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Acupuncture Malpractice Insurance – Do You Have To Pay Them Back?

what happens when an insurance company sends you a letter that says, we paid you money, but oops, we shouldn’t have, and we want it back.

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

Well, Hello there, friends. Welcome in to another show. This is one that I think is going to be important to you and to many, simply because it’s going As you’re aware, I do the network where I help day to day offices with issues, but we do seminars. And one of the big questions I often get, and I’ve gotten a lot this year, in fact, in the last month, is what happens when an insurance company sends you a letter that says, we paid you money, but oops, we shouldn’t have, and we want it back.

Do we have to pay that back? What’s the protocol here? Can they force it? Can they take payment from a future one? Let’s talk about the laws when it relates to that. When an insurance company makes a payment. And then later decides it’s a payment they shouldn’t have made and now is requesting you to pay it back.

Let’s go to the slides. Let’s take a look at what the laws tell us about this. Cause that’s what’s really important is to understand where’s the responsibility. Think of this, you bill an insurance, you verify it and they pay you. And then later they say, oops, we shouldn’t have paid you. The first place we might look is what did the statute of limitations say as far as how they can recoup it?

My goodness, we have a statute of limitations with many insurances that can be as little as 90 days. Often it could be a year and some may be a little longer, but generally a year or less. So if there’s a statute of limitations for them to Make a payment to us, us sending a bill. Is there a statute of limitations for them to force it back?

Let’s take a look at some of the states here. I won’t say I have every state, but this will at least give you an idea. Under federal law, they can do for one year for any reason, just for whatever. And that’s under Fed, so they can force that. But the states are a little bit different.

Look at these first states, Alaska, Hawaii, Idaho, Delaware, they have no statute of limitation. So then what happens in those states? What that will happen is it defaults to the federal statute. I’m going to say it’s going to be. A year. However, look at states like Georgia, 90 days. South Carolina and Texas, 180.

Arizona, California, one year. Notice it only says 12 months. 12 months and one year, a little bit different. I know that seems a little weird, but nonetheless falls in that. What this boils down to, though, is they have a time limit that if they don’t send the request within this time, They can’t force the refund.

So by example, in Georgia, if they send it to you and it’s a year later, you can tell them, go fly a kite because statute of limitation is too old. Much if you send a claim, you’ve all done this. You send a claim a little bit late from the statute, what does the insurance say? Oh, we’re not going to pay.

Kind of like catching an airplane. If you don’t make it by the time it leaves the gate, you’re not getting on. So don’t be afraid to first push back when it comes to just simply statute of limitations. But I want to take it a step further. Because at some point, who’s the responsibility for it? Think of all the work we do to verify insurance.

They say it’s going to be covered. They pay it. And they come back later and say it’s not covered. Let’s take a look at a letter like this. This is under a federal plan. And I think it’s interesting to how this is written. Notice it says here, Dear Billing Department, they’re sending this to us. And it says, in regards to the request for repayment of a claim, the request made to you was voluntary.

Now I want everyone to notice that statement. Now, not often do they say that, but in this case, they’re clearly stating it’s voluntary. So it’s a voluntary overpayment request because you are in Network Provider, you do not have to pay back any overpayment if the overpayment was discovered after 365 days.

Again, this is under the federal plan. So it’s one year. So notice they’re saying, oops, we made this payment and we shouldn’t have, but since it’s over one year, we’re asking nicely, would you go ahead and refund it? My answer? No. Why would I refund it when there’s no requirement? In fact, what they’re saying is We made a mistake.

It’s our mistake, but we want you to pay us back and you chase after your patient to get the money. And I’m gonna say, no, you’re the insurance company. You made a mistake on paying it. You go after your insured. That responsibility is yours, not ours. And again, notice how they put it voluntary because There’s case law that goes with this.

And here’s a letter that goes over the protocols of when an insurance company pays something wrong and they later want to recoup. And now what I want to do here is emphasize really where the case law is. And it goes into this. It says, I would like to bring your attention to these cases. Federated Mutual Insurance Company versus Good Samaritan.

This dates all the way back to 1974, by the way. So none of this is new. Where the court held that an insurance company could not recover the mistaken overpayment. And determine that the insurance company is in the best position to know what policy limits are and must bear the responsibility of their own mistake.

So let’s say, by example, you bill an insurance. They say they have 20 visits for acupuncture. Great. You bill all 20. And then they come back and say, Oops, we made a mistake. It turns out the patient only has 10. They told you it’s 20 and they paid for it. Now they want to come back? No, that’s their mistake.

This is what it’s highlighting. And that goes on here for the City of Hope. Notice this dates back to 1992. It says, Where the court held that in the absence of fraud. A health care provider is not legally obligated to refund payments it receives from an insurer if the insurance subsequently determines the payments were paid in error.

Now again, this is not something you did wrong. You billed it and they just said, oops, there was no coverage. Maybe the person ran out of visits. Maybe the person had limited coverage. Whatever the case may be. Whose responsibility is that? The insurance carrier. So I’m going to suggest do not be afraid to push back and say, based on these two case laws, we shouldn’t refund because it’s your responsibility.

However, what if you’re in network? Here’s where things get tricky. Generally, when you’re in network with a plan, your contract has language in there that says, even if we make a mistake, you have to repay it. That would be true based on the contract, unless The statute of limitations is greater. So notice the federal plan.

Even that one knew after statute of limitations they can’t force it. So the first place to look if you’re in network is to see whether or not it fits the statute of limitations. If it does not, then going to push back on it. But if it does, they’re probably going to force it. You may try sending the letter that I just had here and see what they may respond, but generally they’re going to say no.

In fact, this is what you might find. What if they deduct payment? From a payment? That’s a future payment. Under the contract, they can do that. Now, what if you say, but Sam, they deducted it and it was from another patient? It’s not a HIPAA violation because they’re not sharing information.

They’re just saying, hey, we paid you a hundred dollars before and we shouldn’t have, and we’re going to take the hundred we’re paying you in the future. Again, based on contract. But what if you’re out of network? Do you have to accept that if you’re out of network? If they’ve already deducted the payment.

Obviously, you’re aware of possession is 90 percent of the law. Now it becomes us to push back. I will tell you, I had an office, this is a few years ago now, that an insurance had recouped 6, 000. They pushed back, took to court, they won. They won not only the amount, but some damages, as well as attorney’s fees.

