Tag Archives: Sam Collins

Acupuncture Medical Necessity and Preauthorization– Made Easy

What I want to focus on is the medical necessity of acupuncture. How do we define it? What is it? And then how that leads to pre-authorization as I’m sure many of you have noted acupuncture has become very well covered by lots of plans.

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

Hi, everyone. Welcome to another edition of the American Acupuncture Council malpractice, To The Point, getting your practice better, making your practice improve on many facets. My job as always is to talk about the acupuncture and getting paid for it. How do we create that business model? Today’s edition.

And of course there are five states with acupuncture. That’s mandatory, but many plans now are covering acupuncture, but let’s even go beyond that. What about a cash? I want to focus on a little bit on both of those in the sense of let’s talk about what is necessity, how do we define it? And then how do we use that to get pre-authorizations?

One of the things I deal with quite a bit, and being an expert on coding, billing, documentation and collection is, Hey, how do I get them to approve more care? Particularly if you do the VA. Premera or Ash, any of these types of plans. So let’s go to the slides of room. Let’s talk about the medical necessity of acupuncture and pre-authorization as always, there’s our website and there is my email as well.

Let’s talk about what is medical necessity of acupuncture? How do we define it? And I think you really have to look at it in two ways. It’s really the same, but two different ways you have the patient and you have the third-party meaning. If someone else is paying for it, if you’re paying for something you want to make sure there was service was provided and it was needed.

So from a patient standpoint, let’s think what does a patient need for medical necessity? I come to you. I don’t feel good. I’m in pain. What am I looking for to reduce my. So medical necessity for a patient is, does it work? Does it accomplish why went to which is an always pain management? Obviously acupuncture can treat more than just pain, but you get my point.

Let’s keep it simplistic on the pain level. Did it improve it? Let’s face it does pain medication. It does. You, if you take enough Vicodin or, something more S more significant what it reduced the pain. Sure. But then what is the outcome you’re asleep?

You don’t feel the pain cause your body’s knocked out. So does that really improve anything? So from a patient standpoint, they’re not just looking for pain, Redux. But improvement of their life improvement of their activities of daily living. And so from that standpoint things, but medical necessity for a patient is either they’re getting better or they’re not, if they’re not getting better, what did they do?

They stopped coming simple as that. When we deal with it from a third party, meaning someone else’s. Let’s say a parent is paying for a child. If it’s not working there to stop having them come well, insurance works the same way they want to make sure is the patient getting better. And I think this is where agriculturists often have a hard time.

Acupuncture works very well, as you all know, but I will go back to, did you demonstrate it that’s really going to be an important factor. How did you document that the patient got better is a statement. Like I feel better, really adequate. Think of it like a person. If you put someone on a diet and they go, oh my God, I feel better.

I have more energy. Those are good things, but what’s the purpose of the diet for the. Is to lose weight. So we need evidence of weight, loss, or evidence of reduction of pain. So let’s take a look at how does insurance define this, and this is an Anthem policy, their newest guideline notice just from this year.

And this was their typical acupuncture guideline. Now, with this, it gets a bit confused when it talks about medical necessity and mostly it gets into the types of things that they allow you to treat nausea, vomiting, chronic pain, and so forth. But I want to highlight this. It says the individual being treated continues to experience one or more of the conditions listed above and the requesting physician documents ongoing benefit from the use of acupuncture.

So what is going to be the. Or reduction of these how do we demonstrate it? Is it going to be enough to say I feel better? And I’m going to say probably not let’s take a look at like Aetna, here’s the epic policy when it comes to acupuncture and it talks about the types of things they’re expecting.

And the main thing they’re expecting is this, the plan of care should be ongoing, updated as a matter of hours, condition changes, meaning we have to have evidence of change and are considered medically necessary. Only if there’s a reasonable expectation. That acupuncture will achieve measurable improvement.

This is where I think we have difficulty. A statement of, I feel better is not really measured. So we have to somehow try to attempt to quantify that. And it says, of course the patient should be evaluated regularly. The bottom line is treatment goals and subsequent documentation should result in that.

There’s an achievement of a change. What if we’re saying a pain reduction, we have to stay to such by how even a numerical pain scale while not perfect, at least give some evidence of that. But I’m going to say to you that’s not enough when it comes to pre authorizing care. If you’re dealing with a premier Ash, a statement of reduction of pain is good, but they want a little more evidence.

So let’s take a look at what they all say. Maintenance treatment is where the member symptoms are. Neither regressing or improvement is considered not medically necessary. So keep in mind a lot of times you’ll say the patient’s not getting worse. And while I don’t disagree with that, they’re going to question well, if they didn’t get.

They not get worse. So we have to be able to have some ability to prove it. So this says here, if no clinical benefits is appreciated after four weeks, then treatments should be reconsidered. In other words, they’re not expecting the patient to be better overnight, but some measurable change will even Cigna gets in the mix here.

It talks about it’s protocol. What I’m showing you here is from each carrier. So that way it’s not just Sam getting opinion, but what did they stay that. They say standardized tests and measures a functional outcome measures. And it says measuring outcomes is an important component of acupuncturist.

Practice. Outcome measures are important in direct management of individual patient care and for the opportunity to provide the profession and collectively comparing their results to others. How do we know ours is better? We compare it. So here’s what it says. Second paragraph, the use of standardized tests and measures early in an episode of care, establishes a baseline of status for the patient.

Providing a means to quantify change in the patient’s home. Outcome measures along with other standardized tests and measures used throughout the episode. In other words, we’ve got to measure things. So be careful of, I feel better. That’s good. But when they say they feel better, I want you to measure it simply this way.

When you say your pain is bad, give me a couple of things that you can’t do or have difficulty doing because of the pain. And then as it improves, How have those change. So you want to start to think of, I want to use tools to make this easy and what I want to point out, this is quite easy. I would even say an acupuncturist could have mediocre documentation so long as you’ve documented the aspects of the care that was delivered, the time the services.

And ultimately the outcome, the biggest thing is what is the outcome of the patient? So I like to take ever, of course, behind the scenes for United Anthem and a lots of policies, including Optum. And here’s what they say. One thing is you should use a pain scale. Don’t just tell me their pain is hurting.

Give me a level, the only problem with the pain scale. How do we really measure what is the difference between a seven and a five? So what I believe, and it may be even a better tool. So take a look of what it talks about here, about functional measures, and you’ll notice a common theme, documentation of a patient’s level of function as an important aspect of patient care.

The documentation is required in order to establish medical necessity of ongoing acupuncture treatment. It says the patient specific functional scale of the PSF. Is a patient reported outcome that is easily and appropriate for acupuncturists to demonstrate the care. So keeping it simple, don’t think it has to be very hard, but keep simple things of a patient’s telling me not so much how much it hurts, but how pain affects function.

In fact, I’m going to give you a tool today that you’ll be able to take away from this presentation. So what this is all pointing to is that medical necessity comes down to data-driven. Tracking changes and restrictions of activities that they live, not just paying. Cause if pain was the only measurement, heck we might as well take pain medication, but pain medication, of course, all the other side effects.

And the fact that there’s no increase in function, it means it’s not quality care. So we want quality care that not only reduces pain, but increases function. And that’s frankly, what you do think of how many times all of you have had this miracle in your office. A patient comes to you. They’re basically.

And they’re saying I’ve been to a Cairo, I’ve been to medicine, I’ve tried this, that physical fit. They tried everything and they figured what the heck I’ll let acupuncture give it a shot. They come in and after a visitor too, they’re like, oh my God, I can’t believe it. Think of the. Of that.

I bet some of you became an acupuncturist because that happened to you. What we have to do is deliver that in a way that not just that the patient sees it, but that we’ve documented them, seeing it, think of it. Have you ever been to a medical doctor? And I don’t say this as a negative, but that’s not the way they treat.

If you ever went in and you left going, God, I feel so much better. My headache is gone. That’s not the way they treat. They prescribe the send out of their information. You have the power of someone can come in with a headache and literally leave. Was it before. That’s the powerful. That’s a value that patients want.

We have to make sure did we demonstrate it. So I want you to thinking along the lines of something we call Promus, this is the new term you’re used to outcome assessments, but this term promo stands for patient reported outcome measurement instruments. And you’re familiar with many of these Oswestry, the low back one neck general pain index.

I want to show you some examples to implement some easy ones to don’t make your life too complicated, because frankly, as much as I like this is the one for the Oswestry for local. That’s 10 questions. That’s a lot of information. Will your patients really adequately fill this out accurately? Every time you do it, to make sure you really have got a valid assessment.

And I’m going to say in many instances, no, if you’re going to use this one, I would make it part of the history or exam that you ask the questions because your patient may not remember what they said last time. And how many times have you had a patient tell you they feel better? But yet their pain scale, they note it was higher.

You’re going to go wait, that doesn’t match because they don’t remember. So this is good, but is it sometimes not as valid because patients just simply don’t fill it out accurately. So I’m going to recommend something simpler. This is called the general pain index. I particularly liked this one because it covers almost any condition.

I don’t care if they have headaches, abdominal pain or knee pain, because what this does is it focuses not on how much it hurts, but more about the function. So notice each question. Family and home responsibilities, recreation, social employment, and so on are focused on not how much it hurts, but your ability to function.

If you have good function, it’s a zero. If your function is reduced, it could be, completely it’s a 10. So the higher, the number of them when the patient scores this, the worse off they are. So we do this at the beginning. Maybe they score 30 points. After two weeks of care, you do this again. Now they dropped down 10 or 15 points.

It’s clear evidence. Objective. Of how the patient has changed, not about how I feel, but the function part of it. You correlate that of course, with other objective findings. How about this one? This is something new called the pain interference, and this is something the VA is really pushing and you’re going to notice, we’ll see them.

That’s pretty much the general pain index, except it’s just not as detailed notice. There’s only five ways to report this one, as opposed to the tenants. Where it’s interfere with day activities from a little bit too very much. It’s still good. I just don’t like it as much because it’s not as quantified, but this is when you could do weekly.

