Subject to your benefits, your insurance will pay for up to 60 minutes on any single day.  You are responsible for any remaining balance.  I will pre-verify your insurance benefits so we both know what to expect.

A doctor’s referral is ALWAYS required, as insurance pays only for treatment that is determined to be medically necessary.  I am not allowed to make this determination under my massage license.  Only a doctor can legally determine medical necessity.

I am a preferred provider for Washington State Labor & Industries, Aetna, Cigna, First Choice, Premera Blue Cross, Regence BlueShield, and Uniform Medical.  PIP (auto insurance) is also accepted.  Medicare does not cover my services.  Policies originating in states other than Washington (i.e. Regence Blue Cross/Blue Shield of Oregon) do not cover the services of a massage therapist.

I’m happy to bill your insurance directly if ALL of these are in place prior to your session:

• I have had the opportunity to pre-verify benefits
• I have a current doctor’s referral
• I have your complete insurance information

Otherwise, payment in full is required at the time of service.  I will give you the paperwork to obtain reimbursement from your insurance company, usually in about three weeks.

Co-pays, if required, are payable at the time of service.

 

MORE INFORMATION ABOUT INSURANCE PLANS

Each Group Plan has its own provisions for what is covered.  I will assist you in determining exactly what your plan will cover.

Almost all plans place the following limitation:

“Massage therapy must be medically necessary and for the rehabilitation of function that was previously normal but was lost due to illness or injury.”

Insurance pays only for work on the diagnosis your physician has determined.  When the rehabilitation has been achieved you will be discharged, even if your referral has not expired and you still have benefits remaining.

We are not allowed to treat stress (although it’s perfectly ok if your stress goes down!).  We are not allowed to vary from working on what has been prescribed.  If there are additional areas that need work, you should call your doctor and ask for an additional prescription.

At our first session we will set goals for treatment.  We will know if treatment is helping and when you should be discharged by measuring progress.

We’ll set goals in three areas:

¨       Pain levels, using a scale of 1-10, 10 being worst.  Between sessions, make note of when your pain levels go up or down, and what you were doing that aggravated or relieved your pain.  I will be asking you about these at every session.

¨       Range of motion.  We will assess ROM every few sessions.

¨       Activities of daily living.  I will be asking you about your ADL’s at every session.

à         Think of things that you would normally do that are now limited by your pain or lack of ROM.

à         Think of how much time you could previously do these activities, and how much time you can now do them without pain.

à         Examples of ADL’s:

°          “I previously could play catch with my grandson for 30 minutes without pain, but now I can only do it for 10 minutes.”

°          “I previously could drive in my car for several hours with no back pain but now I have pain after 20 minutes.”

°          “I previously could sit at my computer for an hour with no neck pain but now I have pain after 10 minutes.”

°          “I previously usually slept through the night but now my pain wakes me up every few hours.”

Plan to come to your sessions a few minutes early each time, so you can fill out a short update form so we can keep a good record of progress.  Please understand that in order to comply with my provider contracts I must keep good records and be ready to submit my treatment notes in order to receive payment.