Massage Insurance Billing Discussions - massage and bodywork professionals2024-03-28T14:52:41Zhttps://massageprofessionals.com/group/massageinsurancebilling/forum?feed=yes&xn_auth=noUnitstag:massageprofessionals.com,2016-07-28:2887274:Topic:3597322016-07-28T19:52:27.052Zerica ragusahttps://massageprofessionals.com/profile/ericaragusa
<p>Is there a max number of units allotted per body region? When I took my medical billing class I learned that we could only bill for 2 units per body region per day (I use code 97140). I wonder if this has changed recently? thanks. </p>
<p>Is there a max number of units allotted per body region? When I took my medical billing class I learned that we could only bill for 2 units per body region per day (I use code 97140). I wonder if this has changed recently? thanks. </p> ICD-9 code: is it needed?tag:massageprofessionals.com,2014-11-20:2887274:Topic:3448332014-11-20T01:07:28.680Zerica ragusahttps://massageprofessionals.com/profile/ericaragusa
<p>My thought is that we do as LMT's need an ICD-9 code from a referring physician in order to bill for massage therapy. Is this correct? I recently received a script from a physician referring his patient to me for massage therapy, but there was no dx code. Should I ask for a new script?</p>
<p>My thought is that we do as LMT's need an ICD-9 code from a referring physician in order to bill for massage therapy. Is this correct? I recently received a script from a physician referring his patient to me for massage therapy, but there was no dx code. Should I ask for a new script?</p> Hiring a Medical Billertag:massageprofessionals.com,2012-06-04:2887274:Topic:2634512012-06-04T05:17:35.893ZTrina Throckmortonhttps://massageprofessionals.com/profile/TrinaJoyThrockmorton
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<dd><a href="http://www.massageprofessionals.com/group/massageinsurancebilling#" class="icon delete delete_link" title="Delete Comment"></a><div class="xg_user_generated"><p>I am looking to "hire" a medical biller to bill insurance for my practice. I am a one man show and I work from home. Has anyone had a similar experience hiring someone to do the billing and has it been a good thing? Worth it?</p>
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<dd><a href="http://www.massageprofessionals.com/group/massageinsurancebilling#" class="icon delete delete_link" title="Delete Comment"></a><div class="xg_user_generated"><p>I am looking to "hire" a medical biller to bill insurance for my practice. I am a one man show and I work from home. Has anyone had a similar experience hiring someone to do the billing and has it been a good thing? Worth it?</p>
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</dl> What states/cities, insurance plans can you bill in your state?tag:massageprofessionals.com,2012-03-25:2887274:Topic:2568442012-03-25T17:59:42.678ZJulie Onofriohttps://massageprofessionals.com/profile/JulieOnofrio
<p>One of the most common questions I get is what insurance company can I bill?</p>
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<p>In Most states you can bill for car accidents and work related injuries but there are certain rules in some states like having to bill under a chiro or PT. More states are willingly paying for massage. There are even some companies that have extra CAM benefits for their employees. Each plan and each person who is on that plan is different. so you have to call each time to find out the…</p>
<p>One of the most common questions I get is what insurance company can I bill?</p>
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<p>In Most states you can bill for car accidents and work related injuries but there are certain rules in some states like having to bill under a chiro or PT. More states are willingly paying for massage. There are even some companies that have extra CAM benefits for their employees. Each plan and each person who is on that plan is different. so you have to call each time to find out the details.</p>
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<p>I would like to use this group here to start sharing info on what states you can bill and what insurance companies you can bill. Helping others in your area learn the ropes is an important part of helping the profession grow.</p>
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<p>Insurance billing can be intimidating but once you learn the ropes, it can be a nice supplement to your income. Getting the support you need for handling such a difficult process can help you to get over your fears and concerns about billing insurance. It can also help you with the many ethical challenges when billing insurance.</p>
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<p>Please start adding discussions and start with posting your state/city and what you are finding as far as what companies you can bill and what companies are paying. Please do not share what they are paying right now. (there may be some legal implications around that.)</p>
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<p>So happy billing</p>