I prefer something with numbers, frankly, because it’s a little bit easier to score, but this is a good tool as well, because this is the evidence of the change. If someone’s losing weight, when you put them on a diet, how do you prove it to I’m on scale, then the next time you use these scales. So think of it when you’re going to make a request for services.

We have to have something we can provide to show that the patient’s gotten better. So I’ve taken this from the VA’s requirement for increasing or for requesting additional care. And it says what they’re looking for, a significant durable pain intensity. By functional improvement by clinically meaningful improvement on validated disease-specific outcome instruments.

Oh my goodness. Where have we heard of this? Do you see the consistency here? And of course, if there is any reduction of pain related meds as well, but it says here, objective measures demonstrating the extent of meaningful clinical improvement today. And the rationale for treatment requesting care is what they need.

Show me that the patient, Hey, they’ve improved 20% after two weeks of care and it’s been considered. Why wouldn’t we continue that care until they’ve reached a point of plateauing where there’s not any improvement, realize that so long as the patient’s improving, there’s a reason to continue care when the patient plateaus at a certain point, obviously that’s when we put them on a maintenance, stylish means not covered by insurance, but at least something where the patient can know the value of it.

And notice it also indicates including any barriers to recovery. So you want to think along the lines of, do I have information that someone reading it could go, oh yes, this is what. A statement of, I feel better. Isn’t that valid. So let’s take a look at a medical necessity when it comes to American specialty health.

This is the one that probably can be some of the strictest. What things do they rely on diagnosis? Of course, past history. Those things obviously creates the Verity, but comorbid factors, but notice what they look for, findings things that you can objectify range of motion, palpatory, tenderness, orthopedic testing, neurologic testing.

I’m not saying you have to do all of these already. But you have something that you have to have objective, even if you’re doing tongue and pulse. Tell me what’s better. Give me a way to show on paper. If you will, how the patient is better in a measured. So functional limitations is something they rely on as well.

In fact, if you’re used to the pre-treatment authorization forms and that includes Ash Evercore, Premera, they all refer to these. So I’m just going to say, make your life easy, begin to use the simpler outcome assessments. And I would suggest initial visit and probably every two weeks, but no greater than once a month, understanding that the whole goal is to reduce pain, but more so increased function.

So I’d like for all of you to think for a moment, how am I going to make this happen? We can be a good source for the American acupuncture council of course, is your malpractice carrier, but we also help you with these types of issues for any of you that have our outcome or our our AQI code.

We have all of these forms on there. Take a look, do this QR code. Certainly you can come to our site, take a look at our information. What I want to make sure is that, do you have the right tools and places to go? We’re always going to be a resource for you. I’m going to say to you, if you have any. Where are you going to go?

Don’t Google it. Come to the experts at the American Acupuncture Council. Thank you for everyone. I’ll see you. Next time. .

Cash or Insurance Learn What Works

What do I do to get better? What do I do to get more people?

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Hi everyone. This is Sam Collins, your coding and billing expert for acupuncture, not only the acupuncture profession, but of course the American Acupuncture Council and the Network as well. Welcome you to another edition. And today we’re going to discuss. How do you grow a practice? What are we doing? And what’s going on out there.

And I get this question quite a bit from teaching so many seminars over the years in dealing with so many acupuncturists, one of the common questions are, how do I grow? What do I do to get better? What do I do to get more people? And so I want to address that really from both ends of the patients, you’ll get, whether it’s going to be a cash practice and insurance practice.

Com combination of both. It’s going to be a matter of how do you attract the patients that you’re looking for. And let’s give you some ideas and some things to chew on and think about to see how your practice is going to change. Because one thing I will say is you always have to be willing to admit.

And to make changes. If you think of it, when you first started practice, you probably don’t treat this the same way you did when you first left school or five years ago or 10 years ago, if it’s been a long time and that’s because you learn and grow, it’s one of the reasons we have continued education.

And in fact, I would say, it’s why we call it a practice. And not a perfect, so let’s go to the slides. Let’s talk about what we want to do to grow our practice if you will. So here you go. We just look at how we change from that little bud to something that moves a little bit more. Let’s talk first on what do we consider success?

And this is something I think sometimes is going to be defined differently by different people. And where I have a concern is often too many people try to define what someone else should do, as opposed to just define on your own. So I would say define your own practice success for some of you. It could be, I need to make a million dollars for others.

I just want to help patients. And obviously I think everyone wants to do a little bit of both. I’m not sure I want a million dollar practice. That’s probably a million headaches, but think of how are you going to define what you’re doing? What does a successful. I would say it’s a combination of certainly there has to be a monetary success.

You have to stay open, but at the same token, the satisfaction, this is the part that I’m not sure patients always know what we do or how we do it and the results of care. And I want you to think of it in these terms. How often has you have someone that’s coming to your office? Not feeling good and literally left feeling better.

When does that ever happen? Outside of an acupuncture practice, frankly. Has anyone ever went to a medical doctor with a headache and left with it better? And I’m not saying that as a negative towards the medicine, but that’s not how they treat. So I want to think of what we have to define it, but then if we’re defining it, what are the barriers?

What are the things preventing us from really moving forward and doing a little bit more? How are we getting more people are not getting more people, where’s it going to come from? What things are we looking for? Is it a matter of changing styles and techniques to get better results? So start thinking of what are some of the barriers I’ve set up internally, meaning among yourself, but also among the patients.

I think for patients, you always have to think of how they value our service. And I think this is going to be the number one way to think of it is that people value a service. And when they value. They’ll get it. They’ll pay for it. If they don’t value it, they won’t. So we’ve got to set up that value and think of what is that barrier will barrier as often.

So we have to think of if I’m going to grow a practice and money’s the barrier, how do I change that? How do I make it work? So think along the lines of what is the model I have, like currently, what is your model? Have you really set forward a business plan. It’s something that you set for and say, here’s what I want to do this year.

And literally write down some ideas because until you write it down and then really follow through, it’s going to be too esoteric. So I think it starts with people in. So you’ve got to think of first off the barrier is people just knowing what we do, why we do. So I want to ask you, what does acupuncture do once you think of what you think it does, but I also want to think along the lines of what does the average person understand about acupuncture?

What is defined what’s out in the field that lets them know what we do, what message have we gotten and what message has the profession or others set up for us? I know a lot of what we have to deal with this kind of. Healthcare in the U S is very medical oriented, obviously. And it seems that people like to line up for pills and surgery, but when it comes to making changes in their life, having a better lifestyle to stay healthy, they want to be lied to, it’s okay. In other words, it’s interesting when people think of insurance, we often use the term health insurance, but I would ask you, is it really, is it actually health insurance, or is it sick? In other words, we have a model that we say health care, but is it really, I get there’s some preventative things.

We do cancer screenings and so on, but really is there anything to set up a person to be healthy? So that’s one way to think of there’s a portion of people that are understanding that no, I need to stay healthy and not get sick. So what role are we there and how do people know that they can even access with access that with us?

But I want you to think along these lines here, there’s an interesting meme. Someone had sent to me and I think it fits. How do you think people view acupuncture? Here’s one where it shows what your friends think. Think of, particularly for many of you who went later in life to become an acupuncturist, some of your friends are like, what.

And then of course your mom thinks you’re driving a big needle into someone. Of course that’s not the case. And then let’s face it. This Western medicine have a downside to acupuncture, to an extent. Yes, I will certainly say that’s not as bad as it was, but I’m not going to say there are proponent per se there, we’re not throwing money down the toilet, but that’s often what they’ll say.

What we think we’re doing is so much bigger than that, but let’s take it. There were two realities. What people still do take medications. Don’t do well. Face it, the VA has a problem with suicides and deaths because of the way that. But what do we really do think of this? A patient often feels when they come for acupuncture, but do people know that?

So what is our message? What information is out there? We’re, here’s two examples. The Mayo clinic and Cleveland clinic, this is something they have on their website about what acupuncture does. And though there’s some similarities there’s differences between the two, which you can see here, chemotherapy induced, nausea, dental, pain, fibromyalgia headaches, labor pain, low back pain, neck pain, osteoarthritis.

And so on, on that side. But notice here it says differently. And stroke cramps, sports injuries, cancer, and cancer treatment for side effects, face pain. I think of Justin Bieber recently had that issue. I hope he’s going to an acupuncturist, immune problems, infertility irritable bowel. So this is a pretty broad scope of things that acupuncture does, but yet, how does the average person know this?

Now? I just searched this at their website. So if you think of it, when someone’s searching for what acupuncture. This is going to be the first things that popped up. And I did that because I wanted to see what does come up. So we want to start to think of, if people are seeing this, how are we communicating the message or do we want to communicate a different message?

Here’s something interesting from the company, Kaiser Permanente, a big health insurer and the doctor all in one, it’s an HMO and this is from their head acupuncturist at the Kaiser. And it says, what does acupuncture treatment says in China? Acupuncture is used to treat. It’s not thought of as alternative medicine, which is very true for most people.

It’s a common part of their medical care in China. Acupuncture is often used as complimentary treatment for all types of health conditions. And that’s one of the things that through my work with Maryland and Ellen and others at WHS. The world is beginning to recognize that acupuncture is way more than just pain relief.

We know that acupuncture speeds recovery. I would suggest every person w having any care post-surgery should have acupuncture. However, again, are people aware of it and have they had a chance to try it. And I think this is going to be our issue. So when we talk about growing your practice, we have to attract people that know that what we can do can help.

By example, we leave it up to the other companies. I just showed you what comes up on the Mayo clinic. So if you typed in, what does acupuncture do? The number one is going to come from those areas, but you’ll notice this here companies like United health care use acupuncture as a medic. To advertise people to buy their product.

So do you think that they’re using acupuncture as a tool for people they are, which means there’s access? What if someone says what do you mean? I get acupuncture visits with zero copay. I think I want to go in now realize that this is a plan that I’m not going to say it pays a lot of money, but it pays it above a hundred dollars a visit.

So certainly something that might be viable for some, for others, they may say, Nope, I want to do all cash. What my point is. If a patient comes in with this and you are not available to it, they going to go and, or can you sell them an alternative? Look at this particular company for a Medicare advantage plan, literally they’re talking about acupuncture, but showing it.

