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Physicians – FAQ’s

Physicians
Commonly asked questions by Physicians

What types of patients do you normally see?

Patients who are recovering from soft tissue injuries. We commonly see patients recovering from automobile accidents, surgeries, and sports injuries, to name just a few. We also see patients with fibromyalgia, scoliosis, adaptive myofascial shortening injuries, multiple sclerosis, stroke victims, etc.

Is there an easy way to know if a massage therapist has the qualifications to do medical massage effectively?

Currently the only way to know is to ask your therapists about their training and experience. Make sure that your therapists have training in evaluation and assessment as well as training in advanced bodywork techniques and experience working in a clinical setting.

It is a good idea to have therapists on your team who can handle all aspects of insurance billing, for the convenience of your patients. Outside of PIP claims, not many insurance companies are willing to pay for medical massage yet, but we are hoping that they will soon. We will be happy to call the patient’s insurer to find out what their specific policy will cover.

When you find a good medical massage team to work with, get to know them – get to know their strengths, so you can use all of their services to better benefit your patients.

What should I expect for my patients from a medical massage session at A&E?

During their first session, your patient’s situation will be assessed. We will evaluate your patient’s condition through a series of range of motion tests (in which we are looking for passive, active, and resisted range of motion issues). We will check for contraindications to medical massage, evaluate the patient’s phase of healing, complete a postural and palpatory evaluation, and formulate a plan of care based on your diagnoses and the findings of our evaluation. We will send this initial evaluation and plan to you for your approval. If at any time you decide that the patient is ready for treatment of other body areas, you can download our simple form, fill it out, and fax it to us.

Following the evaluation, if we find no contraindications, the patient will receive treatment. Depending on your patient’s phase of healing and your prescription, this may consist of regular massage (meaning effleurage, petrissage and tapotement only), the application of heat/cold or topical pain relief preparations, trigger point therapy, assisted stretching without active resistance, neuro-muscular rehabilitation (PNF stretches), muscle-energy techniques (MET), myofascial release, or other manual therapies.

Here is what not to expect: In most massage therapy instruction programs, there is training in offering stretches and exercises for the client to do at home, and to advise the client to drink plenty of water following their massage treatment. This is sound advice in most cases, but the medical massage model is quite different. At A & E Medical Massage, although we have been trained in stretches and therapeutic exercises, we will not offer any post-treatment suggestions unless specifically instructed by you, in writing, for each individual case. We will also not treat any area that does not have a soft tissue diagnosis code provided by you.

How will A&E Medical Massage handle my patients’ cases in general?

We have already touched on the initial evaluation in the answer to the previous question. At the end of each prescription, we will perform a re-evaluation and send it to you. Monthly progress reports may also be sent, depending on the length of the prescription, to help you determine your patient’s progress. From time to time, we may call you to request a verbal conference regarding the patient’s progress, and we will be available for you to do the same.

Unless it is not possible for scheduling reasons, each patient will be assigned to one therapist. We do this to promote ease in tracking your patients’ cases, and to increase your patients’ comfort.

At A&E Medical Massage, we hold periodic peer conferences, where we discuss our cases with other medical massage therapists, PTs, and physicians, following HIPAA guidelines. We brainstorm for the patients that are not progressing as rapidly as we or you would like. It is our goal to gain as much normal range of motion as possible for your patients, decrease pain as much as possible, and to do it quickly. Pain hurts, and people have lives to lead. We believe that a good reputation comes from being effective in our work, and we believe that that will also reflect well on you.

Why should I use your form instead of my regular prescription form?

Some physicians will prefer to use their own prescription forms, but we find that our prescription form saves time for us and for our prescribing physicians in the long run. It is clear and concise, and it has all of the information we need to properly handle a prescribed case. This way we don’t have to call you back multiple times and ask for clarification on diagnosis codes or procedures. Massage therapists are licensed as ancillary providers. As such, we are required to have proof of prescription, referral, and medical necessity from a primary care physician, or insurance companies may deny payment on our claims.

Why is there nowhere to specify length of treatment on your prescription form?

