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Medicare, money..

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I'm in agreement about wanting nothing to do with Medicare. It seems to be

an unworkable system, at least the way it's set up, for acupuncturists... we

need to do a thorough intake to really, ethically, treat patients. It's not

financially feasible to do so with a $20 reimbursement.. even assuming that

you actually get reimbursed for all the patients you treat. We are

philosophically and practically different from our allopathic counterparts.

I plan, instead, to set up clinic in an affluent area and volunteer time

every week to a free clinic.. that way, people who need it and can't afford

it are getting treated, we get the word out in a very potent, pratical way

to both the allopathic profession and the public as a whole, and I'm not

suffering with the headache of paperwork for peanuts (which I think, at the

end of the day, ends up amounting to no reimbursement at all, or losing

money, all said and done).

 

I also agree that we would all be better off as a profession if we saw it as

an integral part of our job as healers to educate the public. If more of us

volunteered our time at book stores, medical clinics, health fairs, writing

articles for magazines, etc, or actively supporting professional alliances

with the goal of educating the public, we would see the dividends both

personally and communally.

 

I am an educator and a healer. I teach for a living at the moment and find

that the two are so very intertwined. I love that aspect of the medicine. I

plan on getting involved politically as well.. we do need more political

representation and awareness. Not everyone is suited to be a public speaker

or political representative for the field, but everyone can do their own

part based on their own skills and personality.

 

Give me a " T " , Give me a " C " , Give me a " M " ! Go !

 

:>

Nadia

 

> _____

>

>heylaurag [heylaurag]

>Saturday, November 20, 2004 1:35 PM

>Chinese Medicine

>Re: New to the group/Money, Money...

>

>

>

>

>

>Hi All,

>

>I agree with just about everything I've read on this topic here. But

>I'll add my 2 cents.

>

>I think the one thing that will push the profession forward faster

>than we may even be ready for is Medicare/Medicaid reimbursement.

>Once that happens hospitals and clinics will be highering us

>everywhere so they can make money off us. WE WILL BE IN DEMAND. I

>don't know how that is going to happen though, especially in this

>current climate of Republican dictatorship. I'd really like to get

>more involved in strategizing how to make that happen actually.

>

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Nadia

 

It is perfectly fine for each practitioner not to want to access medicare

when it is available.

 

When you finally arrive at treating patients please offer a new perspective

at that time. I suspect it will be quite different.

 

The enormous value of being THE statutory primary provider of acupuncture for

medicare sets the 'bar' for all health care providers/carriers and self

insureds.... in providing AP/OM services.

 

Who told you the figure of $20 for a medicare reimbursement for an

acupuncture treatment? MDs receive much mroe than that so why would anyone

entertain

such a theory for acupuncturists services? I have heard similar propaganda and

it

has always been rediculous.

 

In the meantime....the fact that acupuncturists in the US are considered

second class providers....this won't change unless the legislatures and/or the

courts change this status quo.

 

When acupuncturists become the statutory providers of acupuncture and

oriental medicine for medicare recipients and federal employees it is certainly

your

right to opt out but please don't inhibit others from accessing their rights.

 

As to educating the public and the law makers.....the profession should be

requiring those in leadership roles to make this a primary priority.

 

If read correctly.....there was a US poll taken and lobbying representation

on the federal level was the number one priority. Why has this not taken place

and how can the profession ensure it happening?

 

Richard

 

In a message dated 11/21/2004 6:41:03 AM Eastern Standard Time,

eastdakota writes:

I'm in agreement about wanting nothing to do with Medicare. It seems to be

an unworkable system, at least the way it's set up, for acupuncturists... we

need to do a thorough intake to really, ethically, treat patients. It's not

financially feasible to do so with a $20 reimbursement.. even assuming that

you actually get reimbursed for all the patients you treat. We are

philosophically and practically different from our allopathic counterparts.

I plan, instead, to set up clinic in an affluent area and volunteer time

every week to a free clinic.. that way, people who need it and can't afford

it are getting treated, we get the word out in a very potent, pratical way

to both the allopathic profession and the public as a whole, and I'm not

suffering with the headache of paperwork for peanuts (which I think, at the

end of the day, ends up amounting to no reimbursement at all, or losing

money, all said and done).

 

I also agree that we would all be better off as a profession if we saw it as

an integral part of our job as healers to educate the public. If more of us

volunteered our time at book stores, medical clinics, health fairs, writing

articles for magazines, etc, or actively supporting professional alliances

with the goal of educating the public, we would see the dividends both

personally and communally.

 

I am an educator and a healer. I teach for a living at the moment and find

that the two are so very intertwined. I love that aspect of the medicine. I

plan on getting involved politically as well.. we do need more political

representation and awareness. Not everyone is suited to be a public speaker

or political representative for the field, but everyone can do their own

part based on their own skills and personality.

 

Give me a " T " , Give me a " C " , Give me a " M " ! Go !

 

:>

Nadia

 

 

 

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_____

 

acudoc11 [acudoc11]

Sunday, November 21, 2004 5:49 PM

Chinese Medicine

Re: Medicare, money..

 

 

 

* Nadia

 

Who told you the figure of $20 for a medicare reimbursement for an

acupuncture treatment? MDs receive much mroe than that so why would anyone

entertain

such a theory for acupuncturists services? I have heard similar propaganda

and it

has always been rediculous.