So I’m seeing a lot more people now becoming a little bit more attuned to say, Hey, maybe I want to try it because we’re seeing it out there more. I want to start to change the narrative and attract people to what I do by example, here’s the company Evercore. Now, sir. 20 years ago, would insurance coverage was different, but Evercore, which manages a lot of plans, you’ll notice here, the things that talks about adjunct cancer care and mental health.

Now mental health is more than PTSD and anxiety, but even anorexia bulemia. Let’s face it a little bit of everything, including menopause. So we’ve got to start to realize that there’s a message out there. Are we directing that message? What is our message? What is your message? If you’re growing your practice, if someone’s going to find you, how are they finding.

Why are they going to come to you? What is the messages like if someone were to look you up on your website or your blog page or anything like that, what would they know? What if they drove by your office? Would they know anything about what you do and the why I should come? And I will tell you, we’ve got to set up that people have to have not so much a need, and I’m not saying there isn’t a need, but a want, and this is something that my mom taught me early on.

She said, people will buy what they want. And big for what they need. And this is part of the reason I think acupuncturists can do very well with cash. Partly because insurance is traditionally not covered as well. So therefore we’ve not relied on it. In fact, the American physical therapy association noted that if patients have a $30 copay, they won’t go into Acupac or go to a PT, or at least a third of them, they don’t find that same thing for Acura.

And I think because we set that message of someone wants the care. It doesn’t just feel like I need it. And we’ve not realized. So in other words, we have to set up and create a value. So if you’re going to grow, you have to grow by expanding some way either you are going to see more people or less people, more visits one way or the other, which means there’s some out of value set up.

So you’re going to think of, as someone drove by your office, What would be the message. Here’s a couple of examples of offices that put up things like, what did they treat? Think of how often someone might have something like fibromyalgia and they’ve never heard that acupuncture can help it. So why would they think you can help it?

What about Bell’s palsy or weight control? We have to set the narrative because think of when someone passes by, they see acupuncture, I don’t even think about it. I’m going to suggest we want to start creating that. Outside your office. What do you do? Do you do fertility? If so, let people know because why would someone come to you if you don’t, they don’t know what you do because you don’t tell them.

In addition to that, I want to think of, what about does your website say about you? Here’s an interesting, I just did a quick search to. Acupuncture and insurance coverage and acupuncture treatment. And this is one of the things that popped up. And I thought this was interesting. What types of health insurance covered?

I, this is actually someone’s website. I didn’t put their information at the top, but notice they’re indicating if someone says, Hey, I have this particular plan. I know what it can do. Aetna banner blue, cross blue shield plans that they take, if you’re going to, except some, I would certainly let people know.

Cause if someone has, But you don’t list it. Why would they come in now? Good news. Do you have to accept insurance? No. In fact, even have to bill insurance. No, that’s a courtesy. My suggestion is always to have a diversified practice. And what I mean by that is diversified in this way. I’m going to take people who can pay for my service, what I prefer, all cash.

You bet I would. But what about the people who have insurance? Would I turn them away now? Certainly if I have a plan that doesn’t pay very well, not too many. But plans that do, I certainly would want to be part of that or at least accept them. Keep in mind if there’s an insurance, you don’t want to build don’t bill.

When you do want to build, you would, but if you’re accepting any, does anyone know? Think of it. What if someone says, Hey, I have Aetna and they were looking for a provider. Would your name pop up? Remember if you don’t have a search engine that does it, it’s going to be a problem. Here’s one that as another website that I did, and those are the things that.

Bell’s palsy, difficult diseases, natural pregnancies, skin conditions, pediatric and geriatric care, migraine headaches, severe and chronic pain. What are they sending that message towards? Who are they trying to attract? Why are people will come into that office? What about veterans? If any of your treating the VA I would ask you, does anyone know that you treat it and in other words, think about it.

When someone sees you, what do they know about. The message we get and sometimes that message we’re letting someone else determine it. So I want you to think of a model situation. You are a business. So think of the show shark tank a little bit. If you were to take your business model onto the show shark tank with someone invest.

Now, I’m not saying in reality, but the idea is that a solid business model. So you’ve got to think of businesses. How do businesses change and grow or close by example, the company series. Was the biggest retailer in fact, had a complete catalog and shipped everything. What did Sears not do? They didn’t adapt.

I think of it. Amazon took their idea. What if someone at serious said, Hey, wait a minute. This company is, we’re going to go back to that. We already have a catalog. Why didn’t they do that? Because I felt there were too big. And so they wouldn’t integrate, they wouldn’t adapt. So what happened to Sears? But it’s interesting when you take other stores, take the store target.

I find that interesting from a business standpoint, if you go into target, you’ll notice when you first walk in there’s a little 99 cents store items in that place. They, they got three, four hours, not a lot, but what is that doing? It’s attracting the nine instance. ’cause people like that stuff.

Why not offer a little bit of it? So think of in your practice, do you offer a diversified way for people to come in there? Is it one way or the highway? I’ll give an example. I have a very good health insurance. I literally have no deductible. I pretty much have no copays. That sounds crazy, but let me have you understand something for that plan.

It costs me and again, you’re going to think. I’m kidding. Okay. About $3,000 a month just under that. So when I say I have no doubt. What does that really mean? Yeah, I don’t, but I’m paying $36,000 for no deductible. So the reality is it’s expensive. So does everyone have that type of policy? No. So if I walked in, I would certainly say, you’d go, yeah, I’m going to take your policy because it’s a really good one, but not everyone’s is, and that’s something you have to learn that there’s nothing wrong with cherry picking.

You can say, oh, I’ll accept this plan, but won’t accept that one. We do the same with any patient. So think about what is your diversification here? Have you seen modern acupuncture? That’s very. That’s an all cash. How do they make that work? Part of how they do it is they make their visits very inexpensive.

So you have to learn how to make volume work. Now, the difficulty is that we can’t have multiple fees for the same service. Now, if you were in a completely cash practice, you can set your fees anywhere you want. But as soon as you bill insurance, now we have to have a balance because you can’t appreciate the ability to insurance patient more than a cash patient, makes sense.

Same price. Now, keep in mind though, this model does work well. It’s a very popular one. Now, how does it work though? People don’t buy a single visit? You can, but it costs a hundred dollars. If you buy packages of visits, it changes to as little as 60 or maybe 40 or even $20 a visit. It’s just a matter of making sure we have done it right now.

I’m going to say to you, is there any reason you couldn’t offer that in your office? In other words, you’re like targeting you offer that cause are there going to be patients interested in it? I have a couple of practices that their whole practice is based on prepaid. Liberal. The in fact, they don’t do anything but prepays.

And she says that they sell about 25 to 30 every month. Her cheapest one is about 600, most expensive, about 5,000. No kidding. Now she will tell you she doesn’t sell that many of the 5,000, maybe one or two a month. Still not bad. The idea being though she set that up. Now the difficulty with that though, was this, when you have that type of practice, if the economy.

Is low. Does that start to dry up? So I’m going to suggest yes, but why do it? And I offer both, in other words, I will take some good insurance, but I’m not taking all of it. And I would prefer to do more cash, get people interested in health care. Remember insurance only covers so much. What about your true health care?

So you want to think along the lines of what about doing that, but here’s the part I want you to see? What does someone see? How is your office viewed? What do they know that you do? What do they know that your costs. How do you come across on a personal level? When people see you, do they see someone professional?

Do they see someone when they meet oh, this is the person I want to go to. This is a person that gave me some writing formation. What is the community around you think? How are you in the city or the community you’re in? How are you viewed? We set that narrative. What is your web presence? What if someone were to search acupuncture to treat whatever and your city, would your name pop up?

Here’s something I’ll guarantee you the American acupuncture council, the network, our education division. If you were to type in acupuncture seminars, guess who’s going to pop up first. We do. We do it by design. It’s not by happenstance. We make sure we put out a lot of information too, about how to run your practice.

And it’s not about all insurance. But that way, people know that you need continuing education in heck we teach a heck of a seminar that deals with just cash. But again, will you show up? What if someone says, man, I have migraines. Have you ever written anything up about it? Is there any information they might find?

Is there any blogs or any written video? Because you remember for a search engine is going to look for people who have put. If you’ve not put any information, you’re not going to come up. So start to think of where do we show up? Remember the old days of a yellow pages. No one does that anymore. So how did they find you?

What are we creating for referrals within our own patients? Is there any newsletters you send? Let’s go old school, send them out via email or even mailing. What do people know? I have an office that what they do is they work with. And every time they sold one of those welcome packets they’re included in there.

Cause I know I get some periodically in my neighborhood and it’s always a dentist or two chiropractor, a few medical doctors, but have you ever thought, Ooh, is that a way for you to go in? Hey, I’m looking for an acupuncturist and then think about what about groups that you might work with? Have you ever thought of any civic groups that might need someone to come do a lecture now?

I’m not saying that’s going to be as prominent now that’s probably coming back, but start to think of how am I adding. Have I worked with any sports teams and I’m talking not professional, but what about being the person for a high school team that helps deal with pain? I’ll give an example. The I coach high school kids.

And one of the things they know is if coach Collins is talking to him about treatment, I’m always wanting them to get acupuncture because I have found a person with acupuncture gets well faster, simple as that. And once they see it work, it becomes a thing. And quite frankly, I coach at the most prominent sports high school in the U S and everyone knows what’s going to happen when you’re one of my athletes.

My goal though is that, do people know that you do that? So where are your patients? There’s lots of patients. Everybody’s account. Technically even some insurance. So start to think of how am I getting my cash? Am I advertising? If you are all cash, how are you using that to your advantage? Is it on your site that your price is cheaper, it’s more affordable or is that the right?

We don’t want to go. We want to talk about the quality of care. Here’s one thing I’m always concerned with is cheaper. Always better. I don’t think so. I’ve never picked a doctor because it’s cheap. No. Now, I’m not saying there isn’t times that many of us do, but I want to think along those lines, but realize there are things you can do.