The only problem is it has to be worth it, because what if you’re talking 100? Is it going to be worth you to file what it takes to go against an insurance company? Probably not, but don’t be afraid, and I’m going to suggest always push back, Statute of limitations, number one. Number two, the case law. The insurance company’s in the best position.

Is it our responsibility when we’ve already done everything to make sure that the policy was covered? And what’s the best way to know a verification? Bill and they pay. And if they’ve paid it, And they later come back and say, it’s our mistake. Generally it’s theirs. Do not be afraid to push back on that.

Here’s something to point out. This is an Aetna insurance. And take a look at, this is an important one. It says, our records indicate the overpayment as noted on the enclosed document is not eligible to offset. So you’re either out of network or it’s past statute of limitations. So they’re saying we can’t offset it.

We can’t take it from money. Therefore we must request that you issue a check or money order payable to us for the above amount. So we’re saying will you please be nice? My answer is, no, thank you. Do not be afraid to push back. They’re obviously looking to see if you’re afraid. Many times you get these letters and IDOT offices just flat out ignore it.

Unless they can force it, what are they going to do, take you to court for it? No, they’re just hoping you don’t know the case law. They’re going to take it in the short. So always be available to push back. Don’t be afraid. In fact, get your patient involved. Ultimately, their policy is one that they assumed it was correct when it was paid.

How do they come back later and say no? Don’t be afraid to push back. As always, the American Acupuncture Council Network is there for this type of question and many more. This is what we deal with on a day to day basis. Take a look at our site or come to a seminar. I’d love to see you in the future.

Otherwise, please take care. Wishing you best, my friends.

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Acupuncture Malpractice Insurance – Using Touch and Moxa to Change the Pulses

As that’s pulse diagnosis. Now, with my system, it’s very important that we feel a flow in the pulse. So when we have our fingers on the patient’s pulses, both left and right, we want to be able to feel a flow of sine waves.

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Hi, this is Dr. Martha Lucas, and I am here to talk to you a little bit about pulse diagnosis today. I want to thank the American Acupuncture Council for this opportunity to talk to you to speak with you because if you know me at all or have watched any of my presentations here, you know that I think the most important skill that we have in Chinese medicine is the correct diagnosis.

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And for me, As that’s pulse diagnosis. Now, with my system, it’s very important that we feel a flow in the pulse. So when we have our fingers on the patient’s pulses, both left and right, we want to be able to feel a flow of sine waves. So for example, here, we would want to be able to see a flow of sine waves.

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Going from this way, and then on the left side, we want it to go this way. And as a sine wave is up and down, right? Yang rising to the peak, and then the yin down. And between these, so between our left and right pulses, we will see the sine waves connect in what looks like the infinity symbol.

These connect this way. around and over and up. So we get the infinity symbol from these wrists. Infinity coming over like this. Sine wave. That’s how we know that all of the organ systems are connected. connected and flowing with each other because good health is the flow of energy, the flow of yin and yang from organ system to organ system.

Now, if you’re not paying attention to the flow, let’s say you never heard of that before, things, yin and yang do the tai chi symbol, they flow with each other, but you’ve never thought about that in the pulses. Do what? You take what you think is slippery away, or you take what you think is wiry away, and then you say, Oh, good.

It doesn’t feel wiry anymore. That’s not really a sufficient goal for treatment. Sure, the acupuncture needles did something. They, theoretically, what they did, if it doesn’t feel wiry anymore, was, They opened up the channel to more energy flow, which is always a good thing. Or if you feel like you felt slippery and that went away.

Then again it opened up the channels for flow. I always pick on slippery and wiry because the name of my book is Pulse Diagnosis. One of my books, pulse Diagnosis Beyond Slippery and Wiry, because I feel like in a lot of schools, especially the school I went to. We all knew how to feel slippery and wiry, but there’s so much more than that, and so many depths of pulses than superficial, middle, deep.

We can feel the depth of even pre birth emotional issues in the pulses, so we know that We can feel the person’s whole life from the very beginning to up to the end when yin and yang start to separate, which looks like this, right? The yin is going, the organ systems are getting empty. They can’t hold the energy anymore.

And so that allows the yang to just rise up uncontrollably. So the pulses literally start to separate like this. And it’s interesting that students sometimes in my. Intern courses will bring, I always tell them, bring in their toughest cases. Oftentimes it’s somebody who’s a little bit older, maybe they’ve got some cancer going on, and they’ll say, feel how this person’s 84 years old and feel how strong their pulses are.

And I will point out to them that isn’t a good thing. That’s not a healthy, strong pulse. It’s yin and yang starting to separate like that so that the yang is hitting your fingertips very hard because it doesn’t have any control. Core down there. So there are many beautiful things to learn about the pulses.

These are what has kept me interested in Chinese medicine for 25 years. In fact, I recently took a little trip to the town where my mentor lived and took it. It’s now a barber shop, but I took a picture of the little building and I’m going to write a little newsletter about how that What is now a barbershop was really my beginning in Chinese medicine with my pulse diagnosis mentor Jim Ramholz more than 25 years ago and how that has just kept pulse has kept Chinese medicine alive for me.

So I wanted to tell you a little bit today also about a recent situation where I Balance the pulses, but I did not use acupuncture because, I like to tell people Chinese medicine is a complete system of medicine, right? Acupuncture is just one of the therapies that we use. It’s probably the most well known therapy, the most very much.

well studied in terms of research studies therapy, but it’s not the only therapy we can use when someone comes in and we need to give them some treatment. And you all know Gua Sha, Tui Na, all that, but with this particular case, I used a combination of just touching the person while I had my hand on certain points.

on either the left or the right wrist, depending on what I was trying to change. And some moxa. So just stick moxa. I didn’t use a moxa bong. In this case, I wanted to be able to move the moxa around to different places with my hand on the pulse. And so I use stick moxa. So this person someone I’ve treated for a long time.

She initially came to me many years ago, probably. 20 years ago because she wanted to get pregnant, she ended up adopting a child, but that child is now in college. So I know it was a long time ago and she’s gluten intolerant. So she was, she, I’ll never forget, told me that if she goes to a restaurant and a piece of wheat has touched the plate on which she ate, she would have some sort of a gluten intolerant reaction.

So in her case The diagnosis of gluten intolerance and her experience with it was intermingled with fear, right? And fear we see in a scattered kidney pulse. The kidneys look, I draw them like little dots on the piece of paper, which means there’s no form to it. It’s just, little pieces of energy that are just scattered in and among the kidney position.

