Insurance Reimbursement For Massage Therapists
Lets take a look at some of the positive and negative aspects of accepting insurance that may help you consider whether to accept insurance.
Spokane Massage accepts most medical insurance including Premera, Regence, BlueCross BlueShield, L& I , PIP , and auto
Our Massage Therapists and Manual Therapists are credentialed with BCBS Blue Cross Blue Shield insurance plans. Contact us, we can check your eligibility.
How To Get Approval For Massage Therapy
Set up an appointment with your medical doctor and let them know that you have HSA, FSA, MSA or HRA funds that you would like to use for massage therapy for treatment/prevention of your condition.
If your physician is not sure about the benefits of massage for your condition, research massage for your condition and share the information with your doctor .
If your physician agrees to write a prescription, they will need to provide three pieces of information:
Be certain that you are getting the correct prescription/documentation in order to use your benefit funds. For example, sometimes a doctor must provide a Letter of Medical Necessity on a standardized form or on the doctors letterhead. Check with your employer, the appropriate department is usually human resources since they administer benefits for employees. If they cant answer your question, they should be able to direct you to the administrator of your benefit plan. Be sure that massage will be covered before you make your massage appointment, so that you are not responsible for paying out of pocket or taking a tax hit.
Once you have the prescription you can set up an appointment for massage. Keep the prescription in a safe place in case you need to provide documentation. Bring your HSA, FSA, MSA or HRA card with you to your appointment.
Regional Health Insurance Trends
A recent study took a regional look at health insurance policies . The researchers focused on northeastern states but included some carriers with a multi-state presence. They noted that massage enjoyed a greater presence in the Western states and that massage was more likely to be included as a benefit in the West.
A number of policies offered coverage for massage but with some limitations. In some cases, being credentialed as a massage therapist would not be enough. Some policies required massage therapists to seek pre-authorization.
It is common to place limits on number of visits and length of sessions. The carrier may state that the treatments must be part of a treatment plan made by a healthcare provider.
Some policies noted particular techniques. Among those commonly noted: manipulation, manual lymphatic drainage, and myofascial release.
Some carriers include massage therapy as part of an optional rider.
Plan providers may have their own group of in-network preferred providers.
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Getting Started With At Home Workers Compensation Massage Therapy
As indicated above, one of our goals is to make things as simple as possible, despite the complications inherent in workers compensation massage medical claims. As one of our clients, you can have a lot to do with how easily we can achieve this goal. The most important thing to avoid delays is to provide us as soon as possible with all of the requested information so we can get things rolling. Usually we will email a standard form to be electronically signed, along with an email specifying what information we need to proceed .
As soon as we have the required information, we will verify the claim and formally request an authorization to treat you. Once we obtain that, we will assign an injury massage therapist based on your indicated preferences and get started! If things work out, you can schedule the next visit with your therapist on the spot!
Keep in mind that if for any reason you ever wish to use a different therapist, do not hesitate to let us know. We want to provide the best match for you. You are not stuck with whomever we happen to have available. In most regions there are many massage therapists who enjoy providing this type of therapeutic bodywork, so if its not a fit, we will keep working until we find one! ! You are also welcome to bring your own therapist! In most cases, as long as your existing injury massage therapist is properly qualified and insured, we can sign them up to work with you under our authority.
Exceptional Massage Liability Insurance
Smart practitioners realize that, while being named in a lawsuit is unlikely, it’s not worth risking your career. In this sue-happy age , even when you’ve done nothing wrong, it’s expensive to defend yourself. Why chance it when excellent protection is so affordable?
Associated Bodywork & Massage Professionals offers liability coverage with the profession’s highest aggregate coverages available: $2 million per incident, $6 million total per policy year. And these coverages protect you no matter where, or how many places, you work. These totals are per member, per year, not a shared member aggregate like other associations offer. You never have to fear if the insurance coverage will be there for you.
Also included are legal defense coverage and no charge for obtaining an additional insured endorsement if requested by your employer or landlord. All this is covered by your basic membership fee.
Unlike the claims-made coverage offered by some other providers, the insurance included with your ABMP membership is occurrence-form coverage, which protects you from late-filed claims. This added feature helps safeguard your businessand your peace of mind.