What about a prompt payment? What about a pre-pay and then of course all the different types of insurance. Now, what you’ll see here as well, there’s nine different ways of insurance. I will point out not all of these are good. And I think this is where people go wrong. You are going to have a practice that’s diverse and accept the things that are welcome to you.

And the ones that aren’t the medical doctor I go to, which is very rare. He doesn’t take PPO and HMO insurance. If you don’t have a plan like I do, he doesn’t accept you. You can pay. But if you’re going to use insurance, he doesn’t accept those lesser ones. Now his practice is busy cause he’s built that you’ve got to be able to stick with it.

Know what you’re looking for? What are the patients looking for? Cause here’s what it comes down to. If your practice is going to grow it’s about patients, it’s about how do we attract them? Start to think of what have I done to attract patients and then start tracking, do things and see, Hey, did that work?

Did it help? Did you create something where you tried to create a referral based within your own. Maybe something you let them know, Hey, have your patients come in or have your friend come in, we’ll give them a free consult. Things of that nature. Does it work? Does it not work? If you do a cash discount, you do a group on, does it work?

Here’s what I’ll say, deliver what you do best, which is to make people feel better and your good care. But we’ve got to make sure people will know that we do that. And are we setting that narrative? If you’re not looking to grow. And even grow a little, you’re going to shrink, which means you won’t be around.

Here’s one of my concerns and this sounds awful, but it’s true. Approximately half of the people who graduated from acupuncture school within five years, no longer practice. And I think that’s mostly from bad management of the business. And I think partly because this is something that’s the hard thing to deal with it and know it doesn’t work.

You can make anything work. If you stick with it, there are practices that do all cash and do very well. I’ll tell you what though, by a tee, they all have really good communication skills. They also generally are in higher than average areas of income and have built that in. But if your practice is about in that type of area, maybe a bit difficult, maybe you want to be a little bit diversified.

I said, deliver what you do best. This is what I want people to feel when they go to an acupuncturist, how do they feel after? And sometimes that’s going to be your best way. Do you have anything on your site that gives patient testimonials about, I can’t believe it. That’s usually going to be the best way to commute.

I help a lot of people, everyday acupuncture offices deal with problems from billing and coding, to collecting, dealing with cash and all those things. And some of the best ways I can communicate is just simply give examples of offices I’ve helped and how we’ve helped them. And that’s how you continue for the rest.

So I’m going to say, go out and start to think if you’re not thinking of growth, if you’re not implementing it. And there’s several ways to go. There’s not only one. We’re here to help you. The American acupuncture council is always going to be your resource. We have a network service where I become part of your office.

Call me, email me. We deal with everything on a day-to-day basis, no limits. And it’s not about insurance. It’s about everything can include insurance. We are a resource go to our. Take a look, we have a lot of free things out there along obviously with these types of programs. But what I will say to all of you is think in your own practice, what am I doing to make my practice better, to make my self better?

I think we’re always doing that, but how do we communicate it? So I’m going to say thanks for the time everyone in next week is going to be Chen Yen. So again, go out, be successful. Hope to see you at a future seminar. Take care, everybody.

Acupuncture Reimbursement Beyond Neuromuscular Pain

…can I get reimbursed for codes beyond pain?

Click here to download the transcript.

Hi everyone. This is Sam Collins, your coding and billing expert for acupuncture, the American Acupuncture Council. And of course, just the profession. Welcome to another episode to always help you get your practice uplifted, make sure you’re getting paid for what you do, because that’s what I do. We try to make sure that you get your claims paid, can get paid for your services.

One of the questions that I get quite a bit, is, can I get reimbursed for codes beyond pain? Now, of course, I’ve been teaching acupuncture seminars now for some 26 years, and so we often get people saying what’s now what was then truthfully, if you went back to a seminar I did in the nineties or early two thousands, there were very little reimbursement beyond simply pain that has changed quite a bit.

We still have to understand, that it’s not quite as open as we would like, but much more so it’s good to know what will get paid and can I get paid beyond pain? So let’s go to the slides. Let’s take a look at what’s occurring here. What’s going on with insurance and reimbursements for acupuncture now as always, here’s my email.

Here’s our website as well, but let’s focus in on acupuncture covering. When insurance has to pay, what do they pay for? And I think this is often where people get off track. The assumption is, oh, they pay for everything. Not quite. And there can be nuances that some will pay for more than others. In fact, there’s one that honestly will pay for everything, which I’ll give you a demonstration of.

One of the things we have to think of is how do people foresee or what do they see when they think of acupuncture? Think of it. Ask your friends, ask an acquaintance. What do you think? I. What do we treat in acupuncture? And I think you’ll invariably give you it’s pain and have an ignorance toward, and it’s part of our.

I think to make sure they understand we do more than that. So by example, I’m showing two offices this year that have some signs up near their office or in their office that talks about the things they treat. Notice this one on the left talks about fatigue, stress, anxiety, depression. And in fact, they don’t get down to anything towards pain until the very end, because how many times people have these types of conditions and think, oh, they don’t associate it that way.

Is there coverage for it? I think partly is making sure people know that acupuncture can treat. And more importantly, or maybe not more importantly, but just as a. Can I get my insurance to pay for it. Look at this other one, they talk about pain first, but then brings in things like anxiety, depression, Bell’s palsy.

Heck I think a Justin Bieber, if you’re familiar with his condition probably should be getting some help from an acupuncturist. So it’s really understanding what do plans cover. Can it be more than just pain? Cause that’s what. Obviously, many of you are aware of the American specialty health model, which I will call the musculoskeletal model or an often I’ll think of it as the physical therapy chiropractic model in that what they cover things like headaches, hip, or knee pain associated with arthritis or extremity pain with arthritis or other mechanical irritation, meaning strains and sprains, or just pain syndromes of the joints and soft tissues back and neck pain.

So you can see here for the most. It’s mostly just pain. A little bit to Nazi with pregnancy, but notice nothing here about abdominal pain or how about anxiety, depression, or anything else beyond that generally? No. Now the good news is pain is often what you’re going to have with any condition, how it manifests itself, but this can be fairly limiting and for many plans can be.

So by example, is there something I can do more than. And not all carriers are the same. There are going to be differences between each of these. And I’m going to demonstrate some of the differences that you’ll see among these to start to give you an idea of it. I’m going to recommend this is why you want to get more continued education with programs like ours, to really get the full breadth of what can be covered and the nuances from state to state region.

So by example, here’s the newest Aetna protocol. And as you’re probably aware all Aetna policies that are now from their commercial line have to cover acupuncture, but you’ll notice here it’s still pretty limited. It’s limited because it says it covers neck pain and headaches, low back pain, nausea, arthritis, chemotherapy-induced nausea and TMJ disorders.

That’s good. This is a pretty nice. Only pain, but it is when you look at these other than the arthritis, so this one could be pretty limited. The good news is Aetna will tell you what codes they cover. So here’s their list, everything from migraines, all the way down to postoperative pain to the teeth.

So pretty limited. Now the thing that this list says though, is that it’s not all inclusive. So the difficulty is you get a list like this and you think, okay, great. This is what I know they’re going to cover. You build these, they pay it, but are there other things that I can do. That they may pay. What we have found is generally other joint pain, but I’ve had a few offices believe it or not with.

That have been covered for anxiety, depression, with the code M 48.1, certainly something you could venture into and just say, if I’m treating that, is it a possibility? Many of them are working concurrently with some type of medical provider treating it as well, but you can dip your toe. What I can say is this one though is pretty straightforward.

This is what they’re doing. Without question, as you can see. That’s pretty much pain Sam. What about Cigna now? Cigna, this is their newest coverage and they cover a lot of things. You’ll notice here in the bullets that says tension types, headaches, migraines, musculoskeletal joint, nausea, post-surgical pain and chemotherapy induced nausea.

So you’ll notice it again is still along the pain. Now this list from Cigna though is vast. If you tell me any joint with a stranger. Or any type of pain to a joint, they’re going to cover it. Myalgia, fibromyalgia. You bet pretty ubiquitous, but again, is it beyond pain? Not really. Not until you get into companies like this particular one.

This is the company Evercore. And to give you the background, Evercore is behind the scenes for most of the products that are sold under Anthem, meaning blue cross blue shield. United health care. And of course, Optum and you’ll notice right off the bat, what they cover are pretty much pain codes. You’ll see.

Okay. The neck, the back musculoskeletal, cervical cranial lumbal sacral pain. But then you’ll notice that the very end of the list, it says internal medical conditions, and this is something that’s remarkable and has been around now for about three years. Take a look at what things. Adjunct cancer care.

Now I want to be careful. They’re not saying they cover to treat cancer, but they’re paying you to treat the symptoms associated, the nausea, the vomiting, the other conditions associated with it. Notice also the mental health conditions. These are things like PTSD. Believe it or not anorexia bulemia but also depression, anxiety.

I would suggest, always be working with probably concurrently, but at the same token, this is something they’re not saying no to notice allergic rhinitis, adjunct post-stroke dry eye syndrome, constipation prostititus pain, asthma irritable bowel. Of course the vomiting you’ll stupid. Look at the very last one medical.

And this particular one, they’re not covering menopause just to say what are we treating you? Don’t you’re actually treating insomnia. And hot flashes. So there’s really been a great growth here. Now I’m going to recommend, again, probably to dig in a little bit more. This is what we do, and that are more advanced or navigating the insurance seminars.

But you can see here while this is a little beyond, I particularly really hope some of the offices that when I first taught seminars, always taught to say, Hey, let’s talk about the code you get paid for. And they said, we didn’t do an internal medicine. I said we didn’t because it’s not paid. Now you can see here.

This is beginning to get paid. Now this company again, I did Anthem’s Optum’s are going to be more or less. In addition. What about another company like health partners? I know a lot of you in the Midwest area will see this one and they do have a pretty good amount of coverage for all the musculoskeletal things as you’ll see here.

But it goes beyond that. Look at section V here, PMs or menstrual disorders. In fact, they give a list of codes and you’ll notice here things like interstitial cystitis, Macedonia, menstrual disorders, vomiting, but take a look at the last. Weakness fatigue, malaise. There’s a lot of change that’s occurring that there’s going to be more so it begins, start asking, will this plan cover and don’t be afraid to ask, does it cover fatigue?

