Chiropractor VS. Spa - Which do you work at and why?

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JE in Seattle, Washington

53 months ago

@ DC in Chicago, Illinois

I agree, asking the question about what a DC bills to insurance is not very productive to anyone. However, may I ask a question that may have more meaning:

What is your expected or average net payment to you from each average billed amount to insurance? If your average billed amount is 125.00 per patient massage session (at my last office it was 130.00/hour) and your average actually received is 120.00. It's pretty basic math. Tax forms and end of year office tally's also have the figures to estimate all this. You probably already have the figures already if you've been in business for a couple of years. If so, you could just give the percentage amount of your average net return on a massage session that you pay an LMP.

LMP's it's helpful for you to ask an employer the above last question. Make life easier for yourselves. Massage is darn hard work, don't allow yourselves to get confused or abused.

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Darren in Rogers, Minnesota

53 months ago

Massage Advantage solves a world of massage employment issues. They are located exclusively in chiropractic offices and pay MT's twice the wages as most franchises. Their program is also designed to help the doctor build their practice all while offering discounted massage prices to the public. It's the best win,win,win in the massage market.

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JE in Seattle, Washington

53 months ago

Darren in Rogers, Minnesota said: Massage Advantage solves a world of massage employment issues. They are located exclusively in chiropractic offices and pay MT's twice the wages as most franchises. Their program is also designed to help the doctor build their practice all while offering discounted massage prices to the public. It's the best win,win,win in the massage market.

So if Massage Envy pays about 15/hour (the same amount I was paid as a housecleaner over 20 years ago, BTW), then your agency makes sure the LMP gets paid about 30/hour. Sounds better, however, I would still expect more since we know that Massage is billed for up to 130 dollars/hour by the Chiros. I would guess that they would net at least 85-100 average/hour over time and then could pay the therapists at least 50-60% of their net. Still sounds like nickel and diming for darn hard skilled labor that tends to cause injury and/or burn out, esp when some therapists attempt to make up for the fact that LMP hands-on work is meant to be a 15-20 hour
a week part of the job, by adding on hours when they should rest their bodies. If LMPs were paid more what they are worth- there would be less injury and burnout and everyone would be happy. All the chiros I know out here pay less than a quarter of what they earn off of massage. This is abuse! LMP's are getting injured left and right and are in pain. What can you do to help this problem? Make sue you find out how much the chiros actually make off of massage, then decide what to recommend as reasonable pay. You can be allies of both the chiros AND the LMP's not just the public-with discounted massage and-and the chiros. Who ever heard of discounted healthcare. Besides the chiros know that many folks get more out of a well done massage session than just from chiro alone. The chiros if left unchecked will abuse and try to over profiteer. Too many LMP's are not quite up on this yet, not until they get injured.

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MaxMT in Modesto, California

53 months ago

I am glad to see the voice of reality. I am not sure why we MTs think that after 500 hours of training we should be able to make 30 an hour in someone's business where they take all the risk.

Supply and demand sucks for us right now, but this is the profession we chose. You can make a million bucks in what ever you decide to do but it will involve more then a part time work week.

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MaxMT in Modesto, California

53 months ago

Another massage therapist where I work was going to ask for 30 dollars from the doctor who provides EVERYTHING for us including advertising. Some of her instructors were advising her on how to get "what she is worth". She is now unemployed and the line to replace her goes all the way down the street. 25k a year is not bad for only working 25 hours a week. Add to that at least 5500 a year in tips. I am not saying that what we do is not necessary and extremely valuable for every person on the planet, but the truth is I didn't go to school for 8 years. I am not a doctor. Why should I expect to live like one, especially if I only work 1/2 of a regular work week.

Our demanding what we haven't earned makes the profession look foolish. When there are less of us, the compensation will increase. This is why nurses make so much money. They are only trained to follow orders. They cannot treat, diagnose, prescribe meds, or perform anything that they are not told to do. They make a lot of money because schools limit the number of graduates each year. That puts the demand higher then the supply. Then you have a nurse (medical technician) earning more then the training and education truly command. This is brilliant. MTs are being turned out in such large numbers that we have done this to ourselves. As a profession, lets begin to limit the number of graduates in our schools and the demand will increase and so will the pay. Of course this will require a significant increase in tuition because that will slow down the production of MTs.

It is a solid, long term, effective plan.

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Darren in Rogers, Minnesota

53 months ago

I'm all for someone earning as much as they can, but reality is reality. There is a limit that the market will pay for the service. We have put together a program that comes as close to meeting the demands of each party as I've ever seen, but unfortunately it's impossible to make everyone happy.

We welcome all suggestions and even critical reviews as this is how we have built what will be the largest and stongeset massage program in the US.

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JE in Seattle, Washington

53 months ago

Darren in Rogers, Minnesota said: I'm all for someone earning as much as they can, but reality is reality. There is a limit that the market will pay for the service. We have put together a program that comes as close to meeting the demands of each party as I've ever seen, but unfortunately it's impossible to make everyone happy.