So in this case, we had a few things to deal with, but for example, this patient never traveled because she was so afraid of gluten. We, I, she ended up being able to travel. She got I think a scuba diving certificate. So she was able to travel and do that. And her life, she still. She doesn’t eat anything with gluten in it, but you can tell that her life was more robust.

She had less fear, et cetera, et cetera. Of course, adopting a child added a good deal of joy to her life. So I would see her on and off after that. But she recently came in just, she looked, she almost looked like a ragdoll. Her spirit was, Not really even there. I thought she looked a little gray.

She was very thin. She’d lost 15 pounds very quickly. She was just basically an emotional wreck, which is why her spirit looked so dull and just almost not there. She looked, she might have, you might say, like an empty vessel. She had a number of emotional. Her daughter went away to college, but that was about a year and a half ago.

She claimed that it all went well, but she had gotten a divorce prior to that. There was divorce, there was the daughter going away to college, which again, she claimed she was totally well adjusted to, but I have my misgivings about that. But she had most recently had a very Separating interaction with her parents and her sister, and her parents are aging and need some care, and so there was the burden of the guilt of feeling like, oh, I’m going to need to take care of my parents.

And now I’ve broken up with the more or less. Plus, she also had a relationship breakup. And because of all this emotional burden, and, she was not able to eat. So that was where the weight loss came in. Everything she ate, even the things she knew were quote unquote safe to eat, she couldn’t eat, lots of vomiting, and panic attacks.

The day she came to see me was in the afternoon. She told me she’d had five panic attacks that day. So I thought, alright, just looking at her, I, and I’m a good and gentle needler. And she is one of my less is more needle patients. I’m sure we all have some of those where you’re, you take the pulses and you study the, I study the pulses to think, what are the four to six needles I can use with this person that’s actually going to change the pulses back to normal and back to balance.

So she’s one of those. But I just said to myself that day, I’m not going to do any needles. So I said, look, let’s get you up on the table and see what’s happening. One of the things that was happening was that her heart was completely blocked. So the liver came up toward the heart, but there was just a big block there.

No movement in the heart pulse at all, which made sense to me because she had just separated herself from some people. It didn’t really go well. She had a breakup, et cetera, et cetera. So the heart doesn’t want to, feel any of that kind of energy. Remember, all of the organ systems are set up to protect the spirit.

So the I, so I had my hand, that’s the left side, right? The left pulses. So I had one hand there, my pulse taking hand. And all I did was put my right hand over her heart. I didn’t put it on any acupuncture points. I just thought, I’m just going to put my hand here as a comforting, comforting.

Motion and lo and behold, it was just unbelievable, the heart pulse opened up. So I thought, alright, so the heart is feeling, it needs to be open, right? How are, how is this energy going to get over to these kidneys, like I told you in the figure 8, if this isn’t open, if the heart isn’t open, the heart’s small intestine position.

I was very thrilled about that. So I just kept that position for a few minutes, just, letting her calm down, letting her breathe, letting her spirit be open, feeling the liver calm down, feeling it get much more smooth, then the kidneys can come in, right? Because the kidneys want to protect themselves against getting stolen away by perverse liver energy.

So I thought, all right, once I get that open, I went over to her. took her right pulses, right side, because of course, she’s got that gluten intolerance, digestive issues. And so in this particular case, her spleen and stomach pulse was empty. So it went down like this. It was, I draw it like a down arrow. So from childhood, she had issues around nurturing.

And and that ended up as gluten intolerance. So in this case, I kept my pulse taking hand on that, those fingers on that pulse and put my hand just on her abdomen. So I spread it out between REN8 and REN12 because I wanted to get as much of her abdomen as I could. And I let that fill up.

I let that particular, the earth pulse, the spleen stomach pulse start to fill up a little bit. So she had some energy to live, right? That’s our nurturing part of our pulses, the earth. So we needed to build that up so she had some energy for actual living. So I got that going, spent a few minutes with my hand right there and then I went back to the left side, tested out, made sure that the kidney, liver, heart positions were still open and flowing.

So I knew I could get some cross pulse flow going. And then I decided I was going to use some Moxa because I thought let’s get some heat back into the system, rebuild the digestion. I think that’s one of the things Moxa is really good for. And I love doing it over REN8, of course, because then we’re really building up the, her basic core, which I think had been damaged by all of this emotional stuff.

So I did Moxa. There for a few minutes again, constantly checking the pulses to see how they were changing. Then I went down to Kidney 1, excuse me, I did it on Kidney 1. And and just generally around the kidney, Kidney 1, Kidney 2, Kidney 3. Again, I wanted to build that energy up, getting it going.

Forced up through the system because remember in the pulses, the kidneys fund everything. In the, in pulse diagnosis, we know that the kidneys Sorry, the kidneys fund everything. So all the energy to all of the other organ systems is coming from the kidneys. So I knew I needed to get those built back up.

So the getting the heart built up, getting the earth rebuilt is going to start from the kidneys. So I worked on the kidneys. I went back up to the abdomen again, did more moxa around. Ren8, Ren12 to rebuild that up. And then I finished the whole treatment by once again putting my hand on her heart area to get the kidneys and the heart flowing together.

And, oh my goodness, after the treatment, she looked So much brighter. Her spirit was alive again. Of course, she felt better. She felt calm. I was a little nervous about the panic attack part. For one thing, I didn’t want to put needles in, leave her in a room when the patient had just told me that she was possibly gonna have a panic attack.

I felt really good about that treatment. And the reason I wanted to share that story was because it goes to show we don’t always have to do acupuncture. The pulses will respond to other kinds of energy. So use all of your skills. If you’re thinking, Oh, today we don’t want to do any I don’t want to do any needles today.

Always take the pulses. Make notes about what the pulses are doing, draw a pulse picture, and then you will have that to compare with at the end of whatever it is, the treatment that you give. In one of my internships, we just did, I did gua sha and some spinal work on a man that one of the students brought in, who came in super crooked and a lot of pain.

He could barely walk. And at that time, again, I felt like, all right, let’s take his pulses because it’s a pulse diagnosis internship. But we just worked on his body using physical medicine from Chinese medicine, instead of using acupuncture needles. And again, we saw a great change in not only his physicality and pain and ability to walk, but in his pulses.