 

 

 

 

Nadia may have gotten this idea from me because I mentioned the arbitrary

amount of $25.00. I was making a point. A Chiropractor (in the state of

Washington) can bill the reasonable price of $45 for an adjustment, but

receives approximately $27.60 for that treatment. That may vary from

state-to-state. I don't know; $45 to $27 looks like a big drop to me,

especially when you look at the stringency of billing, the amount of time it

takes, repeated billings for unpaid treatments (sometimes up to 5 billings

for one treatment). So, what do you end up making when your time and effort

are taken into consideration. How much do you end up paying your billing

service (if you have one) for this one DOS? It isn't worth it to me, but

perhaps it is to you.

 

..

 

 

 

 

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acudoc11 wrote:

<snip>

> there was a US poll taken and lobbying representation on the federal

> level was the number one priority. Why has this not taken place and

> how can the profession ensure it happening?

 

Hi Dr. Richard!

 

Poll? Who took it and when? I must have missed it.

 

Regards,

 

Pete

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When one compares their treatment to a Chiropractic adjustment or as an

Acupuncturist

technician then I guess that person will get the bottom of the barrell for

reimbursement.

 

If one acts like a primary care provider and bills accordingly they won't

wind up with $20.

 

 

 

In a message dated 11/22/2004 12:18:59 PM Eastern Standard Time,

bbeale writes:

Nadia may have gotten this idea from me because I mentioned the arbitrary

amount of $25.00. I was making a point. A Chiropractor (in the state of

Washington) can bill the reasonable price of $45 for an adjustment, but

receives approximately $27.60 for that treatment. That may vary from

state-to-state. I don't know; $45 to $27 looks like a big drop to me,

especially when you look at the stringency of billing, the amount of time it

takes, repeated billings for unpaid treatments (sometimes up to 5 billings

for one treatment). So, what do you end up making when your time and effort

are taken into consideration. How much do you end up paying your billing

service (if you have one) for this one DOS? It isn't worth it to me, but

perhaps it is to you.

 

 

 

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-

<acudoc11

<Chinese Medicine >

Monday, November 22, 2004 10:17 PM

Re: Medicare, money..

 

 

>

> When one compares their treatment to a Chiropractic adjustment or as an

> Acupuncturist

> technician then I guess that person will get the bottom of the barrell for

> reimbursement.

>

> If one acts like a primary care provider and bills accordingly they won't

> wind up with $20.

>

 

Huh??

 

What Medicare pays for services has little to nothing to do with what you

bill for them. Fees are established primarily by bureacratic fiat and

approved Congressionally. If you you are a participating physician, you have

the extremely negligible advantage of having Medicare automatically forward

the unpaid portion of your bill to the patient's secondary insurance (if

any), for potential payment of the balance. The downside of that is that as

a par provider, you cannot balance bill the patient for the unpaid portion

of covered services.

 

You may, however, bill the patient your standard fee for any non-covered

service, but only so long as you had the patient sign an ABN (Advance

Beneficiary Notification), which states the service to be rendered, the fee,

and the reason you expect Medicare to reject the bill. The ABN must be in a

form approved by Medicare, which is readily downloaded off the net.

 

As a non-participating provider, you can bill Medicare and then have the

advantage of being able to balance bill the patient for covered services.

 

You should also know that Medicare will soon be requiring all bills to be

submitted electronically. This places a huge burden on you to ensure that

your software can submit the bill (via a Medicare-approved clearinghouse) in

the proper format and that your entire office management system meets HIPAA

requirements.

 

You should also be aware that Medicare, like other insurers, is likely to

highly restrict the diagnoses for which acupuncture treatment will be

covered, and be prepared for a 3-6 month wait (minimum) for payment. In

fact, I have many bills which have gone unpaid for as long as a year.

 

 

 

Avery L. Jenkins, DC, DACBN, FIAMA

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>

> Wow. First, what a slam to chiropractic. And what arrogance. It won't

matter if you " act " like a primary care provider or not. You will have

absolutely no power over this system. And to think that you'd think you

would is laughable at best. Acupuncturists, like MDs, PTs,

psychotherapists, chiropractors, will be chewed up and spit out at the

same rate.

 

My comparison to chiropractic was to point out that another

" alternative " therapy has not fared well in the Medicare system (nor has

anyone else). And they (DCs)have an incredibly powerful lobby.

>

>

>

> When one compares their treatment to a Chiropractic adjustment or as an

> Acupuncturist

> technician then I guess that person will get the bottom of the barrell for

> reimbursement.

>

> If one acts like a primary care provider and bills accordingly they won't

> wind up with $20.

>

>

>

> In a message dated 11/22/2004 12:18:59 PM Eastern Standard Time,

> bbeale writes:

> Nadia may have gotten this idea from me because I mentioned the arbitrary

> amount of $25.00. I was making a point. A Chiropractor (in the state of

> Washington) can bill the reasonable price of $45 for an adjustment, but

> receives approximately $27.60 for that treatment. That may vary from

> state-to-state. I don't know; $45 to $27 looks like a big drop to me,

> especially when you look at the stringency of billing, the amount of time

> it

> takes, repeated billings for unpaid treatments (sometimes up to 5 billings

> for one treatment). So, what do you end up making when your time and

> effort

> are taken into consideration. How much do you end up paying your billing

> service (if you have one) for this one DOS? It isn't worth it to me, but

> perhaps it is to you.

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