Taking Health Insurance: Handling Paperwork
The paperwork component of billing insurance for massage is potentially the most daunting of all. You may be surprised to learn that health insurance claims are actually legal documents, which means that accurate and extensive record keeping is paramount.
Some of the things youll need to keep track of in order to file for insurance are:
- The clients primary care providers prescription or referral document
- Documented pre-approval request from the insurance company
- SOAP notes
- Documents demonstrating HIPAA compliance
- Clients authorization to release medical information
- Signed statement that the client will pay for any services not covered by insurance
This list is far from exhaustive. Considering the amount of paperwork involved, many massage practitioners who bill insurance opt to outsource the process entirely to athird-party company. Keep in mind, though: this will increase your costs considerably.
Can I Bill Insurance For Massage In My State
If you do decide that billing for insurance reimbursement is a good idea in your particular situation, theres still more to think about. As weve already mentioned, every state is different when it comes to massage therapy and health insurance .
One of the biggest determining factors in many states has to do with your classification as a massage practitioner. In some states, massage therapists are classified as health care practitioners, or HCPs. Washington state is an example of one such state with very clear guidelines for what a massage therapist must do in order to both obtain licensure and be considered an HCP.
If your state doesnt classify massage therapists as health care practitioners, you may be unable to bill insurance for the services you provide to your clients. Check with your individual states licensing board, as theyll be able to provide you with more detailed information.
Massage Therapy Insurance Reimbursement
Massage therapy is gaining respect in the healthcare community, and this brings perks. The American Massage Therapy Association reports that massage therapy is more likely to be reimbursed by healthcare insurance than it was five years in the past .
Healthcare policies vary a good deal. Among the common requirements: that the treatment be provided for a specific health condition and that a medical practitioner write a prescription. Massage might, for example, be allowable as a pain prescription the healthcare community is very interested in alternatives to narcotic drugs .
Massage therapists should be aware that there is a geographic element to healthcare coverage. Its not just a matter of a persons diagnosis but where he or she lives.
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How Do You Find A Massage Therapist Who Accepts Your Insurance
The easiest way to find healthcare that your insurance covers is to check your insurance network and see which massage therapists are available near you. You can also call individual providers to ask whether they accept your coverage and whether a doctor’s referral is required. Be sure you confirm that they accept your coverage before you receive services.
How Do You Make An Insurance Claim
State licensing laws control whether massage therapists can bill health insurance for their services. Massage therapists should fully understand the scope of practice in their state to make sure they are billing health insurance only for services within the state scope of practice law.
Additionally, health insurance claims are legal documents, so massage therapists must collect and retain information supporting their requests for payments. Typically, a claim file must have documentation to confirm that the service was providedat a minimum. Insurance companies also usually require a doctors order for a service before they will pay a claim, so make sure you are familiar with the requirements of the insurance companies they work with.
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How Do Individual States Massage Therapy Practice Laws Influence Whether A Massage Therapist Can Bill For Insurance Reimbursement
First, be sure to thoroughly review and understand the scope of practice that is written in your states law. Every state law is different. A license allows you to practice in your state, however, it doesnt necessarily guarantee acceptance by an insurance company for reimbursement for services rendered.
Be sure to check with your massage practice board who can help answer any questions you may have regarding typical insurance practices and how massage is viewed in your state.
What If Your Massage Isnt Covered
If your massage therapy isnt covered by your insurance, consider these options to help you find and receive affordable services:
- If you have a health savings account , you may be able to use it to cover massage costs if it qualifies as medically necessary. Learn more about HSAs and flexible spending accounts .
- Contact local massage schools to see whether they offer massages at a discount.
- Ask for discounts where you get your massage services.
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Billing Insurance For Massage Therapy: Things To Consider
As youve probably already gathered from what was said above: billing a health insurance company for massage therapy is no simple task. Its not something you can simply decide to do and then immediately implement into your massage practice. Doing so will require a significant amount of preparation, along with a major amount of follow-through in order to actually execute on the back end.
For that reason, its important to take a moment to consider why you want to participate in insurance company billing in the first place.
Are you simply looking to bring in more revenue from your clients? Some massage therapists want to bill insurance because they believe it would increase their level of income by simultaneously bringing in more patients . In some practice areas, this may be sensible. Particularly if you choose to specialize in something like treatment for post-accident injuries and other acute issues, being able to bill insurance can make a lot of sense.