So I just want to encourage you that no matter what. Whatever therapy you use, your pulse diagnosis is your way to get down to what is the cause of going on with the person and how is your treatment working or not. Because remember, if the pulse doesn’t change, then you need to change your treatment plan because the pulses will always respond when you are on the right track.

with your treatment plan. So that’s just one story that I thought just really struck me as let’s use all of our skills. We don’t have to just use that one therapy acupuncture, but we always have pulse diagnosis as our best. basic line of treatment. It tells us what’s going on with the person and their body gives us that feedback of what worked, what didn’t work.

And then we just keep going until we get those nice sine wave, very smooth, balanced, yang and yin connecting each other. So if it’s Martha, again, this is Martha Lucas. If you would like more information about my courses or my post diagnosis internships, you can go to my website, lucasteachings. com. My private practice site is acupuncturewoman.

com and you can email me with questions at drmlucas at acupuncturewoman. com. I am always happy to help someone become the best doctor Chinese medicine practitioner that you can become. And so once again, I want to thank the American Acupuncture Council for letting me talk with you about pulse diagnosis and good luck in your practice.

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Acupuncture Malpractice Insurance – The Greatest Misconceptions About Facial Acupuncture

I get asked frequently is, what are some of the misconceptions that people have about facial and cosmetic acupuncture.

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Hi, my name’s Michelle Gellis. I am an acupuncture physician. And I teach facial and cosmetic acupuncture classes internationally and have done so for about 20 years now. One of the questions that I get asked frequently is, what are some of the misconceptions that people have about facial and cosmetic acupuncture.

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And the reason why there are so many misconceptions about facial acupuncture is people really don’t understand that it is not just for cosmetic purposes. So today I am going to discuss some of the greatest misconceptions about Facial acupuncture. And I’m going to start out by telling you what is facial acupuncture.

Facial acupuncture can be for used for cosmetic purposes, things like sagging, fine lines, wrinkles. Dyschromia, other signs of aging or dark spots, red spots, things of that nature. And it can also be used for neuromuscular facial conditions such as Bell’s Palsy, Trigeminal Neuralgia, TMJ, Stroke, MS.

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ptosis, myasthenia gravis, and many other conditions that affect the face. So the ways in which facial acupuncture can bring all of this together is by treating the different layers of the face, including the skin and the muscles, the fat, the fascia, even the bones. of the face can be treated with facial acupuncture, facial cupping, facial gua sha, microneedling, red light therapy.

You can use submuscular needling, facial motor points, and even red light therapy. So all of these tools and treatments come together and fall under the big umbrella of facial acupuncture. One of the questions that I frequently get asked is, How long does a treatment take? If you’re going for cosmetic acupuncture, don’t the treatments take a long time?

And the truth of the matter is, the way that I teach and practice facial and cosmetic acupuncture is the needles can go in for in 10 to 15 minutes and then your patient can rest on the table for 30 or 15 to 30 minutes and during that time you can go and see another patient and then you would come back into the room, take the needles out, do your cupping and gua sha and if you were going to incorporate red light therapy, you could do that while the needles were on.

And microneedling is typically not done at the same time that you’re doing facial acupuncture, but that is a separate treatment and microneedling only takes 20 minutes for a full treatment. So the treatments really do not take that long. And because Insurance does not cover cosmetic acupuncture. Your patients will be paying you in cash.

You won’t be putting it through insurance. And you’re going to be charging more for a cosmetic treatment than you would for a medical treatment. If you were just doing a standard acupuncture treatment. So what might a typical facial acupuncture customer or client look like? People also have a misconception that your clients are going to be Perhaps older, perhaps they will be in a certain socio economic bracket in order to afford this out of pocket treatment.

In 20 years of practice, my patients have ranged in age from people in their late teens who came to me for acne through patients who were elderly and were looking for maybe not just cosmetic, but perhaps some sort of neuromuscular facial. Conditions like trigeminal neuralgia are very common in the elderly, as well as ptosis, which is where one eyelid is lower than the other.

Because as we get older, the eyelids get weaker. And by using facial acupuncture, you can help people to avoid eyelid surgery by using facial motor points and submuscular needling to help and some scalp acupuncture to help to lift the lids so that your patient does not have to have a surgical treatment.

Facial acupuncture is also A great alternative to things like Botox and filler. And individuals who normally would be going every three months for some sort of neurotoxin or filler in their face could be coming to you for regular cosmetic or neuroacupuncture treatments to help to rebalance the face and to increase collagen and increase the movement of the muscles in the face.

It can help with things like fascial adhesions, and even repositioning the fat on the face that tends to move as we get older. The fat on the face moves down from our cheeks down. And facial acupuncture is not just limited to the face, it can be beneficial for the neck, for the chest, and one of the things that we don’t think about by treating the back of the neck, it helps to affect the face.

the front of the neck. As society has evolved over the past 20 years, I’ve noticed more and more patients coming younger with neck wrinkles across their neck from looking down at their phone all day. We can use our medicine needles, cupping, gua sha, working on the back of the neck and on the front of the neck to help to affect the appearance of the neck itself.

What can your patients expect when they come to see you? Are they going to look five years younger, 10 years younger, 20 years younger? Does it actually work? Is it actually effective? And The answer is yes, and depending on a variety of factors, including your patient’s age, their lifestyle, their diet.

Are they drinking enough water? How much sleep do they get? What is their nutrition like? Plus, their underlying TCM diagnosis. Are they blood deficient, indeficient, chi deficient? All of these things are going to play into how quickly they see results and What sort of results they are going to see throughout treatment.

A typical course of cosmetic acupuncture treatments is about three months with your patients coming once a week. And again, if your patient is older or just genetically, they’re predisposed to more sagging and wrinkles. If they live someplace where it’s very sunny and they’re out in the sun all the time, maybe they play tennis or golf or bike or garden and they’re out in the sun and they live in a place in the country.

where the UV rays are stronger, then it may take a little longer for them to see the results that they want. But, um, these things are not all set in stone. I’ve been surprised sometimes by older patients who’ve had amazing results. especially with things like lifting their lids or really affecting the appearance of their neck with just a few treatments.

So in addition to the cosmetic and the neuromuscular types of benefits that your patients can see. There are also things like dealing with acne for your younger patients or your maybe your menopausal patients who are having adult acne. It can also help with hair loss. The same way that we might use a seven star hammer on the scalp, we can use microneedling, dermarolling, and even some acupuncture to help with hair loss, both in on the eyebrows.

