With the prospect of a troubled economy, some massage therapists may feel more compelled to explore the path of billing insurance companies for massage therapy services. Massage Insurance Reimbursement is a very controversial topic and a very difficult path but having clients coming in regularly with an injury or condition and having someone else (the insurance companies) pay for their massage session can seem very appealing. Done correctly, billing insurance companies can be very lucrative.
Some of the things that you have to know about working with insurance clients is that insurance does not cover palliative (unnecessary) treatments or preventative treatments. Massage will be covered by most auto insurance policies in some way when there is a motor vehicle accident. Massage may also be covered by most states labor and industries or workman’s compensation policies for people who are hurt on the job. In WA and FL massage is actually a part of the major medical insurance companies. In WA massage therapists are able to become contracted providers with companies like Premera Blue Cross and Regence Blue Shield to name a few. WA is one of the first states to accept massage therapists so there is much to be learned from the WA State if you are looking for your state to become part of the medical system. When it first started in about 2000 I think it was, insurance companies paid fairly well and paid without question for the most part. Each year clients benefits gets reduced meaning we get paid less per session and clients are allowed fewer sessions. A few companies have increased their allowable fees through the years but some companies haven’t. With free electronic billing nowadays with companies like officeally.com, the time between billing and getting the payments have been reduced to a few weeks compared to 4-6 weeks.
If you are thinking that you want to explore the aspects of billing insurance companies for massage therapy services you need to be able to set clear boundaries around your sessions. People who are coming in on insurance tend to be the first one’s to not show up or cancel at the last minute because they think that they won’t have to pay for it. I inform my clients on their first session that they will be responsible for a full fee if canceling in less than 24 hours. Clients who use insurance for massage also tend to want to get massage long after their pain is gone or they may try to use it in preventative ways. They also try to use it just for everyday aches and pains caused by sitting at the desk too long or working in the yard or climbing a mountain. If the pain is debilitating and causes a loss in function, massage will cover the session. With car accidents and injured workers you also may see more people who are coming in to make their cases seem worse than they really are thinking that they will get a larger settlement from the insurance company. While I am making these statements more as a generalization and all clients of course are not like that, it is something that you should be aware of when working with clients and insurance. Creating clear boundaries around your sessions can help you create a more successful massage insurance billing business.
There are also more insurance companies who are allowing massage therapists to bill for their services without being contracted providers. You will have to find out what each company allows and what each policy allows so it makes billing more challenging.
Some other things you need to know about are included on my website in the Massage Insurance Billing Manual at www.thebodyworker.com
Some other things to be aware of:
- Setting your fees higher for insurance companies than your cash clients no matter how you want to rationalize could be illegal. You can only charge the amount that you would pay a person to bill insurance. You can’t charge more because it takes longer to get paid or it takes more time to do chart notes. Those are considered part of doing business so your prices should reflect that -ie if you take insurance you may want to raise your cash rates too to compensate for the additional time it takes to bill, write notes and managing the cases and doing all the work it takes to actually get paid.
- Set guidelines for creating treatment plans that have a clear beginning and end. What improvements in the clients condition will let you know when the client is done with their sessions?
- Learn how to write chart notes that include functional outcomes
- Have clients monitor their claims and payments for you and ask them to call when you are not getting paid
What state do you live in and are you able to bill for mva’s, PPO’s, HMO’s, Workman’s compensation?