Theres no question that the thought of being able to treat more patients and increase your revenue sounds like a positive thing. On the flip side, though, there are a number of potential drawbacks that need to be taken into account.
Use Your Hsa/fsa For Massage
Ok, Ill have to apologize to those who didnt know, but Ive been accepting Health Savings Accounts and Flex Spending Accounts for a while now. I know these accounts have become more popular due to higher deductible plans and many companies contribute to these accounts. For the moment, these accounts are the next best thing to accepting insurance in my practice.
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Top 7 Tips For Billing Insurance
For many massage therapists, the thought of billing insurance providers for services rendered may lead to unnecessary stress and uncertainty as to where to begin. Insurance and state laws vary depending on location, which can lead to even more confusion for massage therapists looking to expand their client base by accepting medically prescribed clients.
Here, Vivian Madison-Mahoney, L.M.T., discusses some of the more general issues surrounding the topic, such as how reimbursements work, if they work and where to find more information. Mahoney believes that should be fun and rewarding despite the extra work and challenges that it sometimes incurs.
Where Billing Is Okay
All 50 states allow massage therapists to bill insurance companies for massage sessions with clients who are either injured on the job or in a motor vehicle accident.
A handful of states permit massage therapists to be contracted providers within the healthcare system. With new legislation constantly emerging, be sure to check on the most current insurance billing guidelines in your state. Additionally, experts in the field suggest using an insurance verification form prior to bill submission. This form confirms that your client is covered by an insurance company who will accept your charges.
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Stay Away From Medicare And Medicaid
Medicare and Medicaid are not something you may bill insurance for, as they do not cover the services of a massage therapist, Madison-Mahoney says. Many have tried and have later been asked for a return of reimbursements, she adds. The only way you can be paid for your work on a Medicare client is by cash. If this is done in a physicians office, the physician would have to be sure the Medicare patient signed an Advance Beneficiary Notice form. This form indicates to the client that the services would not be covered under her Medicare Plan.
Join A Provider Panel
Therapists interested in being directly reimbursed by insurance companies can join the insurers preferred provider panel. This usually requires a fairly intensive application process, and approval can take several months. Once the therapist is approved, however, the insurer directly pays the therapist for their services. Being on a provider panel may also offer some marketing benefits because most insurers have a directory of preferred providers that potential clients may use to find you.
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Massage Therapy Insurance Pennsylvania Policy Information
Massage Therapy Insurance Pennsylvania. Therapeutic massage applies pressure to the muscles or connective tissues of the body using a number of techniques designed to relieve pain and stress and promote healing. Massage is generally done using the hands and fingers, but the therapist can also use elbows, knees, feet, or even mechanical aids.
Services may be provided at the therapist’s premises, at a spa, at the workplace or in the client’s home. Individual therapists may be certified by the National Certification Board for Therapeutic Massage and Bodywork. Some therapists receive formal training while others serve an apprenticeship in order to learn the various techniques.
If you are a massage therapist, then you know how to relieve anxiety and stress for your clients, but what about the stress you’d feel if you were sued by a client? If you have the proper amount and type of business insurance in place for your massage therapy business, then the answer will be a resounding “yes.”
Massage therapy insurance Pennsylvania protects your business from lawsuits with rates as low as $27/mo. Get a fast quote and your certificate of insurance now.
Liability Coverage for Massage Therapists
At the very minimum, you should discuss the following massage therapy insurance Pennsylvania policy options with commercial insurance agency who is adept at understanding the nuances of the massage parlor niche:
In-Home Massage Providers
Commercial Massage Businesses
How To Bill Health Insurances Yourself
There are ways to have your massage services paid for by your health insurance companies.
Ive seen clients get reimbursed most to all their money back for the services rendered.
Try these steps a few times to see how your insurance company reimburses. Insurance companies are much more willing to work with their customers directly than they are with massage therapists.
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Billing For Car Accidents
You can also bill auto insurance policies for massage when someone was in a collision with a car/vehicle. In WA State, Personal Injury Protection is required or they may also choose not to have that protection if they can prove they have health insurance that will cover the massage up front. The problem with that is that many of the health insurance companies have limits to the number of sessions that can be done and their allowable fees are usually lower.
