Guest guest Posted January 27, 2009 Report Share Posted January 27, 2009 Anne, Who is Adam Smith? And what is his invisible hand? Thanks, Andrea Beth Traditional Oriental Medicine Happy Hours in the CALM Center 1770 E. Villa Drive, Suite 5 Cottonwood, AZ 86326 (928) 274-1373 --- On Mon, 1/26/09, anne.crowley <anne.crowley wrote: anne.crowley <anne.crowley Re: medicare Chinese Medicine Monday, January 26, 2009, 9:50 PM Wow, this opens up a whole can of worms for me. Compassionate care and earning a living comes to mind. First, let me say that I think Community Acupuncture is a wonderful answer to low-cost acupuncture. The practitioner is not forced to go into poverty, since it is group work and can return a decent wage. Chrios at 5 mins for $27 - like someone said, not bad, but all that paperwork to go with it. I, like Hugo, get very concerned about the government getting into this. I think the profession can take care of itself by offering community acupuncture. I wish it were more available in my area, as I really see it as a unique business model and difficult to integrate into what I do. I really think the experience in my clinic (and I see two patients and hour) is a lot more relaxing and inviting than a 5 min visit with a chiro. At least the chiros I have seen do that, don't give off that relaxing feeling. I think that accounts for the difference in fees and service. I see many in the healing profession that do not give discounts or treat for free, e.g. doctors and dentists. There are many nurses in the healing profession, that at the end of the day, don't say " I'll take a 20% discount because that is what the market will bear.' As we have stated on this site many times, acupuncturists go out of business or work very part time, all the time. Most cases can be attributed to knowing how to run a business, and market a practice. It is tricky in the healing we do. We all want to give it to everyone, but is that really feasible? It took me about 3 years to go beyond break even. If I didn't have my husband's income, I would be a statistic in this field. Later I learned more about running a business and consider myself doing well. One of my colleagues in another area has a very successful practice (again with growing pains) doing fertility work. She just told me the other day she has no retirement. Her health care has a $5000 deductible, so she pays out of pocket for uncovered services. She had some medical work done recently that costs $3000. All out of her pocket. No visits to an emergency room for free. So the real cost of doing what we do is more than meets the eye. I am not even taking into account the cost of going to school, foregone income, overhead, equipment. And, I guess the underlying thing here is, " It really is okay to make money. " It's kinda necessary in the world in which we live. Again, I think the profession is getting creative for its own interest and for the community. Adam Smith's invisible hand is at work. Anne -- Anne C. Crowley, L.Ac., M.Ac., Dipl.Ac. www.LaPlataAcupuncture.com -------------- Original message ---------------------- " Angela Pfaffenberger, PH.D. " <angelapfa > I worked in a chiros office for 7 years and he saw 8 clients an hour, making a > payment of $27 not so bad. His theory was that the adjustment only takes 15 > seconfa and spending 5 minuets per client was generous. > > Also, as a Medicare provider you have the choice to " accept assignment " or not. > Accepting assignment means you take the payment as payment in full, not > accepting assignment means you charge additional what you see fit. Clients that > are poor and do not have any additional coverage may call ahead and ask if you > accept assignment. I also worked in a physicians office where I learned > insurance billing, and Medicare billing is pretty consistent, less cumbersome > than ASH in my opinion. > Having Medicare cover acupuncture is clearly in the interest of patients who are > on very limited income. Objecting to such coverage because you don't want to do > the billing seems very self-centered and devoid of empathy to me. Do you know > that many people suffer from chronic pain and are unable to pay for the care > they need? Does that not bother you?? I wonder why you entered a healing > profession.... > > Regards, > Angela Pfaffenberger, Ph.D. > > angelapfa > > www.InnerhealthSalem.com > > Phone: 503 364 3022 > - > Joni Kroll, D.Ac. > Chinese Medicine > Sunday, January 25, 2009 3:31 PM > medicare > > > While coverage in Medicare might be great for seniors, it may not be so > great for acupuncturists. Current reimbursement for a basic > chiropractic visit is $27, plus a $6 co-pay. MD friends of mine say > that it costs them to see a medicare patient as payment is lower than > their average overhead