We welcome all suggestions and even critical reviews as this is how we have built what will be the largest and stongeset massage program in the US.

Darren and Max:

Yes, there are many different ways to measure all this- years in school, amount paid for schooling, risk of the business, risk of injury, the market, we could go on an on with all these variables. Let's keep things easier here, by starting with the irrefutable numbers- by speaking in terms of net profit of what chiros earn and what the percentage they pay of that to LMTs. Then we can move on to the variables. If you cannot answer that, then this discussion will only be confusing and not reach any substantive conclusion.

I'll start. Here the chiros bill 120.00- 130.00/hr massage. Frankly, they are very hush hush about what they net or profit. Keep in mind their chiro schooling is unrelated to hiring massage therapists. They have their main business, and they have a side business- owning a massage business. Spas seem to be more open about pay percentages. They pay about 60% of their net profit. If chiros are being good business folks, they know exactly what percentage of their net profit they pay MTs. Does anyone know a chiro who will not hide these easy to find out facts and is willing to post these facts (please- no need to post the name of the chiro- if they are open and have a good rate, I'm sure they would be inundated with calls from interested MTs)

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Darren in Minneapolis, Minnesota

53 months ago

I actually was the CEO for the largest private clinic group in MN for almost 8 years. So im very familiar to the fee schedules of a lot of chiro's. Not only that my company operates in 12 states currenly and I consult with chiro's in over 30. The only way I see anyone billing that kind of rate $120-$130 is on personal injury cases. Now to keep this in perspective the Chiro with over $200,000.00 invested in education MUST be the one to prescribe massage in order ti bill that rate, they also MUST oversee the treatment of the patient. Then they must submit to insurance and wait to collect. This in many cases amounts to years to ever complete the collection process, and even then there is a huge possibility they will need to accept less for the services provided then what was billed. Now I have never met and MT willing to wait for payment like the doctor often must. So is it a fair trade off to get paid on Friday for the massage provided on Monday at a lower rate while the doctor must wait months or even years to collect? Greed says "pay me now and pay me big", reality says those with the greatest risk earn the biggest reward.

People can argue you about or should I say disagree about anything anytime, but when it comes right down to it the doctor doesnt want to do the job of the MT and the MT is not educated enough to do what the doctor does. I'm sure most nurses would like to make as much as 50%-60% of the physician, but reality says. "It aint gonna happen"!

If you are unable or unwilling to accept a reasonable or fare wage for your services then do something else. I'm only here to help explain what I see and know to be true and the fact that for all those upset about how they are used, abused, and taken advantage of that there is other options. Those other options might not pay someone what they feel they are worth, but dont most people feel they are underpaid for their efforts?

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MaxMT in Modesto, California

53 months ago

I can get a copy of an explanation of benefits from an insurance company from my doctor. It is for one 15 minute segment. If you would like to see it, I will try to see if I can post it on my facebook or even the doctors facebook page. So, I performed the massage, the doctor recommended it, and billed for it, payed me, and didn't get paid. He said that this is one of the "good" insurances too. Email me at fornosonly@hotmail.com and I will send you a copy of the EOB. Put EOB in the subject line.

I am glad to help everyone understand that just because it is billed, doesn't mean it is paid.

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JE in Seattle, Washington

53 months ago

Mr CEO for chiros - not MT's- I'm still waiting for data. And,yes there is a reason why I don't work for chiros- you are one of the reasons. Beside why do you think the nurses union has to be so diligent to keep "fair" wages. Why don't you work for the MT's? Even though there are more of us than chiros, probably because they have no money left to pay a union and even they did, I'll bet folks like you would lobby against it.

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JE in Seattle, Washington

53 months ago

Max: My issue is not over whether a MT gets paid or not when the chiro does not get paid per massage session hour. My issue is over the % rate the chiro pays an MT from their total net pay received and that goes to the chiros bank account. No one has any idea??? Come on, lets just ask and eventually we will find out. Then we can discuss the variables and how they affect the MT pay.

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Darren in Minneapolis, Minnesota

53 months ago

JE,
Your condescending, disrespectful remarks speak volumes for your regard for  the profession. You reek of ignorance, and can't accept information from those in the know. I was in fact part of the Chiro industry, but today run one of the fastest growing massage operations helping therapist nationwide. I have placed and employed hundreds of therapist in my 10 years in the industry, and they are the number one reason I build the business model I operate today. So before you pick a fight with someone, know your facts.

Other than to stir drama there is no meaningful benefit to your insistence that any doctor l
should disclose there compensation schedules. You want to now what the billable service are go buy a cpt coding book and look them up. Either way it's irrelevant as your not accepting any responsibility inside the doctors offices. Your nurses don't get to base their pay off what the doctor bills? So if your not ok with the level of compensation DON'T DO THE JOB! 

