Fwd: [AACBoard-AnnounceList] Hinchey Bill

[Guest guest]

For comparison.....for auto-PIP.... I utilize the ABC codes and get paid a

respectable amount for time and all services including cupping/Gua Sha etc. As a

matter of fact it was recently commented about in an Alternative Link article

found in the current issue of Acupuncture Today that my insistance in using

the ABC Codes actually encouraged and moved forward 85% of the auto PIP

carriers to begin to recognize and USE the outstanding ABC Codes..... which

you'all

should be looking at using sunce they are way above and beyond the measley 4

codes which AMA/CPT has issued for the AP/OM profession.

 

Back in October of 2003.....AOMNC wrote to AMA/CPT advising them that those

who were negotiating with them did NOT represent the whole AP/OM profession and

furthermore that AOMNC was NOT going to negotiate detrimental codes for use

by the AP/OM profession. Seems that those who did attempt to negotiate with the

AMA/CPT were chewed-up and spit out by that process. One of those negotiating

on behalf of the whole AP/OM profession recently was heard commenting

(paraphrased...... " we tried but the process got out of control and what resulted

wasn;t the intended result " .) One response to such a comment is that we NEVER

negotiate with our competitors. As David alreadys knows.....we certainly don't

and never will.

 

Richard Freibertg

 

In a message dated 2/13/2005 3:00:24 PM Eastern Standard Time,

acuman1 writes:

 

I have used the new codes and found that in WC, auto and health policies I

have received about the same or a few pennies more over the 5 cases returned

so

far. It has involved some education of the carriers thus far, but they are

picking it up quick.

David Molony

 

 

 

[Guest guest]

At 12:44 AM 2/14/05 -0500, Pete Theisen <petet wrote:

>

>mike Bowser wrote:

>> At eight patients/day at $70.00 = $560.00 x 20 days/month =

>> $11,200.00 x 12 = 6 figures income. Where are you at that you cannot

>> make it on this amount? I am shocked. Mike W. Bowser, L Ac

>

>Hi Mike!

>

>One person can make it on 134K year, but what he is making is not all

>profit. Don't know what his rent, utilities, supplies and insurance

>cost. Don't know what he has to pay for help. Don't know how much

>shopping his wife/girlfriend/whatever does . . .

>

>Regards,

>

>Pete

 

$134K gross, minus business expenses (rent, supplies, office, insurance,

etc.) probably comes out to half or less net income. With employees

significantly less. And here in the San Francisco Bay Area (California)

where I live (and, if I recall Alon is somewhere in the East Bay Area),

you're talking close to poverty level. Average houses in this region cost

more than half a million dollars, double the national average. And many

areas, e.g. Palo Alto (where I work but couldn't afford to live), average

home cost is double the regional average, i.e. 1 million plus..And while

there are a lot of people/patients in some areas who have substantial

disposable income, most average sort of earners struggle -- 2 or 3 job

families. Average affluence means less also when fewer and fewer are

acumulating more and more. (In the USA, some 1 percent of the population

owns some 40 percent of everything.)

 

 

[Guest guest]

Those ladies sure can ruin one economically, ha ha.

Mike

W. Bowser, L Ac

 

>Pete Theisen <petet

>Chinese Medicine

>Chinese Medicine

>Re: Fwd: [AACBoard-AnnounceList] Hinchey Bill

>Mon, 14 Feb 2005 00:44:27 -0500

>

>mike Bowser wrote:

> > At eight patients/day at $70.00 = $560.00 x 20 days/month =

> > $11,200.00 x 12 = 6 figures income. Where are you at that you cannot

> > make it on this amount? I am shocked. Mike W. Bowser, L Ac

>

>Hi Mike!

>

>One person can make it on 134K year, but what he is making is not all

>profit. Don't know what his rent, utilities, supplies and insurance

>cost. Don't know what he has to pay for help. Don't know how much

>shopping his wife/girlfriend/whatever does . . .

>

>Regards,

>

>Pete

[Guest guest]

At eight patients/day at $70.00 = $560.00 x 20 days/month = $11,200.00 x 12

= 6 figures income. Where are you at that you cannot make it on this

amount? I am shocked.

>>>>>>I do not know about you but I have expenses

 

 

 

 

[Guest guest]

I utilize the ABC codes

>>>>Unfortunately use ABC codes and get nothing.If you can get these codes to be

excepted I will be the first one to use them

 

 

 

 

[Guest guest]

In a message dated 2/13/05 4:26:43 PM, alonmarcus writes:

 

 

>

> the new codes and found that in WC

> >>>>You do not have a separate WC code in PA? David since the new codes have

> a value attached to them i think you have been getting the same $ because

> many insu companies are not up to date, just wait a little.Have you billed any

> of the blues?

>

>

>

 

Yes, and so far so good. I try to average over $100 a visit, including

modalities, since I have to pay someone to do the calling and writing.