Does it cover abdominal pain? Will it cover prostititus pain, things of that nature to know, because not often as much as I’m showing you this list, does every insurance company produce a little. Not always. So we want dig a little bit further to say what’s covered and I would suggest start keeping a list.

That’s one of the things we emphasize in our program to know the codes that are covered or not covered that way. You have the best idea of making sure you get the best benefit. One thing we want to be clear with the patient, what’s going to be covered. Don’t be fooled. Don’t let your patient before. If you’re not sure something is covered, don’t be afraid to say we will bill your insurance.

And we hope they cover, but we’re never going to guarantee that’s the downside. People want to make people or patients believe everything’s going to be covered. You’re going to give, we’re going to bill your insurance confidently with the condition you have. Will your insurance absolutely cover. We can’t guarantee it until once we build now, here’s the beauty of this start collecting this data.

Does this insurance pay this particular diagnosis? Keep in mind. Most of you don’t use a lot of diagnosis and that’s okay because you see a lot of the same things, but begin to learn which ones are or are not covered. Notice this one here. If someone just comes in and says, I feel tired, health partners is going to cover it, but take a look.

This is one of my latest VA. For the VA take a look at this. This is just this may and notice what it is. Provisional diagnosis, tobacco use to help console the patient there. Now the VA is authorizing for some people to go, let’s try acupuncture to help with this addiction. Notice it says to assist with smoking cessation.

So have we changed? Is there more access to what you do? Yeah, because it’s beginning to be recognized. It’s one of the reasons we’re moving towards ICD 11 is to make sure that we can better account for all the things that acupuncture can do. My hope is we move to something like this. One, take a look for any of you that are in Massachusetts.

You have the Mecca of coverage, blue cross blue shield of Massachusetts. Now covers is in way that most aren’t even aware of. I want to see every state do this. Acupuncture benefits for 12 visits per year, for any reason. So this particular plan is saying, I don’t care what you have. We’re going to cover you for 12 visits.

In other words, an acupuncturist can be an acupuncturist, treat what you’re seeing, not to try to fit into some other guidelines. Notice here, all the things they’re talking about, dental pain, addictions, headaches, menstrual tennis, elbow, fibromyalgia. Now some of that is painted up, but notice digestive, emotional ear, nose, and throat.

Gynecological issues, literally anything. My hope is that we continue to move forward this way, because part of the best way for acupuncturists to get coverage is to collect data among what we treat. So imagine someone with let’s look neurological that has Parkinson’s disease, and we start to collect data that wow, people who have Parkinson’s that get acupuncture have resulted better from.

Do you think that might be something that will be more useful for the patient, but also for the insurance, remember acupuncture is always going to be the more economical choice. And so the movement forward is acupuncture. Can’t be hidden. It works and it works with. So as a consequence, better coverage. So I want to start to say to you, get out and look nowhere you can go.

That’s why we offer this service called the network, get an expert, which means me on your staff. Just hold your phone up to that. QR code will bring you right to the site so you can dig into this. Our Accu code has this list as well. We want to make sure you have the best information. Or no one it’s not going to be paid.

The American acupuncture council is your ally and your resource. Our group is the network. You can go to our site, take a look. Obviously many of you are insured with us as well, but at the same token, we want to be a resource that you can be helped to make sure that your practice continues to thrive and grow.

And that’s going to be about access to your. So I’m going to say to all of you, thanks for that time. Next week house will be Jeffrey Grossman, as always, I’ll say to you, it’s good to be important, more important to be good, be that person to your patient, make sure they can get access to care. The number one problem with acupuncture is people not understanding what you do and gaining access and gain their trust.

Let them try it. They’re going to get better. See you next time.

Cupping – Coding, Billing and Reimbursement

how do I code for cupping? Can I get paid? What is the proper code? Let’s really get into that.

Click here to download the transcript.

Hi everyone. This is Sam Collins, your coding and billing expert for acupuncture and the American Acupuncture Council Network. With our other episode on always looking to continue to grow your practice, to give yourself more opportunity, to see people and help people. And as always, I’m going to give you tips on coding and billing and really practice management.

This is a great time to be an acupuncturist, but how do we make sure we’re getting from gaining full advantage to get access to patients and the services we provide? So what I’d like to do with you today is to talk about coding and billing specifically for cupping. This is one that I get this question a lot is that seminar producer, as well as doing our network services, where people call them with questions.

One of the questions I get is, Hey Sam, how do I code for cupping? Can I get paid? What is the proper code? Let’s really get into that. So let’s go to the slides. Let’s take a look. What’s going on with. And how do we do it? What’s the coding and billing. Please note, there is our website. This is the network, not the insurance company, ACM phone network.

Remember we always have updates and news for you there. So what are we looking for? What do we need to do? What is. A cupping as well. Let’s define that cupping as a therapy at ancient form of therapy, where a therapist puts special cups on your skin or a patient skin to create suction.

That suction is to help with circulation, for pain, inflammation, blood flow, and so forth. And of course has become very popular. You’re seeing it all over. Let’s talk about, we know what it’s good for it. How do we use it? But can we get paid for it? Let’s talk about cutting more to define it more clearly.

What I’ve been able to research is that there’s about 10 different types of cupping, and I’m sure some of you might say, oh no, I think there’s five. This is just what I was able to research. And it shows you can have things that they call weaker, like cupping medium or. Moving cupping. I see that commonly needle cupping using moxa or needles with it empty or flash cupping, full bleeding, cupping.

You got to remember that. Is it within your scope for your state, but I’ve seen it used with herbs water and realize the cups can be made of several substances. I generally see some type of glass. I seen some very heavy plastic metals I’ve even heard. I’ve never seen it. I’ve even heard of bamboo.

And that kind of makes sense. What we want to focus on. How do we bill for it? Is there a CPT code that we can use that says it? The first thing we have to remember is whenever you select a code, and this is something that you must always do, you must select a code that accurately describes the service.

Not has to accurately do not be creative. Don’t select a code because it’s like it, like my example, if you were to use. Would you be able to code that as acupuncture? Just because you put seeds on a point, doesn’t make it acupuncture because it’s not needle. So it can’t be it’s gotta be all the way.

So don’t be creative with what you describe, do not select the code that climate is close. Always has to be exact. And within that. If there’s no code for it, there is a code, always. There’s a code called the unlisted code and it can be a modality or a procedure. So whenever you have any service and we’re talking cupping today that doesn’t have a code, that’s going to be the more likely code to use, but let’s take a look at is their way of coding.

It’s I’m going to show you something. I deal with a lot, which is dealing with audits. Many of you are insured with American acupuncture council. And remember if you’re audited who’s there. Remember, if you have American acupuncture council of malpractice, they’re going to help you with audits depending on your policy, anywhere from 30,000 to $50,000 a defense.

And this was one of the cases we had here was an office that had issues with coding. And you’ll take a look. I highlighted in blue. So here it says on 52 claim lines, manual therapy was identified as. In the medical records and reporting of the code 9 71, 4 0 is not appropriate using for the Madame for the modality to indicate as cupping.

So I want to make clear, some people will say Sam, I’m putting the cups on manually and I’m moving them around. So it makes it manual therapy. Nope. That would not make it manual therapy. It’s. And though you’re doing it manually, it doesn’t make it manual therapy. So again, be very careful and you hear a lot of people say, oh, sure.

When I use a cup, Nope, that would not be correct. And I want to make sure you can see this. This is directly from. And again, very clear that it’s not to be used for it. So is there a code for cupping? So if you start thinking of all the codes, infrared heat. Okay. Hot packs, electric stem.

You’ll notice there is no code for cupping. So we want to talk about how to do it. And frankly, let’s be clear. Is it really even a covered service? And I think that’s what I want to focus more on. How do you get. And to get paid for it by insurance. That’s what we have to have a code, but is it a covered service?

Take a look here. This is the VA and I’m sure you’re all familiar with VA claims. The VA is one insurance that will indeed pay for cupping 100%. You’ll notice here and I highlighted it where they indicate the services that can be provided along with your acupuncture. And clearly. Cupping, along with other things, but cupping is there.

So a lot of people look at the codes that are allowed under the VA. And I’ll give you the list here. Here’s the codes that the VA pays for an acupuncturist. Notice it was updated for this year. And you’ll notice that code. I put the blue arrows it’s 9, 7 0 1 6. Now I would say in theory, I think the VA is saying you could use that code.

I don’t think it’s quite correct, but let’s talk about. Should you use it? 9, 7 0 1 6 indicates something that’s called a Vasos nomadic device. And the indication for it is to reduction of a deem after acute injury lymphedema and the use of a pop. So I want to highlight you see this little, long kind of blood pressure cuff goes over the area.

That’s what a visa nomadic devices. It’s a large pressure device that goes over an extremity or part of the body that gets pumped. To prevent a DEMA post-surgical maybe prevent blood clots. It might have vibration to promote circulation and deal with lymphedema. Now I’ve had some people argue that well, could a cup be listed under that?

I would say I can see the argument, but I think this goes against the rule. It has to either fit it or not. I don’t think this would fit it. So I don’t think this is the best choice. And I also don’t think it’s the best choice, because if you use it, I will say the VA will pay it. But the VA Medicare rate is 12 to 1400.

It has a relative value of 0.35, which means it’s about 25% of the value of acupuncture. So again, not a very expensive code, 12 bucks now that’s better than zero, but is that potentially the best code? So remember an application modality, one area Vaser pneumatic says devices that provide external pumping forces to soft tissues to the lower and upper extremities.

And I would say trunk as well. So you would say with cupping, could it fit that definition? I could see you dovetailing it, but I still will stay. It is not the best. Cupping is very popular. You’re seeing it amongst sports and athletes and my goodness, the rock has even had it. And I love what he does because he has moons of followers that if he’s getting cut, the more people are likely to try.

Do I see even the person’s left, had a lot of cups place it’s really popular. It really has efficacy. I’m seeing a lot of additional practitioners from chiropractors to physical therapists that are doing it. So how do we. I mentioned the visa nomadic device. And I said visa, nomadic. I think you can argue it for the VA.