cost-per-patient. Having done medicare billing > in years past, I know that medicare billing is complicated with rules > constantly changing and with stiff penalties, even for " innocent " > errors. i do realize that other insurance companies often only cover > what medicare covers, and acupunctures inclusion in medicare may open > doors to many who might not otherwise benefit from our amazing > medicine. However, we must be diligent in seeing that our > reimbursements are at levels that exceed our cost of doing business! In > addition, don't think that just because you don't take insurance that > you are immune from medicare laws. Once acupuncture is a benefit, > licensed providers will have to comply with all medicare laws, whether > you take insurance or not. " Opting out " is possible, but is a tricky > cumbersome process, as told to me by MD friends and my chiropractor > husband. Be careful of what you ask for because you might actually get > it > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 27, 2009 Report Share Posted January 27, 2009 Andrea: He is a famous 1700's Scotish philospher, and in modern terms an economic thinker, who wrote " The Wealth of Nations. " In it he writes of the " invisible hand " . If everyone is acting in their own self interest, doing what they are motivated to do, everyone will benefit. It is a very free market theory, however, Adam Smith himself said, he expected men to lend a hand to the less fortunate. He thought it would all be taken care of through the market. I brought him up because I feel our profession can take care of the needs of many, through the different services we offer. I still firmly believe, all of us have a right to earn a good living, covering all of our hidden costs. It snowed in the Washington DC area today. All patients had to be cancelled due to the way we clear roads around here. That is a substantial loss of income. There is no sick pay or annual leave when you are an entrepeneur in the service business. Anne -- Anne C. Crowley, L.Ac., M.Ac., Dipl.Ac. www.LaPlataAcupuncture.com -------------- Original message ---------------------- < > Anne, > > Who is Adam Smith? And what is his invisible hand? > > Thanks, > Andrea Beth > > > Traditional Oriental Medicine > Happy Hours in the CALM Center > 1770 E. Villa Drive, Suite 5 > Cottonwood, AZ 86326 > (928) 274-1373 > > > --- On Mon, 1/26/09, anne.crowley <anne.crowley wrote: > anne.crowley <anne.crowley > Re: medicare > Chinese Medicine > Monday, January 26, 2009, 9:50 PM > > Wow, this opens up a whole can of worms for me. Compassionate care and earning > a living comes to mind. > > First, let me say that I think Community Acupuncture is a wonderful answer to > low-cost acupuncture. The practitioner is not forced to go into poverty, since > it is group work and can return a decent wage. Chrios at 5 mins for $27 - like > someone said, not bad, but all that paperwork to go with it. > > I, like Hugo, get very concerned about the government getting into this. I > think the profession can take care of itself by offering community acupuncture. > I wish it were more available in my area, as I really see it as a unique > business model and difficult to integrate into what I do. > > I really think the experience in my clinic (and I see two patients and hour) is > a lot more relaxing and inviting than a 5 min visit with a chiro. At least the > chiros I have seen do that, don't give off that relaxing feeling. I think > that accounts for the difference in fees and service. > > I see many in the healing profession that do not give discounts or treat for > free, e.g. doctors and dentists. There are many nurses in the healing > profession, that at the end of the day, don't say " I'll take a 20% > discount because that is what the market will bear.' As we have stated on > this site many times, acupuncturists go out of business or work very part time, > all the time. Most cases can be attributed to knowing how to run a business, > and market a practice. It is tricky in the healing we do. We all want to give > it to everyone, but is that really feasible? > > It took me about 3 years to go beyond break even. If I didn't have my > husband's income, I would be a statistic in this field. Later I learned > more about running a business and consider myself doing well. One of my > colleagues in another area has a very successful practice (again with growing > pains) doing fertility work. She just told me the other day she has no > retirement. Her health care has a $5000 deductible, so she pays out of pocket > for uncovered services. She had some medical work done recently that costs > $3000. All out of her pocket. No visits to an emergency room for free. So the > real cost of doing what we do is more than meets the eye. I am not even taking > into account the cost of going to school, foregone income, overhead, equipment. > And, I guess the underlying thing here is, " It really is okay to make > money. " It's kinda necessary in the world in which we live. > > Again, I think the profession is getting creative for its own interest and for > the community. Adam Smith's invisible hand is at work. > > > Anne > > -- > Anne C. Crowley, L.Ac., M.Ac., Dipl.Ac. > > www.LaPlataAcupuncture.com > > -------------- Original message ---------------------- > " Angela Pfaffenberger, PH.D. " <angelapfa > > I worked in a chiros office for 7 years and he saw 8 clients an hour, > making a > > payment of $27 not so bad. His theory was that the adjustment only takes > 15 > > seconfa and spending 5 minuets per client was generous. > > > > Also, as a Medicare provider you have the choice to " accept > assignment " or not. > > Accepting assignment means you take the payment as payment in full, not > > accepting assignment means you charge additional what you see fit. Clients > that > > are poor and do not have any additional coverage may call ahead and ask if > you > > accept assignment. I also worked in a physicians office where I learned > > insurance billing, and Medicare billing is pretty consistent, less > cumbersome > > than ASH in my opinion. > > Having Medicare cover acupuncture is clearly in the interest of patients > who are > > on very limited income. Objecting to such coverage because you don't > want to do > > the billing seems very self-centered and devoid of empathy to me. Do you > know > > that many people suffer from chronic pain and are unable to pay for the > care > > they need? Does that not bother you?? I wonder why you entered a healing > > profession.... > > > > Regards, > > Angela Pfaffenberger, Ph.D. > > > > angelapfa > > > > www.InnerhealthSalem.com > > > > Phone: 503 364 3022 > > - > > Joni Kroll, D.Ac. > > Chinese Medicine > > Sunday, January 25, 2009 3:31 PM > > medicare > > > > > > While coverage in Medicare might be great for seniors, it may not be so > > great for acupuncturists. Current reimbursement for a basic > > chiropractic visit is $27, plus a $6 co-pay. MD friends of mine say > > that it costs them to see a medicare patient as payment is lower than > > their average overhead cost-per-patient. Having done medicare billing > > in years past, I know that medicare billing is complicated with rules > > constantly changing and with stiff penalties, even for > " innocent " > > errors. i do realize that other insurance companies often only cover > > what medicare covers, and acupunctures inclusion in medicare may open > > doors to many who might not otherwise benefit from our amazing > > medicine. However, we must be diligent in seeing that our > > reimbursements are at levels that exceed our cost of doing business! In > > addition, don't think that just because you don't take insurance > that > > you are immune from medicare laws. Once acupuncture is a benefit, > > licensed providers will have to comply with all medicare laws, whether > > you take insurance or not. " Opting out " is possible, but is a > tricky > > cumbersome process, as told to me by MD friends and my chiropractor > > husband. Be careful of what you ask for because you might actually get > > it > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 28, 2009 Report Share Posted January 28, 2009 Thank you, Anne. I appreciate you taking the time to write to me about this. May all your roads clear soon, and patients beat a path to your door! Andrea Beth Traditional Oriental Medicine Happy Hours in the CALM Center 1770 E. Villa Drive, Suite 5 Cottonwood, AZ 86326 (928) 274-1373 --- On Tue, 1/27/09, anne.crowley <anne.crowley wrote: anne.crowley <anne.crowley Re: medicare and Adam Smith Chinese Medicine Tuesday, January 27, 2009, 2:10 PM Andrea: He is a famous 1700's Scotish philospher, and in modern terms an economic thinker, who wrote " The Wealth of Nations. " In it he writes of the " invisible hand " . If everyone is acting in their own self interest, doing what they are motivated to do, everyone will benefit. It is a very free market theory, however, Adam Smith himself said, he expected men to lend a hand to the less fortunate. He thought it would all be taken care of through the market. I brought him up because I feel our profession can take care of the needs of many, through the different services we offer. I still firmly believe, all of us have a right to earn a good living, covering all of our hidden costs. It snowed in the Washington DC area today. All patients had to be cancelled due to the way we clear roads around here. That is a substantial loss of income. There is no sick pay or annual leave when you are an entrepeneur in the service business. Anne -- Anne