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Massage Therapists /Bodyworkers Discriminated Against by Insurers
If you would like to help me in my cause to stop insurer discrimination against massage therapists for direct reimbursement please let me know.
For the record.
Automobile and Workers' Compensation (Labor and Industry in some states) and other liability cases such as slip and fall including homeowners and business injuries do reimburse massage therapists in every state. (With proper coding and billing procedures).
With that said, just recently a couple of insurance companies have court ordered denials for payment on auto cases to PA massage practitioners. However this will be in their favor when licensing is in hand. The orders basically stated that the claims would not be paid due to the State of PA not having licensure for massage therapists. So as soon as licensing is in hand (and should be soon as their Governor signed the bill) these court orders will be in their favor.
The problem is this:
Most health insurance companies WILL reimburse for massage and/or manual therapy techniques. However, they do not reimburse a licensed or certified massage practitioner. They will only reimburse those who do not do the work, such as a PT, MD or DC.
These providers do not do the work, do not have time to, nor do they want to do the work to say nothing of the fact that they are not trained in the procedures as most massage therapists are. Therefore, insurance companies are paying these providers, to in turn pay a massage therapist.
Does this make sense? They pay higher rates, the patient has to pay higher co-pays on the higher rates and worst of all because of the discrimination, not reimbursing or allowing massage therapists to be "in network providers" these policyholders have to pay higher deductibles, upwards of $2,000, to see out of network providers if the insurance will cover them at all as some do in FL.
Any good fortune in FL is due to the Law enacted by legislators in October 1992, due to strong efforts of the FL State Massage Therapy Association, it's legal counsel and lobbyist. I am very proud to have had a significant part in the introduction and passage of this bill as the Insurance Committee Chair for the Association.
While Washington State therapists can join networks due to their efforts to create positive legislation through, their then Insurance Commissioner Debra Senn, and others, they still cannot be reimbursed by some insurance company policies under Federal Guidelines, which like in FL, supercedes state laws. If these two states with extenuating legislation cannot be reimbursed by some health care plans, how do we expect that therapists in states without any special legislation is going to?
In addition, because their original law was an "Every Category Provider" law, when they won and insurers were required to allow WA therapists to be in, or join, the networks, there was nothing to say how many providers of each category they were required to accept. Therefore it is my understanding from many WA therapists I have spoken to, that most of the networks are closed to new therapists.
We need to tackle it in a different way. I have ideas that I will be sharing in the near future to hopefully make efforts to begin to move us forward. It may take us nowhere but I am a firm believer that if we don't try there is no chance of success. If you might be interested just write me a note to: vivmahoney@aol.com
In the meantime, accept the type of cases that will pay and be sure to do it right, be sure you know the rules, guidelines, laws, coding, paperwork, filing time and other requirements such as legal documentation etc. This is a very rewarding business, both in helping those who need it and could otherwise not afford it, and from the extra income standpoint. I am speaking from having been there, and from 20 years of helping other massage therapists reach their goals.
I know because they write or call and tell me so or tell it in my seminars they take to continue to keep up on all the latest changes and to stay refreshed.
May your future be bright and those you help be even brighter!!!
Vivian
Views: 299
Replies to This Discussion
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Permalink Reply by Mike Hinkle on
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Great article Vivian. I personally do not handle insurance work as I am already quite busy. But I do know those that do and want to and I am so glad you are standing up for them. You are such a credit to this profession. Thank you for what you do for all of us!
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Permalink Reply by Angela Lind on
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Vivian, I appreciate your valued work about this situation. I have been affected from this kind of discrimination and has been very frustrating. I live in Florida and it still very complicated to get reimbursed by insurance companies, they just want to pay directly to PT's, Chiro's and doctors.
I would love to know your ideas and anything I can help with just let me know, it would be my pleasure to be part of this great cause.
Angela Lind. -
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Permalink Reply by Vivian Madison Mahoney on
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Angela thank you ever so much. Please drop me a note to: Vivmahoney@aol.com so I can have your email address on file when we get it together. Thanks again!!!
Angela Lind said:Vivian, I appreciate your valued work about this situation. I have been affected from this kind of discrimination and has been very frustrating. I live in Florida and it still very complicated to get reimbursed by insurance companies, they just want to pay directly to PT's, Chiro's and doctors.
I would love to know your ideas and anything I can help with just let me know, it would be my pleasure to be part of this great cause.
Angela Lind. -
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Mike thank you, it is people like you and those who appreciate my efforts that makes it all worth while. It's my husband John that we all need to thank because he is the one who has to listen to me on the phones and sit lonely while I am answering emails all day and half the night. (:-) . But it's because he loves all of this too. From Funeral Director to Massage, either way they lie down for ya.. ha...
