Is acupuncture a successful treatment for medical conditions?
A case report described the effectiveness of acupuncture for relieving or abolishing severe migraines, menopausal symptoms, and chronic insomnia, and ultimately improving quality of life.
After the first acupuncture treatment, the patient’s migraines reduced in frequency and intensity, and she was able to discontinue use of her migraine medications after her eighth treatment.
Subsequently, her menopausal symptoms and chronic insomnia resolved.
Healthcare continues evolving to less-invasive, natural, and drug-free methods, with acupuncture now being a first-line complementary healthcare choice.
Remember, the American Acupuncture Council (AAC) offers an unparalleled track record in acupuncture risk management.
There is a reason acupuncturists have trusted AAC with their business for 50 years.
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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.
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, 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.
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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Over 1.5 billion people worldwide suffer from chronic pain with one-third of American adults experiencing chronic pain.
Research is abundant on the effects of acupuncture on specific painful conditions.
A study of over 17,000 pain patients concluded acupuncture was effective for the treatment of chronic pain and is a reasonable referral option.
Another study concluded there was ‘mounting evidence” supporting the effectiveness of acupuncture in treating chronic low back, neck, shoulder, and knee pain, and headaches.
Healthcare continues evolving to less-invasive, natural, and drug-free methods, with acupuncture now being a first-line complementary healthcare choice.
Remember, the American Acupuncture Council (AAC) offers an unparalleled track record in acupuncture risk management.
There is a reason acupuncturists have trusted AAC with their business for 50 years.
Not an American Acupuncture Council member? Get a Quick Quote and find out how much you will save! Click here!
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, 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.
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.
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Can acupuncture have a positive effect on hormonal regulation in women?
Researchers are looking at how acupuncture may affect hormonal regulation, such as alleviating hot flashes in menopause or addressing menstrual irregularity.
Some researchers are also studying acupuncture’s impact on fertility, and its use linked to getting pregnant sooner and having better outcomes from IVF treatments.
Research on acupuncture has been extensive, with evidence supporting its effectiveness for many health conditions.
Healthcare continues evolving to less-invasive, natural, and drug-free methods, with acupuncture now being a first-line complementary healthcare choice.
Remember, the American Acupuncture Council (AAC) offers an unparalleled track record in acupuncture risk management.
There is a reason acupuncturists have trusted AAC with their business for 50 years.
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I always want to keep you updated first of the year on what’s changing, what’s new, and there’s been things that are changing for this year regarding telemedicine.
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 friends, it’s Sam Collins, the coding and billing expert for acupuncture, the American Acupuncture Council, and most importantly, you as a profession and as an individual provider. As always, we want to make sure you have the most current information to make sure your practice is thriving. And actually just making more money, if you will, or continuing to make more money is our hope.
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I always want to keep you updated first of the year on what’s changing, what’s new, and there’s been things that are changing for this year regarding telemedicine. Now, I know you’re thinking, is telemedicine something that we do a lot of? Maybe not, but I want to point out there’s going to be a place for it.
So I think it’s important to know what these new codes are. So let’s go to the slides. Let’s talk about telemedicine for 2025, because there was a whole new brand set of brand new set of codes in the old system. And when I say old system for 2024 earlier, when we built telemedicine, it was always for. E& M codes.
And then we build with a modifier 25. That has changed. For this year, they’ve updated. But let’s make sure first that we define what telemedicine is. Let’s make a clear definition. Telemedicine means that the provider uses interactive audio video telecommunications between you and the patient, which means literally a live visit.
It’s just audio video. That’s all just live. So in other words, it is a face to face visit. It’s just a face to face visit done online. I think that’s very viable in this day and age. And I think, though, that really started during the pandemic. I think it’s really stuck because we’re going to move that way anyway.
Think of how often with a medical provider, This is going to save a ton of time because how many of us have been to a medical provider? They don’t touch you. They just sit on the other side of the room. Shoot We should have done that audio video better for everyone. That potentially could fit for us as well in certain circumstances But do remember it’s live audio video and here’s probably the bigger Sticking point for many of you because you’re thinking oh good.
