referals

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Joey

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I work in an office which has been established for quite some time. The owner has up and left but leaving the other therapist their to run the business. at times she will return to check on the business and do her own clients that she once had when she was here. She will advertise to her clients and refer them on to the clients in the office. My question is is it eithical or legal for her to get compensation or a perceneforum.xxxe for her clients
thanks
 
referals

petedose said:
My question is is it eithical or legal for her to get compensation or a perceneforum.xxxe for her clients
thanks


I don't understand. Do you think it is ethical for her NOT to get paid for work she is doing? Can you clarify why you think it might be illegal for her to be compensated?
 


I think he's asking if it's ethical/legal for her to get a referral fee for the clients she is referring to other therapists in the office while she's gone.

I don't know if it's legal, but look at it this way. She could refer those clients to anyone. Some of them might go where she referred, some of them might stay in the same location. I personally don't think she should be getting any kind of perceneforum.xxxe unless she is still owning some part of the business, and still has some investment in it. If she did refer those clients elsewhere, how many do you think you'd retain? This is your gamble.

What I think would have been ethical would be for her to sell you her client list for some price, if you wanted it. But to take a perceneforum.xxxe of each client's treatment does seem excessive.

Is the perceneforum.xxxe she's taking/asking for fair? Is it supposed to continue on indefinitely?
 


I don't think it's unethical or illegal to charge a finder's fee - since she is advertising to her clients and paying for that advertising. I ahd an arrangement like that at a tanning salon that had a TV ad and a phone book ad and I didn't have a problem with paying them 10% as I wouldn't have been able to afford the ads.
I would have a problem with selling the clients' list - it may violate clients' privacy from HIPAA's standpoint.
 
referals

k i dont know if im saying it right. My husband is a chemical therapist. It is against his boards conduct rules to get a fee for refering a client to another therpist. What im asking is it in our conduct rules that we do the same. It is her office how ever clients r not property. They can not be bought or sold. Does that make more sense?
 
referal fee

yes as shiva was saying a fee for refering her clients to stay n her business. I believe the perseneforum.xxxe is 20% on top of what her split for rent
 


I don't believe there is anything in our professional code of ethics that says we can't charge a referral fee. However, you'd have to check with your state board, because each state has it's own rules.

I'm curious about this:

I would have a problem with selling the clients' list - it may violate clients' privacy from HIPAA's standpoint.

What about when a therapist sells their business, clients and all? Wouldn't the records go with it? Or at least contact info for the clients?
 
referals

I think he's asking if it's ethical/legal for her to get a referral fee for the clients she is referring to other therapists in the office while she's gone.

Yes this is the question.

The owner has moved out of state but continues to keep his business here also and have a manager run it for him. He comes back maybe 3-6 months to check out how things are going. When he is here he has his own clients that he does.

Now he wants a referral fee for those clients when she is not here.

My husband is a therapist in the chemical field, it is against his board to ask for referral fees if he refers a client onto another therapist in that field. or one that he thinks may help the client more. does this make sense? He is by the way asking for 20 percent on top of the split that he is makeing for rent.
 
referrals

sorry it looks like it posted several times. I was at work last night and i didn't think it posted.
If you have answered thank you for your posting. and I will also check with the state board.
 


I think a 20% referral fee ON TOP OF a split for "rent" is a bit much. He wants that every time someone sees a client that he initially referred to you? Or just the first time? If it was the first time, I guess I'd eat it. If it was every time, no.
 


shivashiva said:
I'm curious about this:

I would have a problem with selling the clients' list - it may violate clients' privacy from HIPAA's standpoint.

What about when a therapist sells their business, clients and all? Wouldn't the records go with it? Or at least contact info for the clients?

My understanding of HIPAA is that we can't disclose ANY information about our clients to ANY third party unless there is a signed release from the client. That includes name, contact info and even the fact itself that they have received massages from us. I have also seen this in a number of ethics books for MT's. The clients have to be sure that their privacy is safe with us.

I agree that would make selling a business tricky. I am not sure what's a good way to get around it. The seller and the buyer would have to look at how the consent form is worded.