And on the head hair, beard hair, and also with acne, skin discolorations like dark spots, red spots, melasma, rosacea, different acne scars. Things that affect the skin, in conjunction with doing our TCM diagnosis, you can effectively help with redness on the face and other skin conditions that your patients might have had to have taken medication for.

ChiroSecure, we can help just with redness. Needle treatments. All of my cosmetic and neuromuscular treatments always include full TCM diagnosis and a full body treatment, which can also be very beneficial when you’re talking about treating the face. If you’re doing a full body treatment and you’re affecting the the different organ systems, not only are you going to affect the health of the different organs that show up on the face, for example, if the kidneys are deficient, they might have dark circles under their eyes.

If they are Large intestine isn’t working well, then they can have a lot of congestion in their skin, or if their lungs aren’t working well, then they can have large pores or oily skin. If the stomach has a lot of heat, they can have that. Acne on the face. So by treating the underlying conditions and the organ systems, you can affect the skin.

And also, for example, treating the spleen can help to lift things up if things are sagging down. Treating the kidneys can help with premature aging. And by treating the These different things, not only are you affecting the skin and the coloration of the skin, the texture of the skin, and the The skin’s ability to snap back and look youthful, but you were also affecting the person’s emotional health.

All of the acupuncture points on the face relate to different organs and when you are treating, for example, stomach four, you are helping the person not only on a physical level to be able to smile more fully, but you are also affecting their ability to process joy. And we do Stomach 9 in every treatment to help people feel more welcome.

And if the person’s face is functioning better, then they are going to feel better. And if they feel better, they are going to look better. There was actually a study done. They took patients and they injected Botox into their forehead and they weren’t able to express anger. And by not being able to express anger, all of that the emotion was still there, but it was being pushed down.

So instead of the emotion being able to be expressed, it was being repressed, and you can imagine what that does to your liver. So when you are doing facial acupuncture on someone, you aren’t just affecting their appearance, you’re affecting their emotional health and their physical health at the same time.

There are different pricing structures. That you can use for different things that you might do in your treatment room to treat the face. For example, facial cupping and gua sha can be done in as little as a half an hour. And so you might have one pricing structure for that. Microneedling is, as I mentioned, a very effective treatment for superficial skin level issues and microneedling treatments in the U.

S. right now. Acupuncturists are charging anywhere from 350 to 600 for a half an hour microneedling treatment. It is important to get trained. You don’t want to attempt to practice facial acupuncture without proper training. There are contraindications, things like high blood pressure, migraines, pregnancy and other things that are contraindications and precautions when you are treating the face.

And the American Acupuncture Council has special release form for practitioners who are practicing facial acupuncture. And there is a list of people who do training specifically in facial and cosmetic acupuncture. That is something that I can’t underemphasize or overemphasize how important it is for proper training.

And to practice before you get out there and practice on your patients. Practice on someone who perhaps a colleague or a family member who you have permission to treat because it is a unique skill set. And using precision needling techniques can really work nothing short of miracles on someone’s face.

I hope I have helped to dispel some of the myths that you might have heard or thought about facial and cosmetic acupuncture. And if you are interested in learning more, you can go to my website, facialacupunctureclasses. com And I have free webinars and blog posts and a lot of information about facial and cosmetic acupuncture.

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Acupuncture Malpractice Insurance – Best of Billing and Coding for Acupuncture

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Acupuncture Malpractice Insurance – What Is Medical Necessity?

I’m having insurance carriers that are coming back and pushing back on some providers or they’re requesting additional information. How do we define it?

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Greetings, everyone. This is Sam Collins, the coding and billing expert for acupuncture and the profession meeting American Acupuncture Council and you. I’m getting a lot of questions as being an expert dealing with lots of issues from writing articles. I get people asking all the time. How do we make sure we have medical necessity?

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I’m having insurance carriers that are coming back and pushing back on some providers or they’re requesting additional information. How do we define it? But I want to go beyond just the carrier. What really is acupuncture medical necessity? How is that defined? Let’s go to the slides. Let’s get into that a little bit and start to give you a good understanding of how do you want to start to approach this, or at least begin to define it.

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So you can define your care. What is acupuncture medical necessity, and who says? Of course you can have the patient. The patients are going to determine medical necessity. Whether or not they want it or not is going to be part of the necessity. Does it make them feel better? Who also determines it?

You, the provider, the doctor, if you will. You’re defining it. How do I define it? What is it that the person should feel? What should they be better about? Or what are we doing? Are we just getting rid of pain? And then, of course, we have to deal with it from an insurance standpoint. And how do we meld all of these things together to start to bring to what really is a necessity and how we might define it maybe slightly differently depending on who it is.

From a patient standpoint, think of it this way. A patient’s going to say, it makes me feel better. It has value. If you can have a person that had migraines. And they come to you now and their migraines are 75 percent less or not at all. There’s a value. They’re going to pay you for that. That is something that they see a value proposition for.

Do keep in mind though, people do things, and this is something my mom always defined, that’s why I’m quoting her. She says people buy what they want and beg for what they need. Have you ever had someone borrow money from you before? Maybe they’d pay rent or something. And then they haven’t paid you back, but the next time you see them, they’re wearing a brand new pair of shoes and you’re thinking, wait a minute.

How’d they buy a new pair of shoes? Haven’t paid me. Because they begged for what they needed, which was to pay rent, but they bought what they wanted, what were shoes. I want you to think of, for cash patients, You have to be the shoes. The person wants it because there’s enough value. How do we create the value?

Because they feel better. They can see the change. So realize that even applies and of course applies for insurance or excuse me, for cash, but even insurance to an extent. Remember, some insurances pay really well, but what about the ones that don’t? High deductibles. We have to create that the patient can see the value.

For me, for acupuncture, this is where I think our biggest growth can be. As people try acupuncture, They begin to realize how much it works. Realize that in the VA, while not very many people are seeking out VA benefits, but do you know for people who do get VA, 38 percent are going to acupuncturist. What are the responses?

It’s very good. Why wouldn’t a VA patient want it when they can see it makes them feel better? Because at the end of the day, it’s treating someone to get them to go, oh, there’s the value, there’s no longer fear. So bottom line is a patient finds it, did it help me? And how do we define health? Always by, do I feel better?

Does it have any less pain? And that’s going to be either with insurance or cash. But create that so the patient understands what are the expectations of care. And then of course it’s how you define it as the acupuncture provider. What are you defining it as? As chi or energy, the very more of A traditional medicine basis, or are you going to go just into, hey, let’s talk about it from pain or dysfunction.