I’m gonna do herbal consults across the nation I’m going to, I’ll slow down. You have to have price, proper licensure. And it says here, make sure you are licensed both in the state where you are located, obviously, but also where the patient is located. So by example, if you’re in California and you’re trying to do a telemedicine visit for someone in Texas or New York or someplace else in California.
You not as a licensed acupuncturist. Now, this is irregardless of if you’re billing insurance, frankly, because you cannot practice in a state you’re not licensed. If you’re saying you want to do some type of herbal consult outside of your state, you’re not doing it as an acupuncturist, you’re doing it as an individual, which means you have no protection.
You’re not, you don’t have malpractice, something goes wrong, it’s on you. I’d be very careful of that. The key factor here is, I think if you’re going to do this, do it for patients that are here because Maybe they have difficulty coming in. Maybe your first visit is going to take an hour because there’s so much information you’re going to do a long consult with them.
Telemedicine might bridge that, so that way when they come in the office, you can get right to it. And or, maybe they don’t have that much time. What about a patient that goes I can’t get off work until this time, I can’t be there. Okay, let’s do some of it, telemedicine. So here’s what’s changed for 2025.
We have some brand new codes and you’ll see these codes. It’s 9800 through 98007. And what these are for. is telemedicine, but you’ll notice they are E& M codes. You’ll notice it says, Synchronous audio video visit for the evaluation management of a new patient, which requires a medically appropriate history and examination.
Straightforward in nature. That’s literally the same thing as an E& M code, except it says synchronous. So in other words, think of these just like E& M codes. 9 8 0 0 0 will be a 9 9 2 0 2, the next one a 4, 0 5. And so much the same way, and I think the easiest way to see these is it’s going to be based on time.
A 15 minute audio video visit, 9 8 0 0 0. 30 minutes, the 0 1. 45 minutes, 02, 60 minutes, 03. And I do think you want to caution that it’s not always going to be about medical decision making, though it could be, which exams mostly are. But if you’re doing a telemedicine with a patient and it takes an hour because of all the information, is it appropriate to use 98003?
Absolutely it is. So don’t be afraid to use it, but document it the same way. You’re going to document I spent one hour over audio video. Tell me the system you use. Tell me the date and time, but you don’t record it. You don’t have to save it somewhere. And it’s going to be all the information you take.
And it’s going to be the same stuff you would take down if they were sitting in front of you. Their history. And maybe some of the evaluation. Now when I say history, realize that’s going to include past history, family history, review of systems, all that stuff. But can it include some exam things? I think at least some.
Could you do potentially a tongue evaluation over audio video, get it close enough to the tongue? Probably. I’d be worried about color a little bit, depending on the cameras, but I think we’re okay. Could you certainly do a range of motion? I think so. Now, could you do tongue and pulse and body palpation?
No, but I think this visit often is going to be one based on a lot of counseling, a lot of history and information. So these are new patients. And these are established patients. They work the same way, just about time. I think time is the more likely use. Here’s the difficulty. How much has this happened in your practice in the last year?
If you’re saying none, it’s probably going to happen none this year, because I think we have to promulgate this. I would say, let’s say you have a patient, they’ve had a car accident, they’re coming in from a medical referral, and you talk with them and you say, hey, we’re going to have to block an hour. for this.
And the patient, Oh, I don’t have an hour. I don’t have an hour until I can come two weeks from now. I don’t want to wait two weeks. Let’s do an audio video. Let’s start there. Now you may wonder what is the value of these? They’re much like the value of a regular E. N. M. They’re slightly less. And by the way, next month we’ll do a program.
The program I do will be on our views. So we’ll go over that. But I’m gonna tell you, it’s roughly 80 percent of what you would build your normal E. N. M. S. There’s no modifier necessary because there’s no treatment. It’s just this visit and what if a visit where the patient’s calling and just goes, you know what?
I need to discuss with you. I’ve got these issues. This visit could be counseling. These could fit. I would just be mindful. Make sure it’s a plan that covers exams. Here’s one of the problems we’re having for acupuncturists. A lot of the plans that you have joined as a provider, you wind up getting into a contract that says we don’t cover exams.
Now, that doesn’t mean you shouldn’t do them. They’re just saying they bundle it and don’t pay it separately. I know a lot of you know what I’m talking about. That’s an upcoming show as well. Anyway, what my point is that be careful. If they’re not covering an E& M code, they’re not going to cover this.