I would never use it outside the VA, but for the VA you could. But I think from a monetary point of view, you’re losing money because it doesn’t pay as well. Using 9 7 0 1 6 will literally get you paid less than 50% of what you would be paid. Otherwise when you use what’s called the unlisted modality code.

Now I want to go back for a second and I’ll go back here and show you. You’ll notice those codes are like, 9 7 0 3 9 and 9 7 1 1 3 9. So you can see they’re all on the list for the VA. In addition tonight 7 0 1 6, but those codes do not have a Medicare value, which means when there’s no value purported by Medicare, they pay at usual and customers.

So what I’m saying to you is simply. If you’re billing, even the VA for cupping, what is the best code to use? It’s going to be the enlist of modality. Whether you want to say it’s unattended or attended. Now here’s the difference. 9 7 0 3 9 says unlisted, modality and modality in this way means something.

You apply to a patient, but you don’t have to be there. Like I know when I’ve had cupping, they placed the. And they leave them there for a bit. I would say that’s an unattended, probably appropriate code, but I’ve also had cupping where the provider is constantly in attendance adjusting and moving them a bit.

That’s going to be more of a procedure or hands-on. So the more hands-on and that you’re spending time with the patient 9 7 1 3 9 would be the better choice if it’s completely unattended 9 7 0 3 9. The difference, just to give an example, if you bill 9 7 0 1 6. They’ll pay a 12 to $14 bill 9 7 1 3 9. I’m going to say payment is going to be between 30 and 45, depending on your area.

So would you rather get paid 10 or 30 or 40? I would opt with the higher one. So how do we code this though, to make sure they know what’s coming says it says unlisted procedure, which means it could be for anything. So you have to indicate cupping on the 15th. Actually, it’s not hard. You’ve all seen a 1500 for here’s an example.

Notice on this line item, it says 9 7 1 3 9. And then in the pink shaded section, right above it, you simply indicate that tells the insurance it’s cupping. Oh, by the way, what if you’re doing moxibustion how would you do that? Actually the same way you would just indicate moxibustion whether it’s fully active.

Or one that it’s unattended. My point here is that coding for cupping, the best code for you would be the unlisted code and indicated this cupping, the VA will cover it. They will pay for cupping. It’s part of the authorization. They will pay it under 9 7, 0 1 6, but at a third of the price. So I think it’s better to use this one.

Now, what about regular? Do regular plans generally cover cupping. The unfortunate answer is no, I’m not finding any type of consistent payment here and there I’ve seen it, but not enough for me to really say yes, it’s covering out. The more likely places to be covered would be personal injury more than likely.

But outside of that, if you go to, gosh, the Cigna, Aetna, the blues general, they’re going to come back and say, it’s experimental investigation, which doesn’t it. From your standpoint, it’s not effective, but you know how insurance companies are without a double-blind study. We’re not going to cover, explain to the patient.

This cupping services is going to be integral to you getting better. We’re going to apply it. This is why, and what we’re doing. And here is the cost. If you show the value and the patient sees the value, they will pay for it and it will be covered. So don’t be afraid to pass it on because if you’re not willing to pass it onto the patient, why bill and insurance, if you’re going to give it away, So I would say, yes, I don’t want to bill for it.

It takes time. It takes effort and it is effective. Quite frankly, I’ve seen some really good responses with muscle injuries that I’ve never seen with other types of modalities. Now we’ll hacky puncture too, but that cupping is really been something I’ve noticed because of the amount of use I’ve seen has really made things work better for patients.

So make it available. Billing wise, what’s the best. Unlisted therapeutic procedure or modality, identify it as cupping and then simply put your price. And when we’re talking just simply price, you’re far better to bill cupping under the unlisted code to the VA. Cause it’s a little bit worth three times the money.

So keep it simple. You know how everybody makes insurance billing hard. You just have to understand the parameters. And that’s what our program with you is to do and realize I do articles and acupuncture today, and this one date back to 2010 and actually talks about it and why I wanted to bring it up today.

That this question though, a lot recently, and it’s because it’s become popular because of the VA. Here’s the thing. You can have me as your. Don’t be afraid to reach out to the network service, because from that I become part of your team where you can call, email me, fax me. However you want to get ahold of me to help you with coding and billing, and frankly get paid my goal to make you better.

I’m your doctor of billing to make your office work better. So go to our side, take a look. I would suggest take a moment to go to our Facebook page AAC. Give us a like there and we always update and put news out. We’re always going to be a resource. The American acupuncture council of course, is your malpractice resource, but will your billing and coding and business to resources as there’s our site, there’s our phone number.

Please reach out to us. Don’t be afraid. My email was at the front end as well. What I’ll say to you all is thank you for the time and next episode, we’re going to have Poney Chiang and again, always go out and be successful. But remember, the success is more about being. Which means being good to your patients, be that person.

And I’ll see you next time. Everyone take care. So what I’d like to do with you today is to talk about coding and billing specifically for cupping. This is one that I get this question a lot is that seminar producer, as well as doing our network services, where people call them with questions.

One of the questions I get is, Hey Sam, how do I code for cupping? Can I get paid? What is the proper code? Let’s really get into that.

Limits to Acupuncture Sets Per Visit

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Hi everyone. This is Sam Collins, your coding and billing expert for acupuncture and the American Acupuncture Council. With another episode to always make sure that you’re on point and making sure your practice is continuing to thrive and to grow our role with the American Acupuncture Council and my service, the network is to always help.

Be the best it can be in implementing the care for your patients and ultimately being paid. One of the things that comes up and I’ve had this question quite a bit from members is there some sort of limit to the amount of acupuncture I may provide someone and that’s a question, certainly some people think do what can I only do two, can I do four?

What is my protocol? Is there some sort of. That I must follow and in a way, yes, but in a way, no. So let’s talk about that. Let’s go to the slides. Let’s talk about what’s going do the type of acupuncture you’re gonna do and what are the limits. So from here, you can see just my basic information, there’s our website, my email address for those that need some extra help, but let’s talk about the care of.

Let’s talk about what is reasonable or what is necessary and what I’d say that always comes back to as a medical necessity. So I’d say the limits to acupuncture more than anything is going to be, what does the patient need? What does it medically necessary? Let’s define that here’s a statement from Cigna Insurance specifically on their acupuncture policy, which by the way, just recently updated.

And it says medical necessity decisions must be based upon patient presentation, including diagnosis severity. And documented clinical findings. So in other words, the more severe the case, obviously the more severe the diagnosis, the more care they might likely need. So you’ll see here, they’re not really putting a limit per se.

What they also indicate is that an individualized treatment, meaning frequency, duration, and so forth is appropriately correlated with the clinical findings. So again, it goes back to severity. So when someone says to me, Sam, is it okay? I do four sets. I’m going to say it can be. But it’s gotta be, is that’s what’s needed it.

I would be careful of a being something that’s based on my style that everyone gets four sets, no matter what. It should be based on what the patient needs. Let’s give one more. Let’s take a look at what Aetna says, and this is Aetna’s clinical policy bulletin, which has also just been republished again, but for 2022, and it says this acupuncture services are considered medically necessary.

Only if there is a reasonable expectation that acupuncture will achieve measurable improvement in the patient’s condition and is reasonable for a predictable period of time. In other words, we’re showing we’re making the patient better. So I’m trying to highlight here is that. They don’t really give a definitive that you can or cannot do whatever is necessary.

In other words, could some patients get better with two, maybe three or even four? Here’s something that came out and we’ve had a lot of offices gotten letters like this. Here’s one from the company empire, which is out of New York, but this is an Anthem company. And we’ve seen this across the U S of course I teach seminars all over and you’ll see here at.

The review indicated your average utilization of acupuncture sessions of what hour are greater or what are greater for personal one-on-one time is greater than what we consider the average of providers. So right there, they’re saying, oh, you’re doing an hour. That’s greater than the others. Now you’ll notice it.

Doesn’t say you can’t do it. It just says, because you’re doing more. They’re trying to say why they’re questioning it, but notice what it says here. We are aware of many factors that may impact the coding of your acupuncture services. So they’re indicating if it is with, for I know someone who treats post-surgical, that is her absolute specialty.

That’s all she does is referrals. Post-surgical patients. She goes, Sam, I generally sometimes do two hours. She’s doing six, seven sets on these patients. But when you think. These are post-surgical patients, lots of severe pain. So would that be reasonable? If they were questioning this, you’re going to just have to be able to respond.

It’s reasonable based upon the severity and need. So is there an absolute artificial limit while in some instances there is. You’ve probably seen something, what they call the medically unlikely edits MUE it’s often termed and you’ll see here. This is the United healthcare is promotion of it. I won’t say promotion, but their indication of it.

This is set up on a federal level and it says this, it says in accordance with the code descriptions and or the centers of Medicaid, Medicare services, meaning medical. Guidelines that CMS national coding initiative, it says the following are, the service limits are as follows. And you’ll notice the initial set is one.

Of course, how many more sets can you have than the first set? The first set is always one, but notice the additional sets all indicate two. So in other words, the amount of sets per this guideline says there’s going to be three pre-visit. I will tell you a lot of carriers have adopted this. I’ve seen this, not just with, I seen it with Cigna plans as well, where they’re pushing these three set part based on this medically unlikely edit.

Now you might look at this and think, wow. Are they picking on our profession? Not really because every profession, chiropractors, physical therapists have limits just like this. And you’ll notice here, I’ve just given a quick list of common codes. Obviously I put acupuncture, chiropractic notice for acupuncture.

The one. The initial two additional chiropractics, only one. And then you’ll notice certain therapies. Like by example, if we moved down to massage, you’ll notice they allow up to four, meaning once you’ve over one hour, they’re going to say no, and these are kind of artificial limits, but they’re just saying they don’t feel that often.

It would be reasonable to do much more than that. So now the issue becomes, if I’m billing insurance, am I limited to this? In a way, it’s what the insurance may cover. They may only cover that many. Can you do more? So let’s say you’re an out of network provider and the patient has a policy where it only pays for three.