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<p>thanks</p>
<p>Julie Onofrio</p> WA Massage Insurance Billingtag:massageprofessionals.com,2012-03-24:2887274:Topic:2566812012-03-24T19:05:46.593ZJulie Onofriohttps://massageprofessionals.com/profile/JulieOnofrio
<p>In WA we can bill for car accidents and for work related injuries through Labor and Industries.</p>
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<p>You can sign up to become a provider with L&I here - <a href="http://www.lni.wa.gov/ClaimsIns/Providers/Becoming/default.asp">http://www.lni.wa.gov/ClaimsIns/Providers/Becoming/default.asp</a></p>
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<p>Other insurance companies that you need to sign up with to become a provider.</p>
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<p>Premera/Lifewise WA - …</p>
<p>In WA we can bill for car accidents and for work related injuries through Labor and Industries.</p>
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<p>You can sign up to become a provider with L&I here - <a href="http://www.lni.wa.gov/ClaimsIns/Providers/Becoming/default.asp">http://www.lni.wa.gov/ClaimsIns/Providers/Becoming/default.asp</a></p>
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<p>Other insurance companies that you need to sign up with to become a provider.</p>
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<p>Premera/Lifewise WA - <a href="https://www.premera.com/stellent/groups/public/documents/xcpproject/pvd_join_our_network.asp">https://www.premera.com/stellent/groups/public/documents/xcpproject/pvd_join_our_network.asp</a> </p>
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<p>Regence Blue Shield - list is closed but you can supposedly get on if you have a group of people who work together ( I think at least 6 people -not sure exactly)</p>
<p><a href="http://www.wa.regence.com/provider/">http://www.wa.regence.com/provider/</a></p>
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<p>Whole Health Networks - Aetna, Cigna, Corvel (some car insurance companies) <a href="https://www.wholehealthpro.com/AboutHealthwaysHealthSupport.aspx">https://www.wholehealthpro.com/AboutHealthwaysHealthSupport.aspx</a></p>
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<p>First Choice- <a href="http://www.fchn.com/ForProviders.aspx">http://www.fchn.com/ForProviders.aspx</a></p>
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<p>Use <a href="http://www.officeally.com">www.officeally.com</a> to bill! It is easy. They will teach you over the phone how to use it. You will get paid much faster. You need to be HIPAA compliant. Here are forms for HIPAA - <a href="http://www.sohnen-moe.com/forms.php">www.sohnen-moe.com/forms.php</a></p>
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<p>Let me know if you have any others to add to the list.</p>
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<p></p> how much do health insurances pay?tag:massageprofessionals.com,2011-03-30:2887274:Topic:1496472011-03-30T00:44:27.763ZJanine Blanchardhttps://massageprofessionals.com/profile/JanineBlanchard
<p>so how do i find out how much health insurances would pay per unit/ hour, if they cover LMT services? which one is known for paying an ok amount and for which one is it not even worth it to bill (with all the extra paperwork involved).</p>
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<p>I believe it is different for every LMT but a general outline would be so helpful...</p>
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<p>Thanks for any input on this!</p>
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<p>~janine</p>
<p>so how do i find out how much health insurances would pay per unit/ hour, if they cover LMT services? which one is known for paying an ok amount and for which one is it not even worth it to bill (with all the extra paperwork involved).</p>
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<p>I believe it is different for every LMT but a general outline would be so helpful...</p>
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<p>Thanks for any input on this!</p>
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<p>~janine</p> Insurance Billing in MA, can someone help?!tag:massageprofessionals.com,2011-03-10:2887274:Topic:1419022011-03-10T22:43:27.265ZKristenhttps://massageprofessionals.com/profile/KristenTammaro
<p>I am a sole practitioner of 5 years with a new office in Taunton. I am looking to talk to someone who is familiar with the procedures and protocols that Insurance Billing entails. I don't know if I want to go this route so it would be helpful if I could chat with soemone who has or is using this method of payment. I know about Vivian's <a href="http://massageinsurancebilling.com/">http://massageinsurancebilling.com/</a> website, but I still would like to hear it from the horses mouth in…</p>
