Let’s get real for a second. You’re in this business to change lives, not to dance to the tune of insurance companies or the Department of Veterans Affairs. But here’s a cautionary tale that might just be the wake-up call you need.
Ever heard of Dr. Dongxin Ma? Probably not, unless you’re a regular reader of legal dramas in the healthcare world. Dr. Ma, an acupuncturist in Austin, recently got slammed with a $2.3 million fine for playing fast and loose with the VA’s billing rules. He billed for 60 minutes of one-on-one care per patient, even if he only spent 15 minutes with them. The result? A lawsuit under the False Claims Act and a career-damaging settlement.
Let’s be crystal clear here – contrary to popular belief – insurance codes are based on face to face time with the patient. It’s not based on needle retention time, which is a popular misconception. The insurance companies scrutinize every minute spent with the patient to ensure accurate billing. When you bill for acupuncture services, the time you spend in direct, personal contact with your patient is what counts, not the duration the needles are left in place.
Dr. Ma was cited for treating up to 61 patients in a single day. Now, seeing 61 patients in a single day? No problem. That’s truly not hard to do and we know a number of practitioners who manage such numbers with ease.
What is IMPOSSIBLE to do, however, is spend 53 minutes face to face time to bill the four units of acupuncture that Dr. Ma claimed. To put it in perspective, that would require 61 hours in a day. Last time we checked, a day totals 24 hours.
This isn’t just about one guy’s misfortune. It’s a stark reminder of the strict, sometimes suffocating rules that come with billing insurance. And that’s a major reason why we at Mitowi Management are all about a cash-based practice. When you rely on insurance, you’re handing over the keys to your practice and letting someone else steer. You and your patients lose the power to make the best decisions for their care.
With our method, you keep that power. We’ve helped thousands of practices transition out of network and regain control of their destiny. Imagine not having to deal with insurance red tape, freeing up your time to focus on what really matters – providing stellar care to your patients and growing your practice.
If you’re ready to reclaim your practice and your peace of mind, let’s chat. Let’s discuss how we can help you make the shift to a cash-based model and leave the insurance headaches behind.
Remember, you didn’t become an acupuncturist to be a paper-pusher for insurance companies. You did it to make a difference. And we’re here to help you do just that, without the bureaucratic BS.
P.S. Don’t wait until you’re neck-deep in paperwork and audits. Let’s talk about making a change today. Schedule your call here.