C. Crowley, L.Ac., M.Ac., Dipl.Ac. www.LaPlataAcupuncture.com -------------- Original message ---------------------- < > Anne, > > Who is Adam Smith? And what is his invisible hand? > > Thanks, > Andrea Beth > > > Traditional Oriental Medicine > Happy Hours in the CALM Center > 1770 E. Villa Drive, Suite 5 > Cottonwood, AZ 86326 > (928) 274-1373 > > > --- On Mon, 1/26/09, anne.crowley <anne.crowley wrote: > anne.crowley <anne.crowley > Re: medicare > Chinese Medicine > Monday, January 26, 2009, 9:50 PM > > Wow, this opens up a whole can of worms for me. Compassionate care and earning > a living comes to mind. > > First, let me say that I think Community Acupuncture is a wonderful answer to > low-cost acupuncture. The practitioner is not forced to go into poverty, since > it is group work and can return a decent wage. Chrios at 5 mins for $27 - like > someone said, not bad, but all that paperwork to go with it. > > I, like Hugo, get very concerned about the government getting into this. I > think the profession can take care of itself by offering community acupuncture. > I wish it were more available in my area, as I really see it as a unique > business model and difficult to integrate into what I do. > > I really think the experience in my clinic (and I see two patients and hour) is > a lot more relaxing and inviting than a 5 min visit with a chiro. At least the > chiros I have seen do that, don't give off that relaxing feeling. I think > that accounts for the difference in fees and service. > > I see many in the healing profession that do not give discounts or treat for > free, e.g. doctors and dentists. There are many nurses in the healing > profession, that at the end of the day, don't say " I'll take a 20% > discount because that is what the market will bear.' As we have stated on > this site many times, acupuncturists go out of business or work very part time, > all the time. Most cases can be attributed to knowing how to run a business, > and market a practice. It is tricky in the healing we do. We all want to give > it to everyone, but is that really feasible? > > It took me about 3 years to go beyond break even. If I didn't have my > husband's income, I would be a statistic in this field. Later I learned > more about running a business and consider myself doing well. One of my > colleagues in another area has a very successful practice (again with growing > pains) doing fertility work. She just told me the other day she has no > retirement. Her health care has a $5000 deductible, so she pays out of pocket > for uncovered services. She had some medical work done recently that costs > $3000. All out of her pocket. No visits to an emergency room for free. So the > real cost of doing what we do is more than meets the eye. I am not even taking > into account the cost of going to school, foregone income, overhead, equipment. > And, I guess the underlying thing here is, " It really is okay to make > money. " It's kinda necessary in the world in which we live. > > Again, I think the profession is getting creative for its own interest and for > the community. Adam Smith's invisible hand is at work. > > > Anne > > -- > Anne C. Crowley, L.Ac., M.Ac., Dipl.Ac. > > www.LaPlataAcupuncture.com > > -------------- Original message ---------------------- > " Angela Pfaffenberger, PH.D. " <angelapfa > > I worked in a chiros office for 7 years and he saw 8 clients an hour, > making a > > payment of $27 not so bad. His theory was that the adjustment only takes > 15 > > seconfa and spending 5 minuets per client was generous. > > > > Also, as a Medicare provider you have the choice to " accept > assignment " or not. > > Accepting assignment means you take the payment as payment in full, not > > accepting assignment means you charge additional what you see fit. Clients > that > > are poor and do not have any additional coverage may call ahead and ask if > you > > accept assignment. I also worked in a physicians office where I learned > > insurance billing, and Medicare billing is pretty consistent, less > cumbersome > > than ASH in my opinion. > > Having Medicare cover acupuncture is clearly in the interest of patients > who are > > on very limited income. Objecting to such coverage because you don't > want to do > > the billing seems very self-centered and devoid of empathy to me. Do you > know > > that many people suffer from chronic pain and are unable to pay for the > care > > they need? Does that not bother you?? I wonder why you entered a healing > > profession.... > > > > Regards, > > Angela Pfaffenberger, Ph.D. > > > > angelapfa > > > > www.InnerhealthSalem.com > > > > Phone: 503 364 3022 > > - > > Joni Kroll, D.Ac. > > Chinese Medicine > > Sunday, January 25, 2009 3:31 PM > > medicare > > > > > > While coverage in Medicare might be great for