Does the info belong to the BUSINESS?
If the business stays the same and just changes the ownership - that may be OK since the client list "belongs" to the business.
However, if my business ceases to operate and I want to sell the list to the MT across the street THEN I may run into problems. In this case I would probably want to contact the clients myself and refer them to that other MT.

I am not a lawyer so hopefully it makes sense! I just know that if my name was "sold" to someone and I got contacted by the new owner, I may get ticked.

20% on top of commission can get too much quickly. Do you need to pay for the first appointment only (finder's fee) or also for when the client comes back?

My arrangement with the tanning salon was flat rent plus 10% and if I remember correctly 15% after I hit $1,000 in sales. I was OK with it for the most part except for December when I had to pay $800 in commission on top of my rent. The employees also booked my appointments and sold my GC's which was valuable to me.

They did get ridiculous a few times: for example, I was doing an outcall at a hotel which I booked myself and the owner wanted me to pay him 10% for that (why?). The manager sided with me
 


In Ohio, that's still a kick-back, and it's a big fat NO NO.....

if it walks like a duck, quacks like a duck, acts like a duck, chances are it's not an elephant....
 
refferals

Thank you all for responding. There is alot of feedback and I appreciate it. I will also check with the state to see if there is anything here and keep you informed.
On the 20% yes he wants it everytime
I offered not to solicate any of his clients because I was not going to pay that. I look at it as part of keeping his business going back here.
however we do have a stipulation that we will not abanden clients. so if one of his clients do come in and is hurting and is asking for a massage, does not mention his name, I guess im not sure untill it happens what i will do.
thanks again and I will let you know what I find out from our state board.
 


Sounds like the bigger issue here may be "employee vs I.C." and which one are you?

Referral fees are not the same as ongoing commissions, and commission is not necessarily the same as a "kickback." Plus some states define it differently.

It's a little different scenario if he is paying you a reduced fee to temporarily see her client (you could say no) or asking you to pay her every time you see a client that has formerly seen her.

If these are clients that she is retaining, and you are seeing them once in awhile or temporarily, it is similar to paying a fee to stand in (Independent contractor.) For instance: business takes in $70 for the client, you receive a $50 fee, business keeps $20. In that scenario though, the primary business should be taking the money in, and then paying you your fees on a 1099.

2nd scenario: your rental contract is $xx/month, plus x% of income generated from these sources and x% of income generated from those sources. You would have the right to weight your income sources as your schedule allows: deciding to take more or less of the higher % opportunities as you see fit.

3rd scenario: your rental is $xx/month, plus x% of ALL session income as a fee that covers wear and tear, maintenance, advertising, utilities...


All of these are perfectly legal, and perfectly normal ways of doing business, unless your state regs specifically has something to say about this.
4th scenario: you rent for $xx/month. Your contract says nothing about splits and commissions. Your landlord tells you that your continued rental is now contingent upon you paying for the "privilege" of serving his clients, and you will not be able to say "no thank you," or else you will be asked to leave.

This would be not only unethical, but very likely illegal on his part.

5th scenario: you approach your landlord, tell him that if he will refer you anyone that you can bill their PIP insurance, you will cut him 20% "referral fee." This is a kickback. The arrangement would be based on fee for referral, the referral would likely not happen without the monetary incentive to the referrer, AND you are involving insurance or a 3rd party pay. Illegal.

As far as HIPAA, some states automatically include massage therapists as covered providers. Some do not. In many states, a massage client's PHI (private health information) is only legally covered if they are seeking massage under a HCP's supervision, if a prescription is involved and/or if you are billing insurance. In many states, if the client is self-referred, a cash client, seeking relaxation or spa massage, or any "elective" massage therapy for "recreation," you can legally buy or sell their information in any way you choose. I'm speaking only of legality, not personal ethics.
 


The business we purchased had developed a massive client list, and had all the paper and electronic records to go with it. That client info transferred to us with the business. Nothing in HIPAA against it.
 


The issue is whether or not it would be considered to be a kickback which is illegal.

I took a class last year from two attorneys here in WA and they said it was considered to be a kickback.