Could you still do four and be paid for four? You could, but not by the insurance company. The insurance company is going to pay three who would pay the. The patient. So you have to be willing to make sure informed the patient. Your plan allows a maximum of three. However, for your case, I believe we need four and here’s the additional charge.

That’s if you’re out of network, here’s the downside. What if you belong to an insurance? So let’s say you belong to United as a provider. You will be limited to three. And if you do a fourth, absolutely. You can do a four. But you will not be paid for it and you can not collect from the patient. Cause remember when you join an insurance, you’re abiding by their rules, which means if they allow three, that’s the maximum that we can do for reimbursement.

If you do more go right ahead. There’s no additional money. So you have to make sure beyond these plans. When you join an insurance, you now will become beholden to these rules. If you don’t belong to the plan, you can tell the patient, this is what your insurance covers. This is what we need. And so therefore you do, what’s medically necessary.

Obviously people want to use insurance and we want to give them the best access, but maybe it doesn’t always cover everything. As we’ve all witnessed. How many of you have been to a doctor and you’ve had to pay substantial money out of pocket or things weren’t covered because your plan didn’t cover.

What do you do? You pay out? Here’s one. This is tri west. Now try west. Remember is on the west coast. Basically Texas and west of Texas that handles the VA. And you’ll notice they follow the same thing, one initial and two followup. So you’re seeing this also for the VA side federal plans obviously, and realize that’s also for Optum, which is part of United.

So to answer directly for some plans, there is a limit of. That’s payable. That doesn’t mean you can’t do more. It just means your limit for payment is three. Which means if you’re in network, you’re stuck with three, but if you’re out of network, can you build a patient for additional you’ll notice the anthems didn’t fall that I’m going to always say, treat what you need to do for your patient.

Treat the patient. Not insurance. Remember insurance is nothing more than an eight and never feel fully trapped into it. You’re going to let someone know here’s what your coverage covers. Here’s what we need to do. Here’s the difference provide what is necessary for your patients. So if you need to do four sets, do four, but if you’re in United health care, you will be limited to three.

So be conscientious of following through and understanding different plans and understand what your rights. In the sense when you’re in network or out of network, remember when you’re out of network, it’s up to you to charge what you feel is reasonable and the patients can choose or not choose to get it.

But bottom line is you are not limited unless you belong to something. When you belong to something like the VA, oh, they can say three are United. And so I will say the medically unlikely edits is there. If you go to a massage there. And they want to do two hours, but the plan only pays for who’s going to pay for the additional hour.

We, as the patient or the patient would, so same idea here. What I want you to take away from this is do what’s medically necessary, do what your patient needs, but just be careful understanding when you belong to a plan, there can be limits. And that limit is three to give you a little history of it.

Pre 2019, it was actually for manual. And three for electro and post 2019, they removed it and went down to three. Now the good news to that is I would suggest that many patients, I know me and myself as a patient, I’ve often not gotten much more than a 30 minute, maybe 45 minute. I’ve never had an hour treatment and I’m not saying anything wrong, but I think most patients can respond.

So we want to treat what’s adequate and be careful if you’re doing an hour. And here would be my question to you. Does the patient really need the hour? Are you just doing extra because you’re not busy enough and I’d sometimes be careful of that. Be careful of having a patient that you overdue, just because you feel like you want to throw everything at it.

Be. Be mindful, be helpful. What’s your patients they’re looking for is a response to care whether it’s going to take 30 minutes or an hour. So don’t put yourself in the realm of limiting, but also bear in mind. What is my cost benefit ratio? And remember, benefits are continuing to increase. Take a look.

And the benefit of 2022, it says Aetna will add acupuncture as a standard benefit in new and renewing commercial health plans in 2022. So everyone who has a commercial Aetna plan will be covered. Now, this doesn’t mean some of the federal ones, but all the commercial ones will cover, which means greater access.

Now will Aetna limits you to three sets? I’ve not seen them. I will say Optum United. But not Anthem and Aetna bear in mind, again, medical necessity. What comes down to, we want patients, we want access, give them the best help and understand do what is medically necessary. We’re always here to help remember the American Acupuncture Council, specifically the Network, not the insurance side.

The network is here to help you. I can become part of your own. Where you can call me, email me, fax me. We even do monthly zoom meetings. Take a look at our site, take a look. It’s very reasonable and as well as always gives you access, have an expert on your staff. Always reach out to us, go to our site. And I’m going to say to all of you.

Thank you. Continue success. Peace. Be with you, my friends catch you next time. Oh, and don’t forget, they’re going to bring it up on the screen. There is another show this Friday, and it’s going to be Michelle Gellis please tune in. We’re always here to help take care of everyone. Seeing that.

How Do You Promote Your Practice?

And let’s focus on what are we doing to promote our practice? What changes have we made? What changes will we make?

Click here to download the transcript.

Hi everyone. This is Sam Collins, your coding and billing expert for Acupuncture and the American Acupuncture Council Network. Giving it another episode to try to always, as we do uplift you uplift the profession. This time, we’re going to go off topic for at least where I generally go, which is going to be coding and billing.

And let’s focus on what are we doing to promote our practice? What changes have we made? What changes will we make? What are we doing to really make sure that we’re getting people to understand what we do, how we do it and how we can help them always think of what is the barrier to care. Some of it is just lack of communication.

And I want you to think of it like this. Think of companies that have went belly up and I’ll think of one that comes to mind, which is the store Sears. Why did they do that? Well, someone at Sears didn’t have enough foresight when Amazon came in and started selling things online. Wasn’t that actually what Sears was, think about that.

What is Sears could adopt and adapt that say, Hey, we do the same thing. Wouldn’t they still be around. So I want to think the same thing about our profession, where we’re going to go, what we’re going to do to promote what we do, make sure people understand because of course acupuncture works well, but until we get more people to try it, it’s never going to be as big as we would like it to be because we obviously want to touch as many people as possible.

So let’s go to the.

Do. And there’s so many ways to think of it, but I want to kind of simplify it a bit. Let’s not make this too complicated. However, I use this to say, how are we perceived? You know, think of these pictures. What do your friends think you do? Your mom thinks you’re inserting a big needle. Western medicine has negative views.

What do people really do? Still take pills, but at the end of the day, look at that. Is that the concept are people that are not seeing a shit understand when they get acupuncture care. Think of how many people you’ve seen, who probably were skeptical before they tried your care. Wasn’t even sure it was going to work.

And then we’re like, oh my God, I can’t believe. Think of how often that miracle happens. When people walk into an acupuncture office, they’ve been to so many places. So how do we make sure to attract more people? I start with, what does the public know about what we do? And I’m saying this generically as our profession, but mostly about ourselves.

So I want you to think of ask your friends, ask your family, if you will, what do I. What do I treat? And I don’t want you to bias them. I want you to literally find out what do they really think about what we do. I want you to have an honest answer because we run in circles among other acupunctures. So we hear this all the time and we think this is out there.

And maybe it’s not asking your family, your parents, just friends. Okay. Acquaintances, people, you just meet casually. I fly. You know, for seminars. And one of the things I learned to strike up a conversation is, Hey, have you ever been to an acupuncturist? And the majority are no. And of course it’s an opportunity though, to discuss what we do, how we do it, and we’ve got to promote that part of it, but I want to know what are they thinking?

And you always want to know. That’s the perception we have, what are we doing to mold that perception make a different, but what I want you to do is really see what’s out there. What do people really understand? What we do, frankly, ask some strangers, see what’s going on. How do they go to the doctor by the way, you know, when they go in and do they pay cash, think of in your own practice, are you a mostly cash practice that can work really well, but think of yourself, do you go in to another doctor and pay cash?

So are you potentially limiting patients? Because we have to know what does the public know about what we do? Does it. Well, what happens if someone does an internet search for acupuncture? What does that say? Well, this is one from the Mayo clinic that talks about and inserts needles to reduce pain. So a lot of people say, well, it’s a pain relief, but is that all that you do?

I think there’s so much more. So what if someone who has fibromyalgia says, oh, I don’t have pain. I have fibromyalgia. I know that may sound counterintuitive. But it is sometimes how people think now on that same website, what they talk about, maybe it’s main to relieve pain, but it does get into things like nausea, vomiting, labor, pain, back pain, but you’ll notice it’s a very stringent on pain.

Now notice it does say menstrual cramps. That’s Mayo clinic. How about house? It says it’s an effective for a variety of conditions, but it’s not for everyone. If you choose an active person discuss with your doctor first, he has a practitioner licensed with proper training. So notice it just gives a vague, well, it treats sorta some stuff.

So again, is that really giving people anything about what we do think of your way? If someone went to your website, what did attract them for the type of condition they have? So let’s take a look. What else can you find on the internet? If you search, what does acupuncture do? The national institutes of health.

Of course, you’ve all seen this nausea, addiction, headache. So this goes a little bit beyond, but here’s one thing I would take a look at. If you’re someone who specializes in treating women with menstrual cramps or medical. Could I find you, if I were to Google acupuncture, treating menopause, would you come up?

Would it come up in the city? Remember internet searches are based on information that’s on your site. If the information is not there, it doesn’t appear. Do you have any type of blogs or newsletters that might give a little bit more what they call it? SEO. So people can get to your site. There’s a lot of things out there, but does it say it for you?

Well, here’s one from a company called Evercore and Evercore is behind the scenes on a lot of Anthem policies, as well as United health care. And you’ll notice here, it lists a lot of things that are way different notice asthma cancer, pain puncture. Might you have something that would promote and say, no, this could be helpful.

I have a couple of doctors in the state of Washington. That’s. They work with a couple of psychologists and psychiatrists, but that’s all they treat by the way it’s paid by insurance. But again, that’s something that they promote because most people would golf. It can treat that. I mean, what if you’re an infertility expert?

What if somebody is looking for that, would they be able to find you, is your, are you telling them what you really do? Let’s look at another carrier. How about American specialty health? And of course, I know everyone has a little bit of problem because they should pay more, but let’s talk about how does American specialty health cover?