seniors, it may not be so > > great for acupuncturists. Current reimbursement for a basic > > chiropractic visit is $27, plus a $6 co-pay. MD friends of mine say > > that it costs them to see a medicare patient as payment is lower than > > their average overhead cost-per-patient. Having done medicare billing > > in years past, I know that medicare billing is complicated with rules > > constantly changing and with stiff penalties, even for > " innocent " > > errors. i do realize that other insurance companies often only cover > > what medicare covers, and acupunctures inclusion in medicare may open > > doors to many who might not otherwise benefit from our amazing > > medicine. However, we must be diligent in seeing that our > > reimbursements are at levels that exceed our cost of doing business! In > > addition, don't think that just because you don't take insurance > that > > you are immune from medicare laws. Once acupuncture is a benefit, > > licensed providers will have to comply with all medicare laws, whether > > you take insurance or not. " Opting out " is possible, but is a > tricky > > cumbersome process, as told to me by MD friends and my chiropractor > > husband. Be careful of what you ask for because you might actually get > > it > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 28, 2009 Report Share Posted January 28, 2009 Thanks Andrea, the invisible hand is working already. Anne -- Anne C. Crowley, L.Ac., M.Ac., Dipl.Ac. www.LaPlataAcupuncture.com -------------- Original message ---------------------- < > Thank you, Anne. I appreciate you taking the time to write to me about this. > May all your roads clear soon, and patients beat a path to your door! > > Andrea Beth > > Traditional Oriental Medicine > Happy Hours in the CALM Center > 1770 E. Villa Drive, Suite 5 > Cottonwood, AZ 86326 > (928) 274-1373 > > > --- On Tue, 1/27/09, anne.crowley <anne.crowley wrote: > anne.crowley <anne.crowley > Re: medicare and Adam Smith > Chinese Medicine > Tuesday, January 27, 2009, 2:10 PM > > Andrea: > > He is a famous 1700's Scotish philospher, and in modern terms an economic > thinker, who wrote " The Wealth of Nations. " In it he writes of the > " invisible hand " . If everyone is acting in their own self interest, > doing what they are motivated to do, everyone will benefit. It is a very free > market theory, however, Adam Smith himself said, he expected men to lend a hand > to the less fortunate. He thought it would all be taken care of through the > market. > > I brought him up because I feel our profession can take care of the needs of > many, through the different services we offer. I still firmly believe, all of > us have a right to earn a good living, covering all of our hidden costs. It > snowed in the Washington DC area today. All patients had to be cancelled due to > the way we clear roads around here. That is a substantial loss of income. > There is no sick pay or annual leave when you are an entrepeneur in the service > business. > > Anne > -- > Anne C. Crowley, L.Ac., M.Ac., Dipl.Ac. > > www.LaPlataAcupuncture.com > > -------------- Original message ---------------------- > < > > Anne, > > > > Who is Adam Smith? And what is his invisible hand? > > > > Thanks, > > Andrea Beth > > > > > > Traditional Oriental Medicine > > Happy Hours in the CALM Center > > 1770 E. Villa Drive, Suite 5 > > Cottonwood, AZ 86326 > > (928) 274-1373 > > > > > > --- On Mon, 1/26/09, anne.crowley > <anne.crowley wrote: > > anne.crowley <anne.crowley > > Re: medicare > > Chinese Medicine > > Monday, January 26, 2009, 9:50 PM > > > > Wow, this opens up a whole can of worms for me. Compassionate care and > earning > > a living comes to mind. > > > > First, let me say that I think Community Acupuncture is a wonderful answer > to > > low-cost acupuncture. The practitioner is not forced to go into poverty, > since > > it is group work and can return a decent wage. Chrios at 5 mins for $27 - > like > > someone said, not bad, but all that paperwork to go with it. > > > > I, like Hugo, get very concerned about the government getting into this. > I > > think the profession can take care of itself by offering community > acupuncture. > > I wish it were more available in my area, as I really see it as a unique > > business model and difficult to integrate into what I do. > > > > I really think the experience in my clinic (and I see two patients and > hour) is > > a lot more relaxing and inviting than a 5 min visit with a chiro. At > least the > > chiros I have seen do that, don't give off that relaxing feeling. I > think > > that accounts for the difference in fees and service. > > > > I see many in the healing profession that do not give discounts or treat > for > > free, e.g. doctors and dentists. There are many nurses in the healing > > profession, that at the end of the day, don't say " I'll take > a 20% > > discount because that is what the market will bear.' As we have > stated on > > this site many times, acupuncturists go out of business or work very part > time, > > all the time. Most cases can be attributed to knowing how to run a > business, > > and market a practice. It is tricky in the healing we do. We all want to > give > > it to everyone, but is that really feasible? > > > > It took me about 3 years to go beyond break even. If I didn't have my > > husband's income, I would be a statistic in this field. Later I > learned > > more about running a business and consider myself doing well. One of my > > colleagues in another area has a very successful practice (again with > growing > > pains) doing fertility work. She just told me the other day she has no > > retirement. Her health care has a $5000 deductible, so she pays out of > pocket > > for uncovered services. She had some medical work done recently that costs > > $3000. All out of her pocket. No visits to an emergency room for free. > So the > > real cost of doing what we do is more than meets the eye. I am not even > taking > > into account the cost of going to school, foregone income, overhead, > equipment. > > And, I guess the underlying thing here is, " It really is okay to make > > money. " It's kinda necessary in the world in which we live. > > > > Again, I think the profession is getting creative for its own interest and > for > > the community. Adam Smith's invisible hand is at work. > > > > > > Anne > > > > -- > > Anne C. Crowley, L.Ac., M.Ac., Dipl.Ac. > > > > www.LaPlataAcupuncture.com > > > > -------------- Original message ---------------------- > > " Angela Pfaffenberger, PH.D. " > <angelapfa > > > I worked in a chiros office for 7 years and he saw 8 clients an hour, > > making a > > > payment of $27 not so bad. His theory was that the adjustment only > takes > > 15 > > > seconfa and spending 5 minuets per client was generous. > > > > > > Also, as a Medicare provider you have the choice to " accept > > assignment " or not. > > > Accepting assignment means you take the payment as payment in full, > not > > > accepting assignment means you charge additional what you see fit. > Clients > > that > > > are poor and do not have any additional coverage may call ahead and > ask if > > you > > > accept assignment. I also worked in a physicians office where I > learned > > > insurance billing, and Medicare billing is pretty consistent, less > > cumbersome > > > than ASH in my opinion. > > > Having Medicare cover acupuncture is clearly in the interest of > patients > > who are > > > on very limited income. Objecting to such coverage because you > don't > > want to do > > > the billing seems very self-centered and devoid of empathy to me. Do > you > > know > > > that many people suffer from chronic pain and are unable to pay for > the > > care > > > they need? Does that not bother you?? I wonder why you entered a > healing > > > profession.... > > > > > > Regards, > > > Angela Pfaffenberger, Ph.D. > > > > > > angelapfa > > > > > > www.InnerhealthSalem.com > > > > > > Phone: 503 364 3022 > > > - > > > Joni Kroll, D.Ac. > > > Chinese Medicine > > > Sunday, January 25, 2009 3:31 PM > > > medicare > > > > > > > > > While coverage in Medicare might be great for seniors, it may not > be so > > > great for acupuncturists. Current reimbursement for a basic > > > chiropractic visit is $27, plus a $6 co-pay. MD friends of mine say > > > > that it costs them to see a medicare patient as payment is lower > than > > > their average overhead cost-per-patient. Having done medicare > billing > > > in years past, I know that medicare billing is complicated with > rules > > > constantly changing and with stiff penalties, even for > > " innocent " > > > errors. i do realize that other insurance companies often only > cover > > > what medicare covers, and acupunctures inclusion in medicare may > open > > > doors to many who might not otherwise benefit from our amazing > > > medicine. However, we must be diligent in seeing that our > > > reimbursements are at levels that exceed our cost of doing > business! In > > > addition, don't think that just because you don't take > insurance > > that > > > you are immune from medicare laws. Once acupuncture is a benefit, > > > licensed providers will have to comply with all medicare laws, > whether > > > you take insurance or not. " Opting out " is possible, but > is a > > tricky > > > cumbersome process, as told to me by MD friends and my chiropractor > > > > husband. Be careful of what you ask for because you might actually > get > > > it > > > > > > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
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