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JE in Seattle, Washington

53 months ago

I'm not picking a fight, I'm just trying to get some facts. Why are you getting you feathers all ruffled up about that? Who's getting dramatic here? But, you don't know the facts I asked for. Just say you don't have those facts. I am happy with my level of compensation so I will do my job, thank you. And I don't need a chiropractor in order to get paid. If I ever find one who can pay what I earn elsewhere- great!
If I ever find one who will pay me an average of over 35 bucks an hour- great! I'll likely work some spare hours there. So far there is no sign anywhere around here of a chiro paying over 25 bucks an hour in the expensive area I live in. Under, yes, but not over. Your area must be doing better than average- Great!

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ChiroLMT in Sarasota, Florida

52 months ago

At our office the only insurance (aside from PI cases) that reimburses us anything for 97140 is Blue Cross Blue Shield.

Each unit of therapy (8-22m) in our office is billed at $45. We get just over $22.

That means that for one hour of manual therapy (which we don't do at our office, we do 1-2 units max/visit/patient) we get about $90. They pay us, usually, pretty quickly, at least within 60 days.

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Sonia in Cabot, Arkansas

52 months ago

What if you don't mind me asking are you collecting on your "cash" massages? Do you offer cash or only PI/ major medical?

You said you bill $45 per unit but only collect $22 per? So about $88, and are you collecting that on ever case?

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ChiroLMT in Sarasota, Florida

52 months ago

We rarely ever (and I mean maybe 1-2 in a month) do any "massage", and that's usually only 30 minutes. Cash price for that code is $20/unit (which would be $80/hour if we did an hour, which we don't.)

BCBS pays about $22 per unit and we "adjust" the remainder off under our contract with them.

For the manual therapy (the 97140) we bill $45 for cash patients (or patients whose benefits do not cover that code, which is most of them). In that case we usually do just one unit per visit.

We do PI cases. If they have insurance benefits it's a little longer for payment, it seems, but not nearly as long as if we have to wait for a settlement. If you've ever billed PI you know they usually try to pay you at a different rate, argue that it's contractual, etc. They try to get "cute" on you and if you don't know the rules, a lot of time an inexperienced front desk billing person will go along with it. We fight for the payment, and usually get the 80% that the insurance will cover. Sometimes they'll have the other 20% covered by either health insurance (if they cover those codes) or the other person's insurance. I'm not a billing person, so I can't give you much more than that on the PI.

I'd say that if we do 30 units of therapy per day, 10 will be BCBS ($22/$45), 10 will be covered only in part (the rest being patient responsibility, this would be a different code then 97140, usually 97110, paid 40-60%), and 10 will be "cash" (no insurance, still paying towards deductible, etc.)

We usually get about 50-60% of what we actually bill for our services. If the average patient has $140 worth of services in a visit, we try to collect about $80.

Does that help?

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Sonia

52 months ago

Yes it does. Thank you very much for the info.

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BBB823 in Scottsdale, Arizona

52 months ago

therapistinga in Atlanta, Georgia said: I currently work for both a chiropractor and a spa. I am an independant contractor at the chiro's office and I make $43 and hour. I supply my own linens and lotion and I set my own hours. At the spa, I typically make $30/hr + $5-20 gratuity/service. I sometimes get tips at the chiro but not very often.
The atmosphere at the spa is more soothing and relaxed. The chirporactic massage is more intense and physically demanding.

If you get this... Or anyone else that can help, I'd appreciate it... When you're working as an independent therapist in a chiropractors office, do you have to handle the insurance billing if they have insurance coverage, or does a general secretary/office personell handle it. And do you pay rent or anything to the chiropractor? There has to be some insentive for the chiropractor, otherwise why would they have you there, lol. Let me know... Anyone... :) Thanks! I'm looking to start massage school in a couple months, so I was just looking at my options. & I'm in Florida, not Arizona, that just generates automatically on my computer... Thanks again!

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bexon22 in Castries, Saint Lucia

52 months ago

Hi, in respond to your question about rent and a percent to the chiro...I believe there should be an agreement between you and the physician, if no question comes up you shouldn't worry about it,since you are not receiving direct payment from the patients, but be sure that you are up to date with things like taxes and other procedure that you should follow.

Liz

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bexon22 in Castries, Saint Lucia

52 months ago

Hi, I haven't been here for a while...does anyone heard about Far Infrared sauna? well I bought one for my practice last Sept and it works pretty well, my clients love it. I believe it's a good investment for a massage practice. If anyone is thinking of adding some other treatment to their practice try the Far Infrared Sauna.

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Sonia in Cabot, Arkansas

52 months ago

bexon22 in Castries, Saint Lucia said: Hi, in respond to your question about rent and a percent to the chiro...I believe there should be an agreement between you and the physician, if no question comes up you shouldn't worry about it,since you are not receiving direct payment from the patients, but be sure that you are up to date with things like taxes and other procedure that you should follow.

