Most providers who bill insurance also offer some type of prompt-pay (time-of-service) discount. That’s allowed, and it makes sense—it reflects the real costs the office avoids when it doesn’t have……
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Financial Policies When was the last time you looked at your financial policy? Do you even have one? Financial policies allow for patient engagement. If patients are aware of and……
Can YOU supervise staff to provide acupressure or massage to patients? Yes, in some states you can, for example, in California, the Business and Professions Code permits acupuncturists to direct……
Starting in 2025 we saw many changes to Medicare Advantage plans. In 2025 Premera BCBS exited the MA marketplace and BCBS of MA discontinued specific plans. This year BCBS of…
Recently it was discovered that Aetna had been incorrectly processing claims for Suffolk County Employees insurance plan (EMHP). Apparently, this plan has a $30 max benefit, yet up until recently…
The 2026 updates are mostly focused on making sure clinics have real, documented systems to protect patient information, (cybersecurity). Even solo-practitioners don’t fly under the radar as far as HIPAA…
Understanding CPT 97110 is essential for accurate billing and proper reimbursement. This code describes therapeutic exercises provided with direct, one-on-one contact, designed to improve strength, endurance, range of motion, and…
Some providers want to join insurance networks that are currently closed to new applicants. While nothing is guaranteed, the strategies below can increase your chances of getting noticed — and…
1. Know What Kind of Audit You’re Dealing With Not all audits carry the same weight. Some have minimal consequences, while others can lead to clawbacks, expanded investigations, or serious……
If you’ve received letters, audits, or “re-priced” claims from any of these companies, you’re not alone. These third-party entities all play behind-the-scenes roles for major insurance carriers — and their…
Let’s face it—no provider truly enjoys talking about money. You’d much rather focus on what matters most: helping patients improve their health, tracking their progress, and celebrating their wins.
Every year we see at least one carrier denying codes that were previously paid. So far this year we’ve had two carriers that all of a sudden started denying codes that were previously covered and paid.
Providers complain ALL the time about Insurance but what does that get you? NO WHERE! Carriers don’t care what you have to say, but they DO CARE, and they HAVE TO CARE, when patients complain.
There are MORE and MORE acupuncturists being asked for records and MORE and MORE acupuncturists are also being audited.
It is important to understand that most providers are contracted as individuals and NOT contracted under a group contract. Instead, they are tied to a tax ID. So, MOST clinics are not considered…
AB1468 is a new bill in the California Assembly which would mandate that all patients WITH acupuncture benefits would be allowed 12 visits before requiring a referral. LINK to AB1468…
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