So it’s got to be a plan that covers an E& M, but I do think this is reasonable in some instances. Realistically though, let’s talk about acupuncture. While I love the availability of this service and the potential to use it, I think there’s a place for it. Is that the way we really want to treat someone?
Is that how we’re going to make them better? Let’s face it, in acupuncture, what you do is hands on. You get in the room, you put in needles, because without needles, you can’t talk me into feeling better. Sorry, give me some advice. But the reality is it’s the acupuncture, it’s what you do, but this can be a bridge.
So focus really on the acupuncture part, but this bridge might work for some, I can tell you major carriers, Anthem, Cigna United Healthcare, they will cover this. Just, again, go back to wait a minute, what does my contract say if I’m part of ASH? Maybe not. Now, there’s also new codes for 2025 for telephone calls.
Now, I say telephone calls, actually, what these are called are synchronous audio visits. Now, the reason I say telephone calls is because I’m old. Young people think, no, I don’t need a phone. You can do it through lots of devices. And so realize, though, it does mean just audio only. Now, these work in the same way as the old phone call codes.
And let me be clear. Remember those old codes for phone calls that you had? 99441 and so on? Those are gone. They don’t exist. But let me be conscientious when it comes to a phone call. Phone calls aren’t very typical. Because phone calls are difficult. A phone call that results in a person coming in for a visit or has been seen within the previous 7 days.
is one that they’re not going to cover. And so make sure we understand that. But they are straightforward. 15 minutes, 30 minutes, 45 minutes, or an hour. Okay? That’s a new patient. We have telephone audio visit here for established patients. You know where this probably works though? You have a patient you’ve treated.
It was two weeks ago. They call you and go, oh my god, it’s killing me. And you spend 30 minutes on the phone and they can’t come for the next month because they’re going to go out of town. That could work. Now notice the scenario I gave because if the result of this phone call is a visit is being appointed, then it becomes part of the visit.
So phone calls aren’t going to be well paid because let’s face it, no one’s going to call. You’re going to go, Oh, just do these acupressure points. I’m not saying you won’t do that. Chances are you want to get them in for a visit. So I point this out because it’s important to know, because you’re going to hear people saying there’s codes changed.
And it’s true, but we have to look at what’s the viability of use for us as providers. Is it really viable? And I would say for most of these, in this sense, probably not. It even applies to this new one, which is called a virtual check in. I had someone the other day as acupuncturist, that’s why I decided to do this.
I want to use this code because the patients are sending me emails. A check in is not an email. A check in is when you have an electronic health record system. That’s protected HIPAA compliant, where the patient logs into their account and then checks in with you with some information that maybe you’re communicating back and forth.
You can tell now, that’s probably not viable. One, I don’t know of a system that’s out there for us that does that. Some medical ones do, but the ones for accus, I don’t see that too often. I’m not saying if you have one that does, great. The problem is going to be, notice it says, provided within the previous seven days or procedure within the next 24 hours.
So in other words, if the result of this is again, treatment. Or, was within seven days of a prior visit? Does not count. So being mindful here, when it comes to use of these, do they really match? Because chances are when someone does a check in or a phone call, what is it going to result in? The person coming in for a visit.
So let’s be careful of being overzealous, but focus in on what we do well. What is the reason that people come to you to receive acupuncture if you could talk them into feeling good? You would have done that already or they wouldn’t need to see you It’s the acupuncture where I think this is helpful is to understand that there can be a bridge Particularly the audio video one that helps the phone call thing or you know The audio only is what I think it helps to get them in the office in that few minutes of counseling though You’re not billing for it directly Indirectly, it’s creating that good patient doctor relationship.
They trust you and you’re giving them solid information. The good news is, your practice continues to thrive. Next month when we go over RVUs, I’m not sure you’re aware, do you know your fees for the first set raised 20%? And that’s where I want to make a focus. So as always, we want to be the place where you get the right information.
The American Acupuncture Council has a very vested interest in all of you. Please make sure you continue to practice well, but I also want to make sure you’re profitable. If you’re not already, go to our website for the network. Take a look there. We’ve got a lot of information to always keep you updated because as always, your success is ours.
Until I see you next time, be well, my friends.
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