Liz

Do yourself a HUGE favor and talk to the folks at Massage Advantage before you make a move. They are experts in working with Massage and Chiropractic. You want to be an employee of the practice for tons of reasons: Like you will be covered under the “Practice of Medicine” law whereby you have greater protection from liability, you will have Work Comp in the event you get hurt and can’t work, you will have no overheard, you will have minimum marketing while you build your base. You base will be build 100x faster with their systems, and you receive coaching that has significant value in your future success. Anyone who tells you they don’t need support or coaching is either naive or ignorant. This is by far the strongest Massage Therapist/Clinic program I’ve ever seen and they are growing faster than any other massage business in the market today. Oh and you will earn top pay while working alongside a doctor.. Ya check it out a heck of gig especially if you just looking to get started.

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Beck in Cabot, Arkansas

52 months ago

BBB823 in Scottsdale, Arizona said: If you get this... Or anyone else that can help, I'd appreciate it... When you're working as an independent therapist in a chiropractors office, do you have to handle the insurance billing if they have insurance coverage, or does a general secretary/office personell handle it. And do you pay rent or anything to the chiropractor? There has to be some insentive for the chiropractor, otherwise why would they have you there, lol. Let me know... Anyone... :) Thanks! I'm looking to start massage school in a couple months, so I was just looking at my options. & I'm in Florida, not Arizona, that just generates automatically on my computer... Thanks again!

office staff should handle all billing. You do NOT want to be involved in insurance billing, unless its a seperate part of you duties and you should NEVER bill your own massages. Unless you like Orange Jump Suits and dont mind time in the pen??? The chances of a mistake happening and you could be accused of insurance fruad are not worth the risk....

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bodyworklady in Battle Creek, Michigan

52 months ago

Hello everyone! I'm hoping those with a little more knowledge than myself in regards to working with/for Chiropractors can make some suggestions. There is a Chiropractor who is interested in "seeing what we can put together" (his words). He would like me to submit somewhat of a proposal of what I would like to financially receive coming in twice per week as a sub-contractor. I have never worked at a Chiropractor's office, so I'm feeling lost on where negotiations should even start. He gave me zero information, but I'm assuming I would supply everything. Does anyone think it is fair to ask for a 70/30 split? Why or why not? If we agree on a percentage, should it be based off of what is billed or what is received? What would you suggest? Should I just ask for a base dollar amount instead? What are the other important questions to ask and terms to solidify? This is new to me as I have just been self employed up to this point. ANY help and suggestions would be GREATLY appreciated! Thank you!

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Beck

52 months ago

Tell him to call Massage Advantage. It will save you a ton of leg work and they are Experts in working with massage/Chiro (it's all they do FYI). There are many legal issues from "dual fee" "Stark Law" and fee splitting situations you can get wrapped up in if your not careful. There were more audits last year than anyother year in Chiro history with more be reported this year, you want to make 100% sure your compliant and these people know their stuff. Well worth a phone call if he is serious about doing it.

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Beck

52 months ago

Tell him to call Massage Advantage. It will save you a ton of leg work and they are Experts in working with massage/Chiro (it's all they do FYI). There are many legal issues from "dual fee" "Stark Law" and fee splitting situations you can get wrapped up in if your not careful. There were more audits last year than anyother year in Chiro history with more be reported this year, you want to make 100% sure your compliant and these people know their stuff. Well worth a phone call if he is serious about doing it.

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Shelly

52 months ago

I agree Massage Advatage is the best!

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MassageMom

52 months ago

Envy will not survive if these people are successful. I did my homework and found they are now in LA so I'm applying at their local center now. From what I've seen this is a whole new meaning to "big easy", and everyone I've talked to agrees! I've worked for 6 years in Chiro offices, but this is the first time anyone has figured it out how to make this a real business. Love it!

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DrCara in Atlanta, Georgia

52 months ago

To ALL MT's: Please send good MT's to me to interview! When you are working you will make at least $29.17 per hour plus tips, plus as an employee I will pay more of their taxes (vs. being an independant contractor).

I have read these posts and so many makie me sad. If you have had a bad experience with a Chiro, PLEASE don't say all are like that! I am a Chiropractor and have one MT working with me. I want to hire 3 more. Please do not bash all Chiro's. If you don't like where you are, leave. You deserve to get whatever was agreed to. You should do whatever you agreed to. That is why you should have a clear contract. I will be totally open about what I expect.

"rent" is $200 a month plus 50%. The result is the MT will make over $30/hr if they are massaging someone. We will schedule and bill ins for them. Having read the posts, that seems reasonable to me. MT can make more if they go out on their own, but I also have invested $15,000 in building out and branding One Stop Wellness. I hear on this post "how can they take so much of the MT's money when they do the work!?"

If you open your own spa you will likely have more than 50% overhead, plus the stress of running it, plus the investment of openeing, plus the risk of loss of all that if something goes wrong. That IS a great option for some MTs. If someone wants a pleasant place to work 20 hours or so a week where they can build a practice and be supported, then this is the place for them.

Please comment if you think this is fair...or very unfair, I want to know.