Mike Hinkle said:Great article Vivian. I personally do not handle insurance work as I am already quite busy. But I do know those that do and want to and I am so glad you are standing up for them. You are such a credit to this profession. Thank you for what you do for all of us! -
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Permalink Reply by Darcy Neibaur on
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Thank you Vivian for sharing all this excellant information, and your willingness to help us all.
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So glad to be able to do it Nancy. I love doing it because I love bringing smiles to peoples faces and money to their bank accounts!!! smile...People like you who are so appreciative, make it all worth while.
Darcy Neibaur said:Thank you Vivian for sharing all this excellant information, and your willingness to help us all. -
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Permalink Reply by Jenny Ray on
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Vivian,
EXCELLENT!
I see so many of my students struggle with this on going battle. Paper work has gotten more time consuming and more difficult, the time involved is ludicrous and costly....Then about half the time claims are denied and the practitioner is left with uncollected funds on the books...I have been at this since forever....before massage schools were invented and have never been licensed in any state, (so I have no voice) but trust me I have an education that would make most practitioners cringe...(40+ years and continuing). I travel the world teaching one modality through 12 different workshops and everywhere is the same...the practitioners simply want to be paid a fair wage for the work they do without always fighting big brother or the corporate world...People like you who have the credentials to support your voice and are willing to use your precious time to improve the profession for all practitioners deserve a an award....so here is one just for you
"HONORARY SUPER-DUPER-HARD-WORKER-ALL ROUND-GREAT-GAL"
Thank you so much for all you do..
jenny -
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Jenny Ray wow, this email from you bought tears to my eyes, rolling down my cheeks. My husband gently wiped them and said, "now I realize even more why you enjoy so much time sharing with massage therapists, rewards are certainly not always monetary.
That Jenny, has been my way of life. That is why I was so successful and loved the challenges of insurance work. It was not that I liked paperwork or insurance. I had major reasons for HATING insurance companies. Among them, my very own insurance company pulled out of the State of FL just to legally avoid the continued coverage of my daughter who was in rehabilation centers with brain injury. This was after us winning 4 major law suits against them for continued coverage of medical services.
The State Insurance Law, allowing them to leave the state had left me with having to bring her home when the rehab center would no longer keep her without insurance coverage.
I was left then to pay $4,600 to $6,200 a month out of pocket for 2 years to keep her out of a raunchy county home.
I was able to do this, thank GOD, because in those 2 years prior to the auto accident I had built my business to a successful level by being willing to accept challenges, losses, delays and denials in the procsses of learning how to promote, bill and be paid for insurance cases because there was not one soul in this massage profession at that time to turn to to learn from.
I loved helping patients find their way through the maze of insurance, attorneys and their recovery of injuries.
I learned the ropes, legally, medically, insurance and terminology wise just to help them. (to get even with insurance companies? Maybe so.
But it was through all of fthis that I learned to work within the system and make it work for me. It worked for me and my family so then I dedicated my life to help it work for others.
Yes, they now have two choices, they can go through the process of learning and losing as I did, or they can invest in my materials and do it right to protect themselves from the start. Would I rather not promote my own stuff and self and promote others instead? Yes, it would be so much easier. But that choice is not available if I want them to succeed by traveling on the path of least resistance.
Jenny you are to be commended for being in this business as long as you have and still having a love for it, working and training others along the way. I appreciate you and thank you ever so much for those kind words. I will frame them with my other awards!!!!!
God Bless You Jenny!!! -
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Wow, it is encouraging to get emails like this, also frustrating to hear that so many in WA have had the same complaints
I think maybe it would behoove a lot of WA LMP's get together or with your State Association if you have one or AMTA WA and make an appointment with someone at the Dept of Insurance and all file the complaint at the same time. Maybe their Consumer Division if possible. I would approach it from the policyholder's view (get prospective patient's on the bandwagon from the stand point that they are unable to receive medically necessary treatment when prescribed by their physicians.
Will this work? I am not sure, but one thing I have always been sure of, if it is not tried, one will never know and nothing gets done. IF it does not work, at least you all would have some input of what may be your necessary next step. But it has to be done in numbers or at least with a leader in that assoc that KNOWS enough about insurance to help make a difference, like Diana Thompson.
I would like to see some in roads with that because it is my guess, IF the non discrimination portion of the health care reform is not destroyed, eliminated etc, the insurance companies, while not discriminating, will do what they have been doing in WA and other states with many providers. Saying,ok, we don't discriminate, we let you all in, but only a few and then close the gates.
Thanks so much for writing!! Please provide me with your name as all I see here is your company name. Thanks!
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