the information system activity review, basically making sure that all these protections are in place to protect the health information that we have with our patients.

I’m not going to take a long time on this, but I do want you to understand how bad these fines can be if we’re not doing what we should be doing. And they go into tiers tier one. We were unaware that we had a HIPAA violation, but we exercise reasonable due diligence, minimum fines, 141. But they can get up to 35, 000 in a year.

And then we have tier two where there’s reasonable cause and actions and we’re not willfully neglectful, meaning we were doing most of the things we’re supposed to be doing, but still not doing some of the things we should be, but we weren’t totally neglectful, but still you can see here a minimum 1, 400 plus 142, 000 a year.

Now we get into these other tiers, tier three willfully neglectful. But you actually attempted to fix things within 30 days. Now, if you fall into that category, again, you can see this, these fines can be devastating to any kind of practice. Tier four definitely don’t want to be in tier four. You were willfully neglectful, meaning you did not do what you should have been doing.

And here’s what I mean by this. And this is what the government says. To use the excuse that we didn’t know what we were supposed to be doing is not an excuse anymore at the level of your education, they expect you to know these things and they expect that you do these things properly. So number four, tier four, you don’t want to be there.

Meaning you didn’t do what you should have been doing and you didn’t attempt to fix it within 30 days. You can see the fines here are quite devastating, 71, 000. And up to over two million dollars in a year. So this is why these things are very important Here’s some questions. I want you to ask yourself and also to ask your staff You know who is your compliance officer?

And you know what you have to have an appointed compliance officer and it has to be on paper. Our HIPAA program is It’s all in there. We have the policies, we have the procedures, we have the HIPAA appointment compliance officer form. So these things have to be done. When is the last time you updated your privacy and information security policies and procedures?

These things have to be done routinely. Do you have regular training and do you have proof that you have this training? Meaning the OCR, the office civil rights, they think, okay, cool. You have a manual, it’s all filled out. That’s great. But if you can’t prove that you’re doing ongoing training, we provide monthly training, by the way, ongoing training, they say, not me.

They say it’s just as bad as not having a manual at all. Ridiculous. Yes, I agree. But this is what they say. So we do not want to fall into that category because think of all those tiers. That’s where we’ll put ourselves. Potentially. Have you performed vulnerability on tests on your networks? Meaning are you making sure that your computers, your systems, your service, That they’re all secure and do we have documented incident plans if in case there’s a breach And we have to notify patients by the way So if we have breaches by law We have to notify patients and you have to have policies and procedures in place for this A few other things, like I talked about earlier, do you have business associates?

Well, a lot of us have business associates. For example, like I said earlier, third party billers. If we have somebody that is billing for the services that we provide, they have to make sure that they are also doing what they should be in regards to protecting patient health information. Therefore, we have to give them what we refer to as a business associate agreement.

And we have this, it’s the form, you fill it out, you send it to them, and that helps add a Big layer protection in case they’re not doing what they’re supposed to be doing. In fact, if you have a business associate And let’s say they have a breach and something happens and the ocr finds out that you did not have a business associate agreement I’ll file with them.

You’re going to get fined. So we don’t want to be there. Do you have physical safeguards, locks? I know it seems very simplistic but Physical safeguards, locks. There’s other things, administrative safeguards, like passwords, making sure the passwords are certain length and in characters and certain kind of special characters.

There’s all kinds of things there. It’s not complicated. I say this a lot of times too. This is a new language for most of us. But it doesn’t have to be complicated because we walk you through a step by step process so you can understand it, you can appoint one of your staff to help you out with these things, but once you understand the process and once you start thinking about things, you’ll feel a lot better that you’re doing what you’re supposed to be doing so you avoid all those tears.

Here’s some thoughts I want you to leave with, and a lot of us think that, and again, like I said earlier, we don’t understand this, so we ignore it, it’s a language I just don’t get it, and I hope that it doesn’t happen to me, and you know what, I hope it doesn’t happen to you either, I hope it doesn’t happen to any healthcare provider out there, because our main focus as healthcare providers is to take care of our patients, that’s what we went to all the schooling we went to for, and that’s what we’re best at.

What’s what we’re best at doing but the reality is this we have to do these things And we do not want to be that ostrich what we put our head in the sand and hope that it happens to us Because you know what it is gonna happen to some of us And we don’t want to be there. We don’t want to be vulnerable.

It’s usually not if but it’s when here’s the cool thing You can delegate one of your staff members to do this so that you can focus on your patients You can take care of the things as you that you’re really good at It’s simple enough to have a staff member take care of it. It’s a step by step process.

There’s modules. There’s chapters It’s just very user friendly You need someone to help? Here’s some next steps. You can download the HIPAA compliance checklist here. You can click the QR code and this compliance checklist is a list that you go to. Now if you can’t answer yes, if you can’t say that you’re doing all those things, this means you’re not HIPAA compliant and this means that you’re at risk.

This means this is a position that you do not want to be in and you want to make sure you get it corrected and fixed. Couple different ways you can get a hold of me. One, you, everybody, you can schedule a demo, demo if you’d like to. You can scan the QR code here. Let’s take you straight to a demo. You can also go to fearlessacupunctures.

com. You can check that out, or if you want to, you can contact me at Dr. Perry at Better Hippo Blueprint. I am more than willing to talk to you, to discuss with you, because I don’t want you to be in a position where you’re potentially going to be fine. I also don’t want your patient’s information at risk.

Just like we, us, when we go to our providers, our dentists, whoever that may be, we don’t want our information leaked, like our social security, you as being in practice, that all of you are. We don’t want you to have those fines. It’s way too much risk. So in the meantime, I do want to thank again, the AAC info network for having us here and discussing with you the vital importance of HIPAA and HIPAA compliance.

And in the meantime, like I said, if you want to, I’m more than happy to discuss things with you and click on the QR codes, check things out and have an amazing day.