In addition, ABMP has procured coverage for hot stone massage and cuppingtwo modalities that are not always covered through other associations.
Bottom line: ABMP’s liability insurance package is a comprehensive program specifically tailored for massage therapists and bodyworkers.
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Six Insurance Billing Hints
Interacting with insurance companies correctly will pay off. The following hints will help any massage therapist realize that billing insurance isnt very hard:
Insurance Coverage For Massage Therapy
Massage therapists rely heavily on various types of insurance coverage to fund care for patients.
Massage therapists rely heavily on various types of insurance coverage to fund care for patients. Employee health benefit plans, claims for auto insurance and workers compensation are all potential sources of funding for massage therapy treatment. In a survey commissioned by the College of Massage Therapists of Ontario, 75 per cent of patients or clients use employee workplace benefits to pay, or partially pay, for their care.
With job-related stress accounting for an estimated $16 billion in Canada and repetitive strain injuries estimated to affect one in 10 Canadians, massage therapists have an opportunity to position themselves as allies with industry in keeping claims for workplace injury and ancillary costs in lost workdays, turnover and employee dissatisfaction down.
Despite the impact of these workplace-related illnesses, many employee benefit plans are being scaled back. Employers are wanting reliable outcome measures and proof that their invested dollars are yielding healthier, more productive employees. Coupled with an increase in massage therapy insurance fraud, RMTs are at risk for losing a major source of funding for patients.
Report from the Field I posed the question on Facebook, Have your workers-with-benefits changed their utilization of massage therapy? Respondents shared the following:
Threats to Employee Health Benefit Plans
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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.
Does Medicare Supplement Insurance Pay For Massage Therapy
Medicare Supplement Insurance wont cover your massage therapy because it is designed to cover additional costs of Original Medicare.
Key Point: What Does Medicare Supplement Insurance Cover?
Medicare Supplement Insurance typically pays for costs such as deductibles, coinsurance, and extended hospital stays, or specific procedures, tests, and items.
Deductibles: These are costs that you will need to pay before Medicare will begin to cover your health care expenses.
Coinsurance: These are the portion of medical costs that a person is responsible for. For Medicare Part A, this is charged on a per-day basis. For Medicare Part B, beneficiaries are usually required to pay 20% of the costs.
Uncovered Costs: Medicare doesnt cover all medical expenses and there are times when you might have to pay for treatments, services, and tests out of your own pocket.
For example, Medicare doesnt cover people if they travel to territories outside the U.S. Most Medicare Supplement Insurance Plans offer this added coverage.
To learn more about the benefits and coverage that Medicare Supplement Insurance can offer, read our guide or if you want to find an insurance company in your area.
If you have Medicare Supplement Insurance, youll probably save money on other medical expenses which will free up some cash to pay for alternative treatments like massage therapy.
Source: Pexels
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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.
Massage Therapy And Hsas
If you have a health savings account , you may be able to use those funds to pay for massage therapy. To count as a qualified expense, the massage therapy must be deemed as medically necessary. Generally, a letter from your doctor will suffice to prove such services as a medical necessity.
Although Medicare currently doesnt cover most massage therapy services, that could change as its role evolves as an accepted medical treatment.
The good news is that even if your Medicare Advantage plan doesnt offer massage therapy benefits, you may still be able to get affordable treatment. If you have a local massage school nearby, you may get massage therapy at a steep discount. Many massage therapy practices also offer membership options that lower the cost of individual sessions.
If you do have massage therapy benefits with your Medicare coverage, be sure that you fully understand the specific benefits available to you before you book a massage. That way, youll avoid any unpleasant surprises at billing time.
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Verifying Insurance Coverage & Reimbursement For Massage Therapy
At the current time, there is no standard coverage for massage therapy services within large insurance providers. This means getting coverage comes down to the reason for care and how that care is defined to the insurance company. Usually, if the treatment is medically necessary, or it fits the criteria of coverage provided by the insurance company, your client will be covered and you will be reimbursed. Additionally, if the services fit into the category of âhabilitative or habilitation treatment,â it may be considered an essential health benefit and your client will receive coverage. Many insurance companies deem massage therapy necessary in the acute phase of treatment, rather than as a long term care procedure.