DAVE

 

 

David Molony

101 Bridge Street

Catasauqua, PA 18032

Phone (610)264-2755

Fax (610) 264-7292

 

**********Confidentiality Notice    **********

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[Guest guest]

If one doesn;t USE the ABC Codes THEN one can NOT reap the benefits. It is

always easier to sit by the side of the road and then jump on the bandwagon

after all the hard work is accomplished.

 

Richard

 

 

 

((>>>>Unfortunately use ABC codes and get nothing.If you can get these codes

to be excepted I will be the first one to use them))

 

 

 

[Guest guest]

wrote:

> At 12:44 AM 2/14/05 -0500, Pete Theisen <petet wrote:

>

>>mike Bowser wrote:

>>

>>>At eight patients/day at $70.00 = $560.00 x 20 days/month =

>>>$11,200.00 x 12 = 6 figures income. Where are you at that you cannot

>>>make it on this amount? I am shocked. Mike W. Bowser, L Ac

>>

>>Hi Mike!

>>

>>One person can make it on 134K year, but what he is making is not all

>>profit. Don't know what his rent, utilities, supplies and insurance

>>cost. Don't know what he has to pay for help. Don't know how much

>>shopping his wife/girlfriend/whatever does . . .

>>

>>Regards,

>>

>>Pete

>

>

> $134K gross, minus business expenses (rent, supplies, office, insurance,

> etc.) probably comes out to half or less net income. With employees

> significantly less. And here in the San Francisco Bay Area (California)

> where I live (and, if I recall Alon is somewhere in the East Bay Area),

> you're talking close to poverty level. Average houses in this region cost

> more than half a million dollars, double the national average. And many

> areas, e.g. Palo Alto (where I work but couldn't afford to live), average

> home cost is double the regional average, i.e. 1 million plus..And while

> there are a lot of people/patients in some areas who have substantial

> disposable income, most average sort of earners struggle -- 2 or 3 job

> families. Average affluence means less also when fewer and fewer are

> acumulating more and more. (In the USA, some 1 percent of the population

> owns some 40 percent of everything.)

 

Hi Chris!

 

If I could gross 134K I would be in high cotton. I have had a loss every

year since I opened which obviously is unsustainable in the long run.

 

My congresswoman, Katherine Harris, is very friendly to the Acupuncture

community (she initially introduced our model practice act as a Florida

State Senator) but she is struggling with the Hinchey Bill. From an

email I received from Bob Marcus, a lawyer/lobbyist, on the subject:

 

" Harris is struggling over whether to co-sponsor the Federal Acupuncture

Coverage Act, because other CAM modalities, such as physical therapy and

marriage and family counseling, want to be included in Medicare as

covered benefits, and Rep. Harris is reluctant to single out her support

for any one modality as an added entitlement under Medicare.

 

Ms. Platt (Rep. Harris' Washington legislative aide) also said that Rep.

Harris was also reluctant to co-sponsor H. R. 1477, because that would

put on an equal footing with Western Medicine, which is

contrary to the dominant position that allopathy now occupies in Medicare. "

 

From this I gather there are two issues: 1) More entitlements, 2.

offending the MDs, who greatly outnumber us and have much more money.

These issues are related.

 

My view is that the more entitlements offered for properly licensed

modalities the better. When patient's can go anywhere for their health

the modality that helps the individual patient the most will be the one

the patient uses. If WM is the best for the patients as the MDs like to

think then nothing will change and the MDs won't have to worry. If WM

has deep-seated problems then competition will help to correct them, a

win-win situation. Surely MDs do not wish to have any problems that may

be lingering within their profession perpetuated. Any MD professing to

be offended by this broadening of options makes him/herself ethically

suspect by so doing.

 

The MD offices are already suffering from overuse. There are signs that

the overwork is leading to mistakes, however the insurance companies are

partly responsible for the overwork with their ridiculously low rates.

Ironically, use of a broader mix of modalities would reduce the total

cost of the program.

 

Regards,

 

Pete

[Guest guest]

I think we all have to agree that Fl and CA are very different places to do

business. I suggest that people doing small numbers of insurance patients use

the ABC codes and fall back on CPT if needed. I use CPT's because my billing

person is not familiar with ABC codes, plus we do oer 30 cases a week, some with

multiple visits, and I merely don't wish to pay him for all the time

necessary to change things (learning how to use it, spending time on the phone

explaining to each examiner 3 or 4 times, waiting and sending out duplicate

billings

while they use the excuse to stall) when I am doing just fine without. He also

works in a DC office that doesn't use ABC, plus the program he uses is not

set up for ABC (TCMPro). It will be interesting to see what the results are when

the first software OM company offers ABC as part of its program.

 

It is

always easier to sit by the side of the road and then jump on the bandwagon

after all the hard work is accomplished.

 

It is, and I plan to in this instance unless it becomes more effective to do

it differently.