In fact, if you have a loss of qi, what is it going to mean? Maybe a loss of energy, but pain, dysfunction, functional change. And so setting up what the expectations are, what are your goals? So if someone comes in with a headache, what’s the goal? No headache, lesser headaches, less intense. Less back pain. I had someone that completely didn’t want to go to an acupuncturist a few weeks ago, an athlete, I recommend it.

I don’t know. I’m afraid of needles. I said, you got to try it. Turns out acupuncture has helped her. And she, in fact, she was able to compete this past weekend and win a medal at the world championships. Bottom line is, Once people try it, they know it helps. Here’s the end of the day. How are we defining that?

I think it’s mostly getting to people so that they can see that the care is helpful. At the end of the day, necessity is, I got to feel better. Acupuncture really is genius and simple. How does the body communicate? When something’s wrong, the body almost always communicates with some level of, I don’t care what, he could be cancer, you’re gonna have pain.

So therefore, acupuncture, I think in its genius, has always focused on that communication. But that communication, we can go beyond to say, it’s not just about pain relief, but long term health. Changes to be healthier. Let’s talk about it from an insurance standpoint. What do they see it as? How do they define it?

Insurance says of course, we know obviously it’s pain. It could be acute, chronic, nausea, vomiting, pretty well covered as well. But it has to be medically necessary, must be delivered toward a defined response. something evidence based, like I can show that the patient is better as a result, meaning they want a continuation of treatment that is contingent upon progression towards defined treatment goals and evidenced by specific significant objective functional improvements.

And again, this goes back to outcome assessments. If you’re not using outcome assessments as an acupuncturist, You’ve got to begin. It’s the easiest way to define your changes. It’s the one most accepted because it’s right there. It’s black and white. The patients start off with a 70 percent disability and after three weeks of care they’re down to a 30%.

Yeah, you’ve made them better. Evidence base is going to be your basis. And it says ongoing services, including monitoring of outcomes of progress with a change in treatment plan, withdrawal of treatment if the patient is not improving or regressing. So in other words, simply put, if the person is not improving, it’s not medically necessary.

There’s got to be a change. Now, you could argue without the care, they would get worse. Here’s what it said. Once the functional status has remained stable for a given condition, without expectation of additional functional improvement, any treatment program designed to maintain optimal health in the absence of symptoms or in chronic conditions without exacerbation of symptoms.

In other words, now it’s maintenance. Now, I’m a believer that And health. When you really think of when we say health insurance, is that what we’re really saying? Are we saying sick insurance? And therein lies the difference. And this may be the bridge of getting a patient to understand, are we going to wait for you to get sick?

Are we just going to keep you healthy in the first place? Why eat healthy food? Why go to the gym? Why they have a better lifestyle? All those things are part of health, but we have to start to find where does insurance fit. And it doesn’t always when it comes to healthcare. And there’s going to be a defining difference of getting the patient to understand, which means we’ve got to really understand it from this standpoint.

What are the expectations? Pain. Decrease it. Make them feel better. The body always responds that way. Now, there’s some things that may not be associated. There are some carriers now that even cover PTSD and anxiety. And maybe they’re not painful, but there’s an outcome of change because there’s improvement.

And I don’t care what you have. If you make a person better, they’re going to have better function. Functional improvement, though, best defined by clinically meaningful improvement on validated disease specific outcomes. If you have a headache, use the headache index. You have PTSD, use that index. Low back, use that index.

There’s all types. If you’re a member of our service, we’ve got them all on our side for you. Here’s the bottom line is, show me how the person is better and what they can do in their life or activities of daily living. Of course, any reduction in pain medication. We are the Society of Drugs. How many times do you watch a TV show that they’re advertising a drug?

They don’t even tell you what it’s for, but just say you better look. What about a decrease there? Let’s keep the person healthy. And then objective measures demonstrating the extent of meaningful improvement. So again, always focus on the patient improving because it says here, additional treatment or as an example to reach further durable improvement or ongoing management.

It’s got to be improvement, not stabilization. And of course, anything that you think is causing the patient to have this recur, it’s going to be improved. is going to be an important part because there is a difference between purely supportive care, meaning I’m keeping them even, or flare ups. Flare up comes, we calm it back down.

Bottom line is medical necessity is defined by, am I making a person better? But who is defining it will determine the payment. A patient will define it easy. You’re making me better out of pain? But once I’m stable, the value’s not there. Where do I fit for insurance? The same way. Your goal. Do what you do well for your patients.

Get them better. Define it in ways that people can see it objectively, and in ways that you can repeat. Ultimately, continue doing that job. The more access people get to acupuncture, the more you’re going to see more people, because realize, once a person goes into acupuncture, it’s oh my god, I didn’t think that was going to work.

That’s really our goal. We’re seeing it in the VA and other places. Your bottom line is, Defining necessity by your methods, by improvement, and melding all of those together. They’re not exclusive, but certainly you’re going to have a lot of patients that may not have coverage. Medical necessity is they feel better.

That’s what you do. I wish you well, my friends, and I’ll say the American Acupuncture Council, our network is always there to help you. In fact, we have an upcoming webinar on VA. You can watch it and view it. I want to make sure that you’re doing as best you can to utilize your business, and as your means of a good lifestyle, but the thing you really like doing is helping patients.

Till I see you again.

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Acupuncture Malpractice Insurance – Spleen and Kidney Channels and Lumbar/Abdominopelvic Dysfunction

And this is part two from a presentation I gave on the stomach channel. So we’ll compare the anatomy of the stomach channel with the spleen and kidney channel.

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Hi, I’m Brian Lau, I’m with AcuSport Education, also with Jingjin Movement Training. We’re going to be looking at the anatomy of the abdominal region of the spleen and kidney channel today. And this is part two from a presentation I gave on the stomach channel. So we’ll compare the anatomy of the stomach channel with the spleen and kidney channel.

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So just a little bit of a heads up I have multiple hats like many of us do. One of my main hats is I’m an anatomist. I lead dissection with AcuSport Education, but also with the University of Tampa. Physician Assistance Program. So I do a lot of exploration in human anatomy. So that’s the lens that we’re going to be looking at as we delve into these Fascial layers of the spleen and kidney channel.

But of course all of that gives a lot of clinical relevance So we’ll talk about it from a clinical perspective also. So let’s go ahead and go to the PowerPoint We’ll start looking at initially the spleen channel. So I have these, Additions to Netter’s Atlas of Human Anatomy. They don’t have the acupuncture points on this.