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DrCara in Atlanta, Georgia

52 months ago

bodyworklady in Battle Creek, Michigan said: Hello everyone! I'm hoping those with a little more knowledge than myself in regards to working with/for Chiropractors can make some suggestions. There is a Chiropractor who is interested in "seeing what we can put together" (his words). He would like me to submit somewhat of a proposal of what I would like to financially receive coming in twice per week as a sub-contractor. I have never worked at a Chiropractor's office, so I'm feeling lost on where negotiations should even start. He gave me zero information, but I'm assuming I would supply everything. Does anyone think it is fair to ask for a 70/30 split? Why or why not? If we agree on a percentage, should it be based off of what is billed or what is received? What would you suggest? Should I just ask for a base dollar amount instead? What are the other important questions to ask and terms to solidify? This is new to me as I have just been self employed up to this point. ANY help and suggestions would be GREATLY appreciated! Thank you!

I just opened up One Stop Wellness in Roswell GA. I hired 1 MT and am interviewing for 3 more MT positions. I ran the numbers, and at 30% I would be loosing money. I can't speak for anyone else, but I offer 50%/50% off what is received (Don't go by what is billed), plus the MT pays $200 toward the rent. (That's $2.50 per hour room rent. Hope that helps.

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DC in Chicago, Illinois

52 months ago

If you are an independant contractor(IC), then as the name means, you should be independant....pay rent do your own billing etc.I recommend all IC's familarize them selves with the IRS's 20 rules that decide if you are or not an IC with your current relationship so you can avoid penalties.

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DC in Chicago, Illinois

52 months ago

But not if you are independant... you need to bill out with your own TIN & NPI, not under the DC or MD's liscence.... honestly if I was a MT I would't waste the time & effort. ALWAYS check with your attorney for state specific's.

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DC in Chicago, Illinois

52 months ago

If your are a sub-contractor, keep in mind your are an independant contractor and must pay your own taxes... I would recommend billing them a flat fee per massage...forget the spit...hard to figure out at the end of the month and keep track of billed/collected/percentages etc... the best business is one kept simple & know what you are to do (job duties, what are you expected to do other than massage, are you being fed patients or expected to bring them in)... put it in writing so it can be referred to in the future...this helps if things get a little sour......so I ask you what are you comfortable getting paid to show up & massage

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DC in Chicago, Illinois

52 months ago

Read the IRS's 20 rules that define an IC/employee...if you pay "rent" then you are not an employee....I personally think percentages are complicated (unless it is cash) to keep track of & therefore a source of conflict. I pay an hourly rate as true employee (payroll taxes & all). They show up for a four hour shift... We try to fill their schedules as best as possible pay over $30/hr (I believe a fair percent average of collections about 45%)and if they don't have patients to massage then they help out around the office for 'down time' at half that rate)....my therapists love the arrangement & feel it is fair (my observation is the more seasoned they are the more they feel it is fair)

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DrCara in Alpharetta, Georgia

52 months ago

DC in Chicago, Illinois said: Read the IRS's 20 rules that define an IC/employee...if you pay "rent" then you are not an employee....I personally think percentages are complicated (unless it is cash) to keep track of & therefore a source of conflict. I pay an hourly rate as true employee (payroll taxes & all). They show up for a four hour shift... We try to fill their schedules as best as possible pay over $30/hr (I believe a fair percent average of collections about 45%)and if they don't have patients to massage then they help out around the office for 'down time' at half that rate)....my therapists love the arrangement & feel it is fair (my observation is the more seasoned they are the more they feel it is fair)

Dear DC in Illinios. PLEASE be careful about giving tax advice. You said "if you pay "rent" then you are not an employee...." I believe you are incorrect and if anyone follows this advice they may have a problem with the IRS. Everyone should Check with their CPA or Attorney. I am neither, so check if I'm right, but I believe paying rent is NOT enough to define IC status. My understanding is that it is more about control over what work is done, when, and how. I believe the preferred position of the IRS is that of employee. You basically have to PROVE IC, not the other way around. They may not say so, but it is almost as if "employee" is the default.

In my office it is easy to track percentages...our office software tracks it easily. It sounds like your arrangement is great for both you & the MTs. There are different options, but I agree completely that putting expectations up front helps everyone.

I love and respect my MTs...and I want to hire 3 more. I am interviewing now, so readers please send your Atlanta friends to me if they want a supportive place to see their clients or grow a practice.

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RogerDC

51 months ago

The wheel you all trying to reinvent has been done with Massage Advantage. If you really want compliance you MUST use a third party, it's the only way to give you 100% protection and yes I asked my attorney. You will be ok on one side, but not on others, watch out for Stark Law.