Length of treatment is determined by the areas diagnosed by you for treatment. On each date of service, a maximum of two physical medicine CPT procedures (15 minutes each) per body area, with a maximum of four total CPT codes per date of service, may be billed to insurance. The three body areas that are considered industry standard for physical medicine billing are the axial skeleton, upper extremeties, and lower extremeties. Four total CPT codes would require that a minimum of two or more body areas are diagnosed to be treated. If three body areas are diagnosed for treatment, the maximum CPT usage is still limited to four. If we are given four diagnosis codes, but all of them are in the axial skeleton, the patient is still allowed only two CPT codes per date of service. This is also why it is inadvisable for the patient to see us and the physical therapist on the same day.

Is it a good idea to prescribe medical massage at the same time my patients are in physical therapy?

Only you can answer that question. PT often focuses on increasing strength, but a large body of evidence and scientific studies show that it is not necessarily efficient to strengthen before lengthening. This is why some physicians find that prescribing both together generates the fastest improvement for their patients.

Why should I send my patients to A&E Medical Massage?

This is another question only you can answer. But here’s why we think you should. At A&E Medical Massage, we seek to have good working relationships with our physicians, and to communicate regularly about each patient. But we also understand that your time is limited and valuable. We know that if you send us your patients, you are trusting us with someone very important. That is why we make a point of never stepping outside the bounds of your prescription. If you refer a patient for cervical sprain/strain, your patient will be treated for cervical sprain/strain, and nothing else. If we find that adjacent areas may have related pathologies, we will inform you of our findings, and ask if you feel that those areas are also ready to be worked. But unless we have a specific soft tissue diagnosis code from you, we will not treat an area. Period. Please be aware of this.

We are also very much interested in continuing education, expanding our toolboxes, and learning all we can about soft tissue therapies. It is important to us to provide the most intelligent, educated therapy possible to help your patients recover fully and quickly. No matter what the standard for medical massage therapy becomes, know that we will not stop there. When you are passionate about something, it drives you. We love what we do, and we hope it shows.

Can medical massage affect patient compliance?

Sometimes a patient will discontinue treatment because he or she feels that there is no more improvement to be had, or they don’t want to rely on pharmaceutical therapy for a protracted period of time, or they do not see the long-term benefits in your plan of care for them. Whatever the reasoning, sending those patients for medical massage can be a good way to get them to improve enough that they are willing to continue with the remainder of your recommended treatment.

Information for Physicians

  • Orthopedic/Medical Massage by Prescription
  • Nationally Certified Medical Massage Therapists
  • Motor Vehicle Accident Cases/PIP Insurance Billing

You need quality, professional, consistent therapy that gets results for your patients who are recovering from soft tissue injuries. We can help. In addition to all of the benefits of medical massage/manual therapy that you already know about, A&E Medical Massage offers some less common services to our physicians, including the following:

  • We will insist that your patients keep all of their appointments with you. They can come see us only if they are current with your plan of care. Following your recommendations is essential to your patient’s recovery, and we will do everything we can to encourage their trust in you and their compliance with your directions.
  • We will work only on those areas covered by your prescription. We know that there are reasons why you diagnose what you diagnose, and reasons why you might omit other areas. When you send your patients to A&E Medical Massage, they will receive focused outcome-based soft tissue techniques that are designed to increase range of motion and decrease pain to diagnosed areas.
  • We will perform a detailed evaluation at the time of the initial visit and a re-eval at the end of each subsequent prescription. We will send you these reports so that you can more easily track your patients’ progress, and fine-tune a plan of care that best fits the needs of each individual.
  • We are Certified Medical Massage Therapists. Each of us has at least 500 additional hours of training and years of professional experience dealing with injury cases. Soft tissue injury work is our specialization. Your patients can feel comfortable in our professional environment and confident that they will get individualized help for their specific injury issues.

Other questions?

If you ever have any questions or comments about our clinic, or about the way we are handling your patients’ cases, please do not hesitate to call or email us. If we don’t answer the phone when you call during regular business hours, it is probably because we are with a patient. Your patients will enjoy the same undivided attention when they are at our clinic. Please leave us a message. We will get back to you as soon as we can.

Allow our professionalism to benefit you.