Vivian Madison-Mahoney 2008 Massage Therapy Hall of Fame Inductee Vivian Madison-Mahoney knows first-hand the challenges & problems you face beginning your massage practice and incorporating medical referrals and accepting insurance for payment. She began just like you. After about a year of working out-calls at the rate of 6 to 8 (full hour or more) treatments a day, she opened a massage therapy practice that specialized in injury, disability, physician referrals, & insurance related cases. She is a regular columnist for “Massage Today” Magazine. She also writes articles for the “AMTA Florida Chapter Journal" Newsletter and the FSMTA's “Massage Message" Magazine and advises these associations about insurance related issues. Vivian says, "I guarantee there’s no one instructing massage therapists in insurance billing with this level of hands-on experience & knowledge working with medically prescribed, insurance cases. I do not teach how to get rich. I teach how to increase your income, help others who would otherwise not be able to have your services and to protect our profession!"

Terminology (Insurance, Medical & Legal)

2 CE Credit Hours

Working with phsicians, lawyers and insurance companies? Knowing their language benefits you and patients in your care.

You will learn some of the terminology for: Medical: Documentation, Directions or Position Codes, Treatment Codes, Condition Codes, Body Area Codes, Prescription, Diagnosis, Diagnostic Code, Modalities, Procedures, Dependent, Disability, ICD-9, MRI, MMI, IME, PTD, TD, CPT,

Insurance: Authorization. Workers' Compensation, Personal Injury, No-Fault, Verification, Evaluation, Re-Evaluation, E&M, Upcoding, Downcoding, Unbundling, Insured, ERISA, Medicare, Medicaid, Adjuster, Carrier, Primary, Case Management, Standard Disclosure, Clean Claims, Supplemental, Co-Payment, CMT, HMO, PPO, MCO, Med Pay, TOS Fees, Out of Network, Participating Provider, Subrogation, UN-insured, Under-Insured, Med-Pay, Affinity, Self Insured, Overutilization, Frequency & Duration, RBRVS, Subscriber, Member, SOAP, Vocational Rehabilitation, Charting, DOI, DOA, MVA

Legal: Interrogation, Interrogatories, Deposition, HIPPA, Hearing, Judge of Compensation Claims, Defense, Plaintiff, Affidavit, Dispute Resolution, Kickbacks, Brokering, Fee Splitting, Rental Arrangements, Safe Harbor, Mediation, Assignment, Arbitration, Appeal, Brief, Lien, LOP, Fraud

Insurance Billing Procedures, Laws & Rules

4 CE Credit Hours

The class will cover the following:

• Advanced preparation, what it takes to get started	• Tools of the Trade You'll Need
• FORMS, covering all forms, broken down into 5 categories	• Files, folders, how to set up forms, files and folders
• Is accepting insurance worth it?	• 9 simple steps to accepting insurance cases
• Cases to accept	• Cases to avoid
• How to find out if there are loopholes you might get through	• Current FL Laws as they pertain to PIP /auto insurance
• Interviewing patients	• Treating patients what to be aware of and why
• Communicating with insurance adjuster, what to ask for	• Documentation & know documentation is legal evidence
• 3 magic things to prevent delays, denials & reductions.	• All about codes, CPT & ICD-9 Codes, when & what to use
• Fees, Legal, Ethical, and UCR	• Can I charge more for insurance cases? If not, why?
. NPI (National Provider Number) How to obtain and why	• Filling out the NEW 1500 Claim Form, what goes where on the form
• Knowing the claim form, what goes with it in the mail	• Submitting claim form, how to prevent denials and delays
• Explanation of Benefits, what is it, what do you do with it?	• HIPAA Laws & Privacy Rules, do they affect you, if so how?
• Should I submit claims electronically? If not, why not?	• Collections made easy, how to limit collection processes
• Main causes of problems & how to prevent them up front.	• What it takes to be a success in one sentence
• Any unfinished business	• Questions and Answer session.

IRS & Taxes, "Deductions a Massage Therapist Can Take"

2 CE Credit Hours

"To avoid is legal, to evade is illegal"