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BBB823 in Walkersville, Maryland

51 months ago

Okay, so if you're an independent contractor & paying rent, do you still typically give a percentage per session to the spa or chiropractor? Didn't really get a clear answer. Or is it just typically rent fees? & If you are renting a room in a spa/clinic can you do your own marketing using your own name or do you have to market the spa you are renting out of? & if you are an independent contractor that means I'll have to get my own business license & liability insurance? Once I get into it I'd really like to be a little more incharge then just working for someone, making my own hours & handling my own taxes, etc. I obviously wouldn't be able to open my own spa or wellness center right off the bat, so I was thinking renting somewhere would be a good option. Thanks again for your help! & again, I'm in FL, not wherever this website is posting... lol

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DC in Chicago, Illinois

51 months ago

Was not trying to give tax advice but rather an opinion. Agreed always check with your CPA/ATTORNEY.
Just saying if I had to pay rent somewhere to work I would consider that a space sharing agreement rather than an employee position/relationship. What software do you use. MY OPINION. I cann't (& neither can my attorney or CPA) see how you can hire a MT in our type of businness as an IC. Just don't want to roll the dice and have to pay all that back taxes....although the IC would be safe. You be the judge...

INDEPENDANT CONTRACTOR RULES

An individual is generally considered an employee rather than an independent contractor by the IRS if the worker . . .

1)Must comply with company instructions about when, where and how the work will be performed.

2)Receives training from or at the direction of the company.

3)Performs "ordinary and necessary" business activities.

4)Does not retain the right to delegate work to an assistant or subcontractor.

5)Is aided by assistants hired, supervised and paid by the company.

6)Has a continuing relationship with the company.

7)Works a schedule set by the company.

8) Works full-time for the company.

9)Works on company premises.

10)Performs duties in an order set by the company.

11)Must submit regular reports to the company.

12)Is paid in set amounts at regular intervals.

13)Receives payments for business and travel expenses.

14)Uses a significant number of company- provided tools and materials.

15)Has little or no investment in the resources required to perform work.

16)Cannot make a profit or suffer a loss from the services provided.

17)Does not work for more than one company at one time.

18)Does not consistently seek work from general public.

19)Can be fired for reasons other than failure to produce results specified in a contract.

20)Can quit at any time without incurring liability.

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Sonia in Cabot, Arkansas

51 months ago

All of this is 100% correct. one small piece to the pie for most DC's is: IC's CAN'T REFFER AND GET PAID FOR IT, THEY MUST BE EMPLOYEES! And there are ways even this has to be structured. Also IC's can get in ton of issues dealing with Fee Splitting. So billing thru the DC's licenses to compensate the IC is a big NO NO! Tax issues will be your least concern if you get in this boat. And before someone responds "So and so or I’ve done it this way before" you better know your state laws as they are forever changing.

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BBB823 in Charlotte, North Carolina

51 months ago

That's why I'm asking how it typically works, legally, how does the Chiropractor or Spa you are working out of make money on you being there, other then rent, or is that just it. Otherwise I don't see why they'd want an independent contractor instead of an employee working for them, making more of a profit... I'm just saying I'd rather work on my own, making my own set hours, doing my own promotions & want to know how that typically works. If you do or can advertise yourself, if you have your own company name inside the spa/clinic, or you promote them. I'm sorry I was a little confused by the response, I'm just asking HOW it typically works... LEGALLY... I wouldn't do anything not by the books, I want to do everything completely legal.

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Sonia in Cabot, Arkansas

51 months ago

BBB823 in Charlotte, North Carolina said: That's why I'm asking how it typically works, legally, how does the Chiropractor or Spa you are working out of make money on you being there, other then rent, or is that just it. Otherwise I don't see why they'd want an independent contractor instead of an employee working for them, making more of a profit... I'm just saying I'd rather work on my own, making my own set hours, doing my own promotions & want to know how that typically works. If you do or can advertise yourself, if you have your own company name inside the spa/clinic, or you promote them. I'm sorry I was a little confused by the response, I'm just asking HOW it typically works... LEGALLY... I wouldn't do anything not by the books, I want to do everything completely legal.

Most Chiro’s and Spa’s use what is referred to as a “retail model”. Simply put they mark a service up, pay you less and earn a profit. This matters not if you and employee or an IC the results for profit are the same. As a true IC paying booth rent or room rent. You will typically keep all you collect in exchange for the privileges of working in the space. Benefits are less responsibility by the MT for marketing, staffing (someone to schedule for you), laundry, etc. So although you gain some freedom to come and go this is not always the best solution to building a full book. My suggestion is look into building a relationship with companies like Massage Advantage. They work out the details, make sure your compensation is fair, 90% of your marketing is done for you and what isn’t they help guide on for the best results. This also mean long term more profit for you as you not using your cash to purchase flyer, etc. Also this is one way to work with other MT’s, so in the event your become injured or ill there is someone to help cover those client. Much easier to keep them than to find a new one if you know what I mean? In establishing a working relationship anywhere there needs

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DC in Chicago, Illinois

51 months ago

1)Set up your own business, rent space where you like, see patients when you like, massage, collect the $.
2)Have someone hire you. They tell you when & where to massage.