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Like I put these on manually. Netter is just one of the gold standards of anatomical illustrations, and it’s just such great illustrations that I thought I would add the adapt it by adding, in this case, the spleen channel. And as we know, the spleen channel is on the lateral edge of the rectus abdominis so useful information, but we can talk about the significance of that in just a second.

As we travel down to the lower portion of the spleen channel on the abdomen, we have spleen 12, spleen 13 at the inguinal ligament, spleen 12 also, but it’s on that lateral border of the femoral artery. So this will be our first window into understanding the depth in the fascial layer that makes up the spleen channel.

So keep that one in mind as we go to the next image. So what this next image is showing, also from Netter’s Atlas of Human Anatomy, is the arteries. There’s another image for the veins. They run together, but the vascular structures of the anterior abdominal wall. First of all, notice that this epigastric artery in the vein, like I said, runs together.

directly with it. That’s in a separate illustration for Netter, but that’s fine. You get the general idea that it’s running along here. That branches off of the femoral artery, or excuse me, the iliac artery in that region where it’s connecting with the femoral artery. So it’s branching off of that region of spleen 12.

And where does it go? It goes deep to the rectus abdominis, behind the rectus abdominis, And that’s the territory that it travels. In my mind, this is the Chiang Mai. This is the the vessel that you can palpate on the front. You can often feel a strong pulsation, especially if people don’t have good circulation in the aorta.

More blood shunts through this area. So it’s like a reservoir. It can open up or close up depending on the needs of the body. And it runs and follows the trajectory of the Chiang Mai. It branches into the thoracic artery and vein, which go to the breast, kind of one of the functions of the chong mai.

Sends out branches along the intercostal arteries and veins, and then eventually it branches into cervical arteries too that go up into the face. So That’s the territory that we’re looking at for the spleen channel. We’ll look at another image in a second on that. Also the chong mai follows the kidney channel points.

So again, we’re looking at a fascial layer that lives behind the rectus abdominis. And that’s going to be the deeper yin channel territory of the spleen and kidney channels. So here’s the kidney channel points. The kidney channel points are going to be on the medial edge of the rectus abdominis, pretty close to the linea alba, 0.

5 sun. And it’s going into the rectus abdominis muscle, but my target tissue is not at the rectus abdominis, but that posterior rectus sheath. So when we compare that to the spleen channel on the lateral edge of the rectus abdominis, same thing. It might be into the muscle, but posterior rectus sheath is going to be my target.

So this would be an easier image to look at if we can see a cross section to understand that layer. So here where we were last time, when we looked at the stomach channel is following these fascial layers of the external oblique, a little bit of the bifurcation of the internal oblique fascia going on top of the rectus abdominis.

The needle can get into that anterior rectus sheath, maybe potentially into the muscle. But that’s the territory, that’s the depth, that’s the region that I want to address when I’m treating it. Whereas, if I’m in the spleen channel, or the kidney channel, we’re looking at the internal oblique fascia, transverse abdominis fascia that goes posterior to the rectus abdominis.

So this posterior rectus sheath. So if I’m coming in at the spleen channel at that semi lunar line, I’m into this window of tissue that goes deep to the rectus abdominis. If I’m coming at the medial edge of the kidney channel, again, I want that needle to traverse down to that posterior rectus sheath. So I want to affect this layer here, multiple importances of that, but one very simple one is if I look at this bigger cross section, rectus abdominis.

Spine, erector spinae, quadratus lumborum. Is that fascia layer is continuous with the transverse abdominis and the internal obliques? And that’s going to continue to come into a seam at the thoracolumbar fascia as a structure called the lateral raphe. And that lateral raphe is going to separate into a deeper layer that goes between the quadratus lumborum and rector spinae, and a superficial layer that goes above the rector spinae.

So point is when I’m treating this deeper fascia layer, I’m speaking to, communicating with. The musculature like the quadratus lumborum and rector spinae. So there’s a lot of fossil communication between the front and the back through these abdominal fossil layers.

If I follow that posterior rectus sheath up first of all, let’s go back to the anterior rectus sheath. If I follow the anterior rectus sheath, part of the stomach channel, that’s going to go superficial to the ribcage. So I’m looking up at the diaphragm, there’s the xiphoid process, the stomach channel would go on the anterior surface of the ribcage.

If I’m following that posterior rectus sheath up, that’s going to blend in with the diaphragm. So it’s a different layer, only separated by, an inch and a half, two inches, pretty small distance. But but it makes a big difference internally if I’m going deep to the ribcage, and wrapping around to the back versus going superficial to the ribcage.

So this is my interpretation with the spleen sinew channel. It connects with that ribcage, excuse me, connects with the diaphragm, loops around and attaches to the spine through these attachments of the diaphragm called the cruciate the diaphragm. So when I’m treating this fascia layer, I’m going to have a much bigger impact on breathing much bigger impact on spinal health also.

Kidney channel, the kidney sinew channel doesn’t really travel through the abdomen, so I didn’t use that image, but there’s a lot of discussion with the kidney channel of how it loops into this region of related fascia. Especially with the lower rectus abdominis, it has a lot of connections into the pelvic floor, through the abdominal layers, into the multifidi.

This is the low connecting channel. It talks about that channel coming up that layer. We’re talking about posterior rectus sheath following the kidney channel to a point just below the, um, pericardium. The pericardium sits right on top of the diaphragm. So that’s exactly what it does. It comes to a point right to the, just below the pericardium, and then it loops around into the lumbar spine.

Like I said, a lot of anatomy, you don’t have to get in the weeds with it. But there’s much more of a connection with the diaphragm, much more connection with the pelvic floor, much more of a connection with the lumbar spine when we’re treating that posterior rectus sheath. That’s the take home. So let’s look at some pain patterns that are common when you’re treating the rectus abdominis.

We looked at this one with the stomach channel also because you could get trigger point formation in the belly of the muscle or at stomach 25 and this tendinous inscription between bundles of muscle. But very frequently. When there’s dysfunction here, it’s more on the edge of the muscle at that semilunar line, maybe a little bit of the obliques, maybe a little bit of the rectus abdominis fascia.

It’s like a triad between the muscle groups of the obliques, rectus abdominis, and that fascial seam where all of that fascia comes together. That can be a very prominent area for trigger point formation that can give a very gassy, distended feeling when you palpate it. Maybe that’s what patients are complaining about.