An easy way to increase your chances of massage therapy being covered by insurance is to ask your clients to obtain a referral from their primary care physician. In a recent survey conducted by the American Massage Therapy Association, 67% of respondents indicated that their primary physician recommended they receive massage therapy. A prescription or referral from a physician is important for reimbursement because massage therapists are not licensed to diagnose medical conditions. With a referral from a doctor, the massage therapist can include the ICD-10 diagnostic code and referring provider on their CMS-1500 form, and increase their chances of reimbursement.
How To Get Approved To Accept Insurance For Massage Therapy
Some states require massage therapists to carry liability insurance as part of the licensing requirements to practice as a massage therapist. Even if insurance is not required in your state, protecting yourself from lawsuits by paying a few dollars a month for a liability insurance policy is generally a good idea. Most major massage therapist professional organizations offer a group rate on liability insurance for members or an insurance rider is automatically included as part of the benefits package when you pay dues to join the organization.
1
Complete your massage therapy training. Most massage therapy programs require at least 500 hours of study and take six to 12 months to complete. Subjects studied include anatomy, physiology, kinesiology, business management and ethics, as well aslots of practice in various massage techniques.
2
Apply to become a licensed or registered massage therapist in your area. Almost all states and some cities regulate the practice of massage therapy. Licensing typically requires graduation from an accredited school and passing a written and/or practical exam.
3
References
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Massage Therapy Vs Physical Therapy
While people might confuse massage therapy and physical therapy, there are distinct differences between these treatments.
The goal of physical therapy is to relieve symptoms of pain, help people with movement issues, and treat abnormal physical functions caused by injury, disability, or a health condition.
For example, a person that suffers from mild scoliosis can visit a physical therapist who will assist them in regaining proper movement and muscle strength.
On the other hand, a massage therapist can alleviate the symptoms of body pain and discomfort, but they are not trained to identify or treat the sources of these medical conditions.
For example, a massage therapist might be able to relieve pain from scoliosis, but they will not be able to give patients daily exercises or a treatment program to address their underlying medical problem.
Source: Pexels
Getting A Doctors Prescription For Massage
If massage is covered, the next thing you will need is a doctors prescription for massage therapy. This prescription must come from your health professional, as long as s/he is a medical doctor , chiropractor , naturopath , dentist or osteopath , among numerous others, including psychiatrists. As long as your health care practitioner can legally diagnose, prescribe treatments or medications, and has a D in their title, youre good to go.
If you are already seeing a doctor about your condition, call and ask for a massage prescription. If you havent seen a doctor, you will need to get examined and then request the prescription. Your doctor is likely to offer medication before massage, so you may have to bring massage up directly. Be ready to share your research on how massage helps conditions like yours.
Your massage prescription will need the following information:
Mail your prescription to Frederick Massage Therapy or hand-carry the prescription to your appointment. Keep a copy of your prescription in a safe place that you can locate if needed.
If your insurance covers massage and your doctor wont prescribe it, consider getting a second opinion.
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Who Likely Provides Reimbursable Coverage And Who Does Not
Unfortunately for Medicare and Medicaid recipients.
Massage therapy is generally not covered or reimbursed.
The same often true for persons covered under a Health Management Organization .
It is possible for massage therapy to cover by these as well as major insurance companies.
But it depends on the policy held by the patient or client as well as the state where they live and receive massage treatment.
For example, does Medicaid cover physical therapy in a nursing home?
The answer may very well yes given the patients circumstances.
Different states have different laws and requirements in order for massage therapy to cover or reimbursed after the recipient pays for the massage out of their own pocket.
Insurance types that likely to pay in whole or in part for massage therapy services.
Either directly or through reimbursement are major medical providers such as Humana, Blue Cross, Aetna, etc.
Workers Compensation, and the Personal Injury Protection provided by auto insurance companies in the event of an injury sustained from an auto accident.
Again, this depends on the coverage of the client or patients health insurance plan.
Although some states mandate that they cover massage therapy services should all of the requirements are met.