I wrote about it on my blog and you can see the article they wrote on it.

http://thebodyworker.com/massage_blog/legal-business/

You would probably need a lawyer to find that out or I think this is one area where our professional associations fail us big time.

Julie
 
referals

petedose said:
I work in an office which has been established for quite some time. The owner has up and left but leaving the other therapist their to run the business. at times she will return to check on the business and do her own clients that she once had when she was here. She will advertise to her clients and refer them on to the clients in the office. My question is is it eithical or legal for her to get compensation or a perceneforum.xxxe for her clients
thanks

I am not sure about legality but I don't see why not? If she has an agreement with other masseuse, and they are willing to give her a cut to get more business, what is wrong with that?
 
referals

For all who are interested I did check with iowa board of massage. There is nothing in the rules or regulations about kickbacks. As far as his clients and the 20% Im choosing not to solicate her clients however, i will not abanden them ether. Thanks for everyones thoughts
petedose
 
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    TUESDAY at 𝗔𝗟𝗜𝗖𝗘 𝗦𝗣𝗔, 4915 Steeles Ave. E, Scarborough 𝟰𝟭𝟲-𝟮𝟵𝟴-𝟬𝟴𝟵𝟴. 3 Young Beauties Today at Alice Spa. Open 10am to 9pm: ASHLEY (12pm-9pm) is a beautiful slim Korean student, snow white skin, 5'2, 100 Lbs, natural C Cup, pink nipples, baby face & voice, can accomodate bbbj cim cof rim dfk, excellent services. CLOUDIA (11:30am-9pm): is Vietnamese, young, petite 5'2" & 96 Lbs
  45. wilson holistic centre:
    new girl works at 💋535 Evans Ave today 💕💕💕☎️☎️416-531-6969☎️☎️
  46. HolidaySpa:
    Tuesday at 🌴😎🌅𝓗𝓸𝓵𝓲𝓭𝓪𝔂 𝓢𝓹𝓪🌅😎🌴3517 Kennedy Rd, Unit 4, Scarborough ☎️𝟰𝟯𝟳-𝟮𝟰𝟳-𝟭𝟭𝟵𝟵☎️: EMMA, JENNY & CINDY. EMMA is a very beautiful slim Chinese honey with C Cups, beauty face, & nice services to drive you wild. Jenny has a medium build, nicely curvy with a slim waist, pretty face, and very flexible skills. Jenny will make you very happy. CINDY is slim
  47. SugarLoveSpa:
    Tuesday at ❤️💙 💜⎝𝗦𝗨𝗚𝗔𝗥 𝗟𝗢𝗩𝗘 𝗦𝗣𝗔⎠💖💗💘: CHRISTINA, MIMI, JENNY & TIFFANY. 1270 Finch Ave W (at Keele St), Unit 18. North York. CHRISTINA is Spanish, C Cups, 5'3", tall & nice curves, very open minded. MIMI is a slim & busty Asian/Euro mix beauty, 50Kgs & 1M60. Mimi has a very versatile range of services. JENNY is a sweet & young Korean girl with C Cups. Very versatile services.
  48. Soul Relax Spa:
    ✨ Looking for a relaxing escape? ✅ Click Here Meet🌸Nina🌸Anna🌸XukaCall us today for the best treatment and service experience. Click on our Username and FOLLOW US for updates ! Call now ☎ 289 - 298 - 5662☎️ Your ultimate relaxation awaits! ✨
  49. bnwellness_wilson:
    We have 4 young girls are working today, young pretty Mia 25’s with curve body and young Taiwanese Victoria slime 25’s open mind, young sexy Sophia with curve body 30’s and cute GFE Lina are providing deep tissue massage, pls call 4163985777 book appointment and walk in always welcome,back entrance and parking available, 350 Wilson Ave North York
  50. Red Rose Spa:
    🌸 We have 11 hot brown girls today 🌸 MONICA, ANGEL, SONIA, PRIYA, AMANDA, PAOLA, PREETI, KIRAN, ANGELINA, MONIKA, SALMA 🌸 2588 Birchmount 🌸 2 Invergordon 🌸 647-702-8800 🌸 Please visit for a great erotic massage
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