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BBB823 in Charlotte, North Carolina

51 months ago

Okay so I think the way I should go about it then is after I graduate maybe work as an "employee" at different places build some clientele & then rent a room from a spa/chiropractor, get my own liability insurance, which it sounds like I'll need anyway with other places, & then go from there. As an IC I should be able to set my own hours, collect the proffit from the services I provide & I just need to pay my own taxes. I seen some places that have rooms for rent that say you can either pay rent or split a portion of your services, but why would you want to do that if you're paying your own taxes? I was also looking into it & it looks like if the facility you're renting from is collecting money off of your services it can be considered a "kick-back" & is not legal?? I rather just do my own advertising, make my own hours, do my own taxes & pay rent. Nobody answered me on if I do that though if when I'm advertising I use my own name or the spa/clinic my room is out of??? & I think I'd just stay away from medical billing, if its an option, just because it seems more of a hassel then it can be useful accepting insurance plans... Maybe my best bet would be renting a room in a spa... Does this sound about right or am I missing any other legal things that can cause a problem with doing this in Florida? I appreciate you help!

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XrossKore.com in Farmington, Michigan

50 months ago

Melissa said: Work for chiro.In the past we have had unloyal massage therapist trying to take patients out of practice and offering them cheaper rates. We want to grow a loyal team of employees and create a system which benefits the pateient with great care and results from treatment. Would like to hear from MT as to what would be your dream pay and what would keep you loyal as a tema member to a pracvtice and grow together ????

I have been working Chiro offices for 11 years. I have a system that is in place, just documenting the process. I operate out of 3 chiro offices with a team of 8 therapist under me. So I own the massage part of the practice and chiro runs his part. The therapist also have contracts that are fair to both parties. I set up pay increases starting usually after the MT has proved themselves. Then gradual increases from there. Assisiting the new therapist and training them on how to build there clients to what the want. Give of yourself some juicy info to help along the way. I also offer profit sharing depending on their time worked and the effort they put in to help themselves. I set up a code of honor for the practice and during the interview I show them the code. If they don't like then see ya. If with a group of therapist ask them what they think should be the code (rules) for them and make sure everyone on that team has the right to even question the boss about the code. So If the boss is not following the code the others will not either.
have loads of info. to share and will be able to share more if you would like.
Mark

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XrossKore.com in Farmington, Michigan

50 months ago

Rose Masters in Redondo Beach, California said: I have been a massage therapist and an energy worker for the past 20 years i have worked for my self in my own studio as well as for Chrio's and i have rented space my experience with Chrio's is that they for the most part want the M.T. to provide clients - linen - oil's - music and the table. Most want the M.T. in addition to go out and set up a chair and do free chair massages, to help grow the Chrio's practice, most Chrio's will pay any where from 10 - 15 per massage.

At present for the past 2 and a half months ive been working for a female Chrio she agreed to pay me 30 $ per massage i had asked for more, she doesn't have client/patients she may have 10 so she only works a few days a week and only a few hours a day, she held an office meeting - with me an herself - this is the sum total of the office staff, she decided that i should do my own advertising and promotion, She seems to have forgotten that she told me she needed to pay me 30 $ out of 85 for deep tissue, because she was going to be advertising well that has not happened, So i am really thinking of either leaving her office or letting her know that if i am to advertise and promote myself i will need to be paid at a higher %,...

Hello, Through my experience and research the chiro is actually considered a Dr. so due to the STARK ammendment act. A Dr can't recieve kickbacks a percentage paid to the MT is considered a kickback and from talking to a chiro attorney this true. Please check it out. I want to see MT's working in conjunction with Dr.'s so we can help more people live a happier healthier life.
The only legal way to work in Dr.'s office is to either rent space or be an actual employee. I prefer to rent and run the massage side so as to help double up on the advertising with the chiro. Of course with the two of you coming to an agreement usually in writing that way we don't froget and there is the agreement.
Mark

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XrossKore.com in Farmington, Michigan

50 months ago

JE in Seattle, Washington said: Max: My issue is not over whether a MT gets paid or not when the chiro does not get paid per massage session hour. My issue is over the % rate the chiro pays an MT from their total net pay received and that goes to the chiros bank account. No one has any idea??? Come on, lets just ask and eventually we will find out. Then we can discuss the variables and how they affect the MT pay.

The percentage a chiro pays was answered by the STARK amendment act. Chiros are considered DR.'s and percentages are illegal due to that act because it is considered a kickback to the DR. Only 2 ways I have found to do this rent space and provide your own equip. and supplies or become an employee. Check it out. I hope this helps.