To learn how to bill for motor vehicle collisions you may need to take a class. There are many attorneys in WA State who will teach these classes to massage therapists. Adler Giersh is one of the most popular and they are a big supporter of massage here.
You can also learn some of the basics of billing insurance in my Book – Insurance Billing Manual for massage therapists available on my other site – www.massagepracticebuilder.com
I also have a meetup.com group that meets regularly to talk about various issues and offers short classes on various topics like massage insurance billing in WA State.
If you are billing insurance in WA State, especially health insurance you will want to be a member of the American Massage Therapy Association WA Chapter. It is really because of this group that we are able to bill insurance. Each year they work to protect our right to bill and are working to keep ahead of the many changes that occur in legislation and with insurance issues.
Billing Insurance For Massage Therapy
Regardless of your situation and insurance provider, you must have a recommendation from a doctor to treat a specific medical condition which includes the recommended number and length of massages. With that said, here are some instances in which you may be able to have insurance pay for some or all of your therapeutic massage treatments:
- Health Savings Accounts : Some health insurance companies offer high deductible plans that may be paired with a health savings account. A health savings account is a bank account that you use to pay for qualified medical expenses with tax-deductible contributions . So while you are still paying out-of-pocket, there are substantial savings available through the tax advantages.
- Personal Insurance Protection : This type of insurance is an extension of auto insurance plans and covers medical bills for injuries resulting from auto accidents.
- Workers Compensation Insurance: Therapeutic massage for work related injuries can often be covered by workers compensation insurance. If youve been involved in an accident at work, check with your insurance provider to see if massage therapy is covered.
While these options are available to help cover the costs of therapeutic massage in North Carolina, only a small percent of the population can take advantage of them. If you feel that therapeutic massage for pain relief should be covered by health insurance in NC, I encourage you to with the North Carolina Department of Insurance.
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Health Insurance For Massage
We can help you with your health insurance for massage!
In most situations, we will need to call and check your benefits for massage. Some insurance companies may require a prescription before you come in. We can help you get that prescription or referral with ease!
Our list of insurance companies we are in-network with or accept:
- Regence Blue Cross
- OHSU PPO & PPO Plus / Moda
- Moda / ODS
- Providence
- Laika Care/ First Choice Health
- All Auto Insurance Companies
- Health Savings Accounts
- Flex spending
*If your insurance is not listed, just ask and we will look into it!
**Insurance plan requirements change each year.
Start by asking these questions:
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For Therapists: The Pros And Cons Of Accepting Insurance
A study published in JAMA Psychiatry found that psychiatrists are less likely than other health care professionals to accept insurance. Some sources report similar numbers for therapists, psychologists, and others in the mental health care profession. This may decrease access to quality mental health care and prove frustrating for both therapists and clients.
While therapists who do accept insurance may be able to see more clients, insurance reimbursement is not a panacea to the many challenges of running a practice. Every therapist must weigh the benefits and drawbacks of accepting insurance, then decide which insurance panels and what approach to insurance payments will offer the greatest benefits with the least amount of hassle.
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Accepting Insurance: From A To Z
I really appreciate all the phone calls and e-mails from therapists about insurance billing issues. It is through your questions and problems that I learn and can direct my research and better help others.
I often hear people say, “I would love to accept insurance, but so many therapists tell me it’s dreadful, not worth it, time consuming, costly, and on and on.” I find nearly 100 percent of the time, when checking deeper into the situation, that the disappointed or exasperated therapist did or didn’t do one of the following:
- did not really know how to bill insurance in the first place
- used incorrect codes
- accepted cases that don’t reimburse under any condition
- did an improper interview and initial evaluation with the patient
- did not properly document treatment
- did not have a properly written prescription, if they had one at all
- did not use codes within their scope of practice
- insisted on taking certain types of cases, even when I’ve warned against it
- did not obtain authorization to treat an injured worker
- did not fully confirm benefits prior to billing insurance
- filed incomplete or incorrect claims, or used an improper claim form or
- did not check to see if the insurance policy covered massage therapy or manual therapy techniques when provided and billed by a massage therapist.
Accepting Insurance: From A to Z
AAdjuster, the claims handler at the insurance company. must be obtained from the adjuster to treat a workers’ comp case.
K.KISS: Keep it simple, Stupid.