DAVE

 

In a message dated 2/15/05 9:46:54 AM, acudoc11 writes:

 

 

>

> If one doesn;t USE the ABC Codes THEN one can NOT reap the benefits. It is

> always easier to sit by the side of the road and then jump on the bandwagon

> after all the hard work is accomplished.

>

> Richard

>

>

>

> ((>>>>Unfortunately use ABC codes and get nothing.If you can get these codes

> to be excepted I will be the first one to use them))

>

 

 

 

 

 

David Molony

101 Bridge Street

Catasauqua, PA 18032

Phone (610)264-2755

Fax (610) 264-7292

 

**********Confidentiality Notice    **********

This electronic transmission and any attached documents or other

writings are confidential and are for the sole use of the intended

recipient(s) identified above.  This message may contain information

that is privileged, confidential or otherwise protected from disclosure

under applicable law, including the FTC Safeguard Rule and U.S.-EU Safe

Harbor Principles.  If you are the intended recipient, you are

responsible for establishing appropriate safeguards to maintain data

integrity and security.  If the receiver of this information is not the intended

recipient, or the employee, or agent responsible for

delivering the information to the intended recipient, you are hereby

notified that any use, reading, dissemination, distribution, copying or

storage of this information is strictly prohibited. If you have

received this information in error, please notify the sender by return

email and delete the electronic transmission, including all attachments from

your system.

 

 

 

 

 

 

[Guest guest]

DAVE

 

Between Florida and California there exists at least 60% of the

practitioners within the United States and then when one adds in New Mexico,

Arkansas and

a few other states where APs are primary care providers......I guess that

speaks much to a standard different from other states such as PA where

practitioners are still in the dark ages when they MUST get the permission slip

from

an MD in order to administer acupuncture. That must be what is meant by

'doing things differently'.

 

Hmmmm... your billing clerk determines what codes you use? Mighty

interesting. One would think that the practitioner/boss would determine those

kind of

issues.

 

As to volume.....I suspect it is the other way around. That the majority who

simply bill just 1 CPT code as opposed to the some 50+ codes + what is

referred to under CPT as E & M codes already available under Alternative Link's

ABC

code system. It is your choice to bill a lot less. Maybe in those 'different'

states one ALSO has to ASK permission from the MD as to what you are allowed

to bill? I wouldn't know since I live and practice in one of the most

progressive states in the US.

 

As to DCs.....they apparently are still 'in the ether'. One day, all will

wake-up. Then again ...maybe not. The system has a way of keeping the populace

and practitioners numbed and dumbed so they can be fleeced and then taken to

the slaughter-house.

 

No doubt there are those who like to reap the benefits of the few who

perform all the hard work. I am sure there is a name for those kind of

people....but it escapes me at the moment.

 

Richard

 

In a message dated 2/15/2005 12:58:59 PM Central Standard Time,

acuman1 writes:

 

 

I think we all have to agree that Fl and CA are very different places to do

business. I suggest that people doing small numbers of insurance patients

use

the ABC codes and fall back on CPT if needed. I use CPT's because my billing

person is not familiar with ABC codes, plus we do oer 30 cases a week, some

with

multiple visits, and I merely don't wish to pay him for all the time

necessary to change things (learning how to use it, spending time on the

phone

explaining to each examiner 3 or 4 times, waiting and sending out duplicate

billings

while they use the excuse to stall) when I am doing just fine without. He

also

works in a DC office that doesn't use ABC, plus the program he uses is not

set up for ABC (TCMPro). It will be interesting to see what the results are

when

the first software OM company offers ABC as part of its program.

 

It is

always easier to sit by the side of the road and then jump on the bandwagon

after all the hard work is accomplished.

 

It is, and I plan to in this instance unless it becomes more effective to do

it differently.

DAVE

 

 

 

 

 

 

[Guest guest]

Thats is the most incorrect analysis possible.

 

The DAMAGE has already been done by the new CPT codes.

 

By using the ABC Codes one can begin to correct subject damage.

 

Richard Freiberg

 

In a message dated 2/12/2005 11:39:16 AM Central Standard Time,

alonmarcus writes:

 

Passing the Medicare bill will result is all compensation for acupuncture

becoming as low as our new codes. For those that have not experienced the

new rates you will receive $17 per half hour of direct patient one to one

care. If you what this to be the future of OM support the bill

 

 

 

 

 

 

 

[Guest guest]

numbers of insurance patients use

the ABC codes and fall back on CPT if needed.

>>>Do you know any company that is paying for ABC. I definitely do not what to

spend time with constant denies

 

 

 

 

[Guest guest]

I just got an insurance EOB today, first feedback using 97810 instead of

97780. The company is " Definity " (relatively new, seems to pay consistently

so far). They labeled the 97810 as " KNOWN PROCEDURE " , but paid the same

rate as previously (2004) on the same patient using the 97780 code!.