Research continues to support acupuncture for relieving pain and enhancing the healing process.
The National Institutes of Health (NIH) found acupuncture for pain relief has the most evidence, especially for some chronic conditions like osteoarthritis and lower back pain, as well as tension headaches.
A review of 11 clinical trials also suggests acupuncture may help with symptoms associated with cancer treatment.
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!
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.
Disclaimer: The following is an actual transcript. We do our best to make sure the transcript is as accurate as possible, however, it may contain spelling or grammatical errors. Due to the unique language of acupuncture, there will be errors, so we suggest you watch the video while reading the transcript.
Hey, greetings 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.
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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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.
Not an American Acupuncture Council member? Get a Quick Quote and find out how much you will save! Click here!
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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