They often want to stretch that area sometimes that can refer all around to the back it can refer deep into the pelvis, it can feel like it’s internal in the pelvis. It’s a pretty broad distribution of pain that patients might either complain about or might be a component of their low back pain, for instance.

Or distention, bloating, et cetera. So along the spleen channel is the very frequent aspect of where these trigger points form. Anywhere from spleen 15 to about level of stomach 27 is pretty common. So you’re feeling at that semilunar line, feeling for fibrosity. I usually push a little into the edge of the rectus abdominis.

Another region where there’s common trigger point formation would be the medial edge. Now we’re at the kidney channel. So if I’m at that medial edge, it’s like I can scoop deep to the muscle and, I’m palpating slightly into the rectus abdominis, but I’m really feeling more for that posterior rectus sheath.

It’s like I’m going through that medial edge to get to the posterior rectus sheath. I can direct into the rectus abdominis itself, or I can direct into the linea alba along the REN channel. And same thing, a lot of pain, especially below the belly button umbilicus, maybe halfway between the pubis and the umbilicus is a common region.

It’s not going to always be exact. But along that kidney distribution is a very common area of trigger point formation for deep abdominal pain, especially abdominal pain that’s related to menstrual pain, dysmenorrhea. So for those patients who are having very difficult sensations during menstruation, this is a key area to look at.

You also have this paramedis muscle, which attaches to the linealba. That’s going to be at the lower kind of kidney 11 region that you’d have access to that. That can give a certain amount of pain in that abdominal area that can spread up to the umbilicus. The lower portions. We talked about this one of the stomach channel could be at the lateral edge along the stomach channel because this muscle narrows quite a bit as it gets to the pubic bone.

There’s not a whole lot of space on the muscle left here at the pubic bone, but really often it’s in that mid belly just off the linea alba. That’s where you frequently get this deep radiation bilaterally into the lumbar spine. And iliac crest region that can be its own pain pattern driving lumbar pain, but it might also be a component of things like lumbar facet pain.

Very important area to palpate, usually just above the pubic bone. Sometimes you even have to press the muscle into the pressing it into the pubic bone to elicit this sensation. But it’s a common area where there’s trigger point formation that could be a big component of lumbar pain that you wouldn’t necessarily think if you didn’t know the referral patterns.

Obviously you’d be palpating in the iliac crest, gluteal muscle, sacral area, lumbar spine. There might also be trigger point formation there because of its communication front to back. But don’t forget about this area. Alright, just a good netter image to see that. Spleen channel runs along the lateral edge, stomach channel runs in the middle, but as I get lower down, that line of the stomach channel really takes me to the lateral edge of the rectus abdominis.

If I move over a little bit to the kidney channel, that’s frequently where I’m going to find that trigger point formation right up against the pubic bone. Whoops.

I’m going to go back to this muscle. The other kidney channel points will take me through that medial edge so I can get to the rectus abdominis and feel into that posterior rectus sheath, spleen channel points. Again, I can through that lateral edge of the muscle at that union where it’s going to then dive deep underneath the rectus abdominis.

So any aspect that I’m needling through kidney and spleen, my tendency is to think into that posterior rectus sheath, which is slightly deeper than the muscle. So last time we looked at the motility of the stomach organ. This is looking at the kidney organ because movement in this area, if we can free the movement and control the abdominal movement we can get that flexion extension.

The kidney organ itself moves along the psoas. As I take a deep breath in, that drives the kidney down, it creates a certain amount of rotation in the kidney also, and the exhale and the diaphragm rises, the kidneys rise with it. There’s a movement from diaphragmatic breathing that if I can open that up by working on the the channels, increased breathing, that can be helpful, but it can also allow me to get a more more, efficient movement that can help mobilize the kidney organs, which is going to have good impact on the kidneys themselves, but also with lumbar pain and abdominal type situations that could be involved with the channels.

All right. So let’s look at a exercise that I do and I teach quite frequently. It’s called the spinal wave. I have a video for it. I can talk through some key points. This will be on the PowerPoint. Let me get to that slide. And this is on my YouTube channel, JingJinMovementTraining, if you want a reference, I also go into more verbal instruction on it.

But this one doesn’t have any narration, but I’ll narrate over it. Spinal wave is engaging the rectus abdominus. lengthening it. Engaging, ribcage comes closer to the pubic bone, so posterior tilt, neutral to anterior tilt, posterior tilt, anterior tilt. Same time, that ribcage drops, so this is a different variation where I bring that wave up to the whole spine.

And chest opens, but same spinal wave.

And this video shows variations with the arms and sending that energy out the arms, but whether you get that aspect of the patients, that initial one with the hands on is really the key starting position for patients, there’s a rotational version, et cetera. So you can build on it. Like I said, there’s this instruction is on my YouTube channel if you want to look at it a little bit closer.

All right, so maybe I have a few moments to go over that in my studio. I’m going to exit the PowerPoint and let’s back up and we’ll look at that real quickly.

All right, so let’s look at the spinal wave. I often, when I’m working with patients, I have them put a hand, and I do it myself this way too, put a hand on the lower rib cage and put a hand just below the umbilicus. So lower dantian. The hands aren’t doing anything. The hands are just helping me find that movement in the abdominals.

So the idea is I want to initiate that movement by pulling the pelvis up in the pubic bones. I’ll take me into a posterior tilt. Ribcage descends. Expand. Press. Expand. So I’m using the abdominals to drive spinal motion, drive kidney motion. Inhale, fill that area up. Exhale, compress starting from the pubic bone, rib cage follows.

Inhale, exhale. So you can also start this seated with patients, because very frequently patients are stiff with the spine, or yourself if you’re doing it for your own health. Sometimes they just want to do it with the knees, so they just move the knees or they move the hips or something like that.

But they have to engage the center. So pulling up the pubic bone, down the rib cage. Top hand shifts back, expand. Bottom hand shifts back, top hand shifts forward. Press, expand. Press, expand. So it takes control, takes practice, you’re engaging the front, expanding the front. You actually engage the transverse abdominis quite a bit, this one.

That’s why I like this one for the kidney and spleen channels as you’re starting to engage. Those deeper abdominal areas, exercising, massaging, increasing circulation between the front. Very nice. Thanks for checking this webinar out. Also, thank you to American Acupuncture Council, I always appreciate the opportunity to go over this information.

A lot of fun for me very exciting stuff in my mind hope you enjoyed it, and I will see you guys another time.