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Kris in Fox River Grove, Illinois

50 months ago

XrossKore.com in Farmington, Michigan said: I have been working Chiro offices for 11 years. I have a system that is in place, just documenting the process. I operate out of 3 chiro offices with a team of 8 therapist under me. So I own the massage part of the practice and chiro runs his part. The therapist also have contracts that are fair to both parties. I set up pay increases starting usually after the MT has proved themselves. Then gradual increases from there. Assisiting the new therapist and training them on how to build there clients to what the want. Give of yourself some juicy info to help along the way. I also offer profit sharing depending on their time worked and the effort they put in to help themselves. I set up a code of honor for the practice and during the interview I show them the code. If they don't like then see ya. If with a group of therapist ask them what they think should be the code (rules) for them and make sure everyone on that team has the right to even question the boss about the code. So If the boss is not following the code the others will not either.
have loads of info. to share and will be able to share more if you would like.
Mark

Hi Mark,

I am definitely interested in your "process". I am located in the Chicagoland area, and am looking to create a business where I have therapists working for me. Any info you can provide would be appreciated. -Kris

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JayJ1964 in Wilmington, Delaware

50 months ago

XrossKore.com in Farmington, Michigan said: I have been working Chiro offices for 11 years. I have a system that is in place, just documenting the process. I operate out of 3 chiro offices with a team of 8 therapist under me. So I own the massage part of the practice and chiro runs his part. The therapist also have contracts that are fair to both parties. I set up pay increases starting usually after the MT has proved themselves. Then gradual increases from there. Assisiting the new therapist and training them on how to build there clients to what the want. Give of yourself some juicy info to help along the way. I also offer profit sharing depending on their time worked and the effort they put in to help themselves. I set up a code of honor for the practice and during the interview I show them the code. If they don't like then see ya. If with a group of therapist ask them what they think should be the code (rules) for them and make sure everyone on that team has the right to even question the boss about the code. So If the boss is not following the code the others will not either.
have loads of info. to share and will be able to share more if you would like.
Mark

Hi Mark, Do you accept insurance in your offices & handle the billing with insurance companies or do you not use insurance, I mean the patience insurance, not liability. Also do the therapists that work for you work as a seperate independent contractor through you or are they an employee of yours, if so how do you handle paying them, do they get a percentage? I'm really interested in the route you took. Thank's for any info!

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sonia in Cabot, Arkansas

50 months ago

JayJ1964 in Wilmington, Delaware said: Hi Mark, Do you accept insurance in your offices & handle the billing with insurance companies or do you not use insurance, I mean the patience insurance, not liability. Also do the therapists that work for you work as a seperate independent contractor through you or are they an employee of yours, if so how do you handle paying them, do they get a percentage? I'm really interested in the route you took. Thank's for any info!

you can't accept insurance payments billed under the doctor. this is illegal and called "fee splitting".. the only way this works legally is if they are truly two separate business, which means different names, tax id's, returns, and NO sharing of payments. Which would bare the question why do it in chiro offices?? this would also require a contract from said Massage Co and DC. there better be an exchange of rent of some form of traceable payment for operating within the practice. you also can't refer back and forth "Stark Law" violation if this is truly a separate business. So I too would love to know how you’re doing it and doing so legally????

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JayJ1964 in Encino, California

50 months ago

sonia in Cabot, Arkansas said: you can't accept insurance payments billed under the doctor. this is illegal and called "fee splitting".. the only way this works legally is if they are truly two separate business, which means different names, tax id's, returns, and NO sharing of payments. Which would bare the question why do it in chiro offices?? this would also require a contract from said Massage Co and DC. there better be an exchange of rent of some form of traceable payment for operating within the practice. you also can't refer back and forth "Stark Law" violation if this is truly a separate business. So I too would love to know how you’re doing it and doing so legally????

That's what I was wondering, like why would a Chiropractic office do that if they aren't making a profit some way. But I do see alot of massage rooms for rent out of spas & chiropractors, so I just assumed that it was just a way for them to get some money off of their rent. I understand that if you are doing this that you can't bill insurance through the chiro, but do massage therapists bill their own, or do they typically not even bother with insurance companies because it's difficult to get payment from them, for massage I mean. (atleast that's what most of the post's sounded like) I would love to rent a place out of somewhere but just trying to figure out how people do it. Because just starting off in massage would be too difficult to just start up your own practice, so I thought renting a room out of a spa/clinic would be ta good way to start, all legally, own name, taxes, payments, etc. etc. Let me know what anyone thinks or comments. I've also asked that in the past, as far as having your own business name, but located in a clinic/another spa, don't see how you'd do that really.... unless your name is only used in business forms, taxes, cards etc, just not located anywhere on the outside of the building? lol

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XrossKore.com in Oak Park, Michigan

50 months ago

Massage and the leagalities are complicated and yet the benifits are a bounus. Keeping the business seperate is a must and the benifits are sharing office space and staff. ie waiting room reception, billing. The Stark ammendmant is very important and that is the challenge. Doing your own insurance is a risk yet the risk can be reduced by following certain steps and educating yourself on the state laws in place. This one move on a MT's part can increase the visits in your office. The referral process comes at the descretion of the patient/client. They have a choice in who they see and when. I am creating a solution for massage therapist to help bring some of these issues to light and enable our industry to grow. Thank you;)

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