Well, they talk about kind of, neuromusculoskeletal kind of what I call the chiropractic end of it. So it talks about headaches, hip pain, neck pain, back pain, and so on. So again, that promotion is there for that, but is it promoting. What, if someone were looking for this, what is it saying? Is this information on your site?

If you take this plan, here’s the conditions that we cover and we can help you. I mean, obviously marketing is done by every company. A RP uses acupuncture to market their product. Take a look. Here’s an ad for them. Medicare will cover here’s another one for a company called clever care. This is a TV.

They’re using acupuncture to cover. Now what about this? It says Medicare advantage. Is there anything that you’ve done? So if someone has Medicare advantage, they know they can come and see you. Is there anything as they pass by Medicare advantage here, take a look at this one. This is the United healthcare one.

And think of the promotion here. They’re literally using you to promote their business, but are we utilizing it to promote ourselves? Can you imagine if you have a zero copay acupuncture visit, do you think that’s very hard for some of the. Probably not now we would have to accept payment in full from these plans, but I’ll tell you they’re about a hundred dollars a visit and they cover much more than you think here’s their acupuncture coverage for this Medicare part C policy.

And you’ll notice that it says acupuncture, routine codes, but not all inclusive. And it’s not only including acupuncture, but what does it include? Therapies, things that you do, whether it’s massage exercise. Uh, myofascial release or manual therapy wash off 20, not so much more. Do people know that we do this?

Can it be something that might attract them? Always think of what is going to attract someone. What is going to make them know that what you can do can help them. Here’s another one from good morning America, where they talked about prescription for wellness and it indicates acupuncture. And. How about something like that on your side to make sure people know, okay, we do herbs.

Someone may be looking for that, tell them what do you do, herbs for? What can help? How does it help? And I’m not saying write some long drawn out article, but there’s a little bit of information that at least is introductory. So someone can go, oh, I think I want to try that. So here’s what I want you to do.

If you’re thinking of marketing, what do you mean. Start thinking, what is my thing that I do? How do I know people are going to find me if I do it? So here’s a couple of interesting offices that I think has done something in a positive way. The one on the left is an acupuncture office that they’re in a medical building.

And when you walk by their office, this is the sign. And look at all the things she’s talking about. Fatigue, stress, tension, anxiety. When someone’s walking by. They treat anxiety, they treat arthritis and notice it. Doesn’t just say pain. Now. Pain is many times the origin of most of these, but people often think, well, no, I have fibromyalgia.

I have TMJ. We want to let them know. Yes, we can treat it. Notice that even talks about veteran’s benefits. Look at the one on the right chronic pain, neck and shoulder stress, depression, insomnia tendonitis, Bell’s palsy, nasal analogies, weight control PMs. You want to think of who am I attracting? If you do a lot of sports medicine, guess what you should be talking about?

I do sports medicine. There, isn’t a professional team. That’s a professional sports team that doesn’t use and promote acupuncture. I know several acupuncturist who work directly with the teams and that’s their whole job. But again, are we promoting that this P do people know that they can come to us for it?

Often think of if someone says, what does acupuncture going to do for me? They may not. Because they’re going to have a condition that they’ve never heard, it’s going to be helpful. So I want you to thinking, when a person sees your website or your office, what do they see? What do they know? Will you be able to help them?

So what does it say? Does it talk about you where you went to school? Does it talk about your philosophy? Does it talk about the conditions? Would I be more important is a little bit of that. What have been some of your success stories of people you’ve helped? How you’ve helped them change? Think of that someone searching, like, if you think of it, if you did a Google search in your area and said acupuncture for menopause, would there be anything from your office that will come up?

If you put information like that on your website, guess what Google does. They pull that information and then that’s how someone would be directed to it. I want you to think, how does it attract. What is someone looking for? And remember, it’s not something that you need to write a lot, but something that’s going to go.

Oh, okay. Cause think of most ads don’t take that long. Does it really communicate to their needs? I mean, think of what is your specialty? What are the things that you treat? I have an office. He does only infertility. So I guess what’s prominent on it’s infancy. And he’s very busy because he’s had good success.

Everyone wants to come in because if you have a 50% increase and people getting pregnant, who doesn’t want to spend that extra money considering they’re spending 20,000, all, all the other things. So think of it this way. What is the barrier? I think one of the barriers of care is just people not knowing, but it’s often fear.

So is there anything on your site that talks about the gentle approach and that you won’t feel anything? Think the other barrier can help you. What does communicating to the patient about how it helps them kind of put it from the patient’s standpoint, if you were looking, would, you know, what’s helpful and of course, money, I think that’s often the biggest barrier.

So you want to start to think of, are there things that you’ve done on your site to show people you make it affordable? I always use cars as a way of showing you how we make things look before. When you see some of these fancy car commercials, particularly the mercury with Matthew McConaughey, do you know, they never tell you that car actually costs $80,000, because if they told you that you’d never want to buy it, but if they say, oh, you can lease it for 4 99, that seems affordable.

So also think of, are you having anything in there that helps the patient understand? Do you offer payment plans? Do you offer any other types of discounts do even take insurance and I’m not saying you have to, but you got to think of this. Someone has insured. And they want to come to you what they know.

So for instance, when you belong to any insurance or you accept insurance, I would certainly want to put it on my side. I want people to know, yes, we do take blue cross blue shield or Aetna. And I’m not saying you have to, but you got to think of if someone’s looking, how are they going to find us? And that leads me to something that the American physical therapy association talked about last year.

Now, as a seminar person, I teach seminars not only to acupuncturist, but to chiropractors, physical therapists and medical. And at one of the programs, and one of the things that the American physical therapy association literally said was this many of us look at the way chiropractors have branded themselves in the last few decades and feel a twinge of resentment.

Why can’t that be us? So think of it for a moment. Do chiropractors do a lot of marketing? Do they let people know if you’re in a car accident, you can see me. By example, if you treat the auto injuries, does anyone know you treat them? If you treat VA patients, does anyone know. Is there any way for you to find that out if I look at your site, because if I’m looking and I can’t find it.

It doesn’t mean anything to me, I’m going to move elsewhere. So realize that even these professional associations are beginning to realize that they have to do more, to do their own branding acupuncture. Let’s take control of the message. Let’s take control to put out there whether or not this stuff is covered by insurance.

I do not care because is there a value to what you do? Remember something my mom always said is this people buy what they want. And beg for what they need. Acupuncture is something people want not necessarily needed. And I hope you notice with the connotation. I mean, something that they value they’ll do think of how many people go, oh, I gotta pay that bill.

But what I really want these shoes in a way, that’s what we want to be. Someone who I know there’s enough value there. And trust me, the value can be high. What if someone’s had migraines taking medication that’s not helping. And they come in for a handful of visits to. And they’re gone. Is any of that information somewhere for people to see you allow the patient to do a testimonial?

I certainly would think of it. There’s a great opportunity here that I think all of us haven’t really taken heat of. You have control. Think of how much easier it is with the way you can market now with internet based. Forget Facebook. No, one’s looking at that anymore. Even Instagram too short. I mean, Tik TOK, forget it.

It’s just simply your site. People are doing searches. Are there any acupuncturist in this area that treats what I have or takes my insurance. So I want you to think of who are these patients going to be? If you have a mostly cash practice, talk about it, tell them why you do it. You’re making it affordable.

What if you offer pro pays or prepays? And then of course you have all these insurances. So in my opinion, there’s 12 ways to get. And I want to highlight a few of these. I mean, if you’re treating personal injury, workers’ comp VA Medicare parts seen. It’s why I bolded and underlined I’m in a Medicare part C policy.

It can be fantastic if you didn’t watch last month’s show with me, take a look. There’s some great opportunities. Here’s the thing. You need people that need your care and watch your care. And that’s where your practice will grow. Because one thing that I can always say is acupuncture does really work very well.

Once someone is. But what’s that barrier. Do I know that you can help me? How do I pay for it? That’s what mostly people are thinking. So we want to make sure we set ourselves up that yes, this is how you can come to us. Here’s how we can help. You always know there’s ways of promoting that. Like even on our website, the American acupuncture council network, here’s something last month we talked about Aetna.

Now has all of their commercial plans, not necessarily federal, but all commercial plans now have acupuncture benefits. Wow. What if you’re in the state of Massachusetts that you don’t even need to have a diagnosis? You can treat anything under their plan and there’s 12 visits. But what I want to know is does anyone know that besides you take a good look at how you’ve marketed and branded yourself when you meet someone, do they know you’re an acupoint.

Do they see someone that’s a professional, trust me, getting out in the public, having people know you is one of the best ways for people to come in because it’s people they trust and bottom line people, they help. So think of it. What have I done? Create a plan. Start to put a few things out and track what attracted people when they come in how’d you find me, then you’re going to start to learn what works.

Remember every business does that. Don’t be serious. They’re going to be people who promote and do better than others. Why? Because they have taken some, I guess, old fashioned put the nose to the grindstone and just tried some things, maybe what works for you is not for someone else, but there’s always something.

What I want to say to you is acupuncture has a great opportunity. The access that you have now to people and the understanding the growth potential is infinite. Think of addiction. Think of the VA and all the things that are there, but does anyone find you and I’ll leave it with that? What about a VA patient?

If you’re doing VA, if a veteran was looking for someone, what they find you don’t leave it to happen. Hopefully, we’ll take a little bit of this and do a little bit at a time. I’m not saying you have to be perfect, but it’s trial and error. What I’ll say to everyone is get out and help yourself. We’re always here to help you.

The American acupuncture council is your partner. We want to make sure you’re doing well. Anything that you need, if you need help with coding, billing, documentation, medical necessity, you want to verify that your notes are fine. Not getting. Come to us, we offer two services to do that. Just go to our website.

If you need further help go to our website, we’re always going to be there. Don’t be afraid to call or email. I’m going to say to all of you. Thank you very much. Here’s our phone number and information there. Ultimately, we’re here for you now. Pay attention Friday, coming up is the host will be Shelly Goldstein.

I’m going to say until next time everyone. This is Sam Collins, your coding and billing expert. I’m here for you. Go out and be a good acupuncturist..