If you are like most massage therapists, there is a long list of reasons why you do not accept insurance for massage. It’s complicated, time-consuming, and there are many pitfalls that can lead to payment delays for months or quite often total non-payments, just to name a few.
These are very real and understandable concerns. Accepting insurance clients is very risky for a massage therapist. Our goal is to change that. We can make it possible for you to see certain kinds of insurance patients without any of the complications or risks normally associated with insurance billing and it is 100% legal and legitimate and payments to you are guaranteed.
Which type of insurance can we work with?
Before getting into some of the details it’s important to understand what kinds of insurance we can work with and which ones we cannot. We work with the types of insurance patients who have the kind of insurance that is likely to pay our bills. Makes sense right?! Currently this primarily includes insurance related to an injury such as an auto injury, work injury, or slip and fall type injury claim. We do not work with insurance such as regular major medical insurance, Medicare, or any other PPO, HMO, or other types of regular health insurance. Hopefully this will change in the near future but for now we can’t work with these.
How does it work?
It’s generally pretty simple, however in order to ensure that what we do does not violate any laws related to patient referrals, kickbacks and things of that nature, it must work in a very specific way.
Basically what happens is, when you encounter someone who has been injured and has medical benefits available through some kind of insurance claim to pay for necessary medical expenses, instead of telling them “no I’m sorry I don’t accept insurance” you can tell them “there is this company that I know that does accept insurance – we can check with them to see if it’s possible, and then if you’re interested in using me as your therapist, you can request me once everything else is all set.”
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When a patient contacts us, we have a few forms that need to be signed and we will gather some basic information about the patient’s condition and the claim. Once we have that, we will contact the insurance provider to see if it is a claim we will be able to work with. Assuming everything looks good, we will then be ready to match the patient with a qualified and contracted massage therapist, like you!
Before going into more detail, it is important to point out that for legal reason that patients must specifically request you to be their therapist, and also that they retain the right to request a different therapist at any time. In other words, you referring the patient to us does not automatically guarantee that you will be assigned to that patient and we cannot force the patient to continue to use you if they for any reason want to try someone else at any time.
That having been said, presumably in most cases they should be interested in trying you assuming they are not already familiar with your services. Or in other cases it may be someone you’ve worked on before and already have a relationship with, and in that case there’s a very high likelihood that the patient would be interested in working with you. For our part, it actually makes things a lot easier if a new patient comes to us and they already have a specific, qualified therapist they want to work with. We have no motivation to steer them elsewhere as long as they can get competent treatment from you.
Assuming you hold the proper credentials in your state and meet our other requirements including professional liability insurance coverage we can very quickly and easily contract you to perform the therapy once we get to that point. It’s important to point out that unless you live in an area where we regularly serve clients and maintain a standing therapist roster, there is really no need for us to enter into the contract until we have a patient actively requesting you.
Once we have the patient’s benefits verified, a request for you and your contract completed, we would then, adhering to a doctor’s prescription, authorize you to perform a certain number of sessions that we can guarantee your payment on, as long as you submit your soap notes in a timely fashion. We pay for these assignments like we do for any other job that we assign to a contractor, whether related to insurance or not. We pay a flat pre-set rate within 10 business days from the date of service. The rate is a little higher than our normal pay for a one hour deep tissue outcall massage. (We prefer not to post the rate publicly but this gives you at least some point of reference).
By law we cannot offer any kind of split or percentage on what we collect from an insurer nor can we withhold your payment for the services you provided in case we do not get paid at all by the insurance company! So essentially we are assuming all the risks and headaches dealing with the insurance company and you are simply providing a contracted service at a set, flat rate guaranteed to be paid.
Services can be provided in the client’s home, or in a licensed massage establishment.
So the next time someone asks about getting massage through insurance, if it’s one of the kinds that we do accept (auto injury claim, workers compensation claim, etc.) send them our way and make sure they ask for you. We have no incentive to try to assign your referral to someone else. It’s honestly a lot easier for us when a client comes to us with a therapist in tow than us having to go out and find someone completely new for them.
We hope to work with you, as we have with several other massage therapists in this fashion, in the near future!
If you have someone ready to go and have questions, please call our main number, ext. 3.