<p>I am a sole practitioner of 5 years with a new office in Taunton. I am looking to talk to someone who is familiar with the procedures and protocols that Insurance Billing entails. I don't know if I want to go this route so it would be helpful if I could chat with soemone who has or is using this method of payment. I know about Vivian's <a href="http://massageinsurancebilling.com/">http://massageinsurancebilling.com/</a> website, but I still would like to hear it from the horses mouth in MA.</p>
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<p>Thanks and Blessings!</p>
<p>Kris Tammaro LMT</p>
<p>RelaxationWorks.co</p> Billing NYS no-Fault insurancetag:massageprofessionals.com,2010-09-21:2887274:Topic:1070692010-09-21T16:20:37.985ZDeb Evanshttps://massageprofessionals.com/profile/DebEvans
DOes anyone know how to do this? or a link to tell me how? I know I need to do soap notes, I can find the form, and I know the CPT codes-- but where are the times, (how many 15 minute treatments can the patient receive per day? do I have to be on some kind of list? or just use my license number?) thanks!
DOes anyone know how to do this? or a link to tell me how? I know I need to do soap notes, I can find the form, and I know the CPT codes-- but where are the times, (how many 15 minute treatments can the patient receive per day? do I have to be on some kind of list? or just use my license number?) thanks! Massage Therapists /Bodyworkers Discriminated Against by Insurerstag:massageprofessionals.com,2010-02-09:2887274:Topic:646002010-02-09T16:35:45.897ZVivian Madison Mahoneyhttps://massageprofessionals.com/profile/VivianMadisonMahoney
<div><p>If you would like to help me in my cause to stop insurer discrimination against massage therapists for direct reimbursement please let me know.</p>
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<p><strong>For the record.</strong></p>
<p>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. <em>(With proper coding and billing…</em></p>
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<div><p>If you would like to help me in my cause to stop insurer discrimination against massage therapists for direct reimbursement please let me know.</p>
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<p><strong>For the record.</strong></p>
<p>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. <em>(With proper coding and billing procedures).</em></p>
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<p><strong>With that said,</strong> 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.</p>
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<p><strong>The problem is this:</strong></p>
<p>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.</p>
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<p><strong>These providers do not do the work</strong>, 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.</p>
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<p><strong>Does this make sense?</strong> 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. </p>
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<p><strong>Any good fortune in FL</strong> 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. <em>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. </em></p>
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<p><strong>While Washington State therapists can join networks</strong> 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?</p>
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<p><strong>In addition, because their original law was an "Every Category Provider" law</strong>, 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.</p>
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<p><strong>We need to tackle it in a different way</strong>. 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: <a href="mailto:vivmahoney@aol.com">vivmahoney@aol.com</a></p>
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<p><strong>In the meantime, accept the type of cases that will pay</strong> 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.</p>
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<p><strong>I know because they write or call</strong> 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.</p>
<p>May your future be bright and those you help be even brighter!!!</p>
<p>Vivian</p>
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<p> </p> Anthem Blue Cross in Californiatag:massageprofessionals.com,2010-02-08:2887274:Topic:642442010-02-08T17:37:04.435ZJody C. Hutchinsonhttps://massageprofessionals.com/profile/JodyCHutchinson
Good morning everyone,<div>Here's an update on Blue Cross of California and how they are impacting healthcare. Recently, BC had decided to limit reimbursement for Physical Therapy to $75.00 per visit with a 12 visit per year cap. Many PTs in my area are furious and are considering stopping acceptance of BC patients. </div>
<div>BC has also raised premiums again, some by 39%, citing increasing healthcare costs. What baloney! BC is dishonest. They pay MTs to go to health fairs and do chair…</div>
Good morning everyone,<div>Here's an update on Blue Cross of California and how they are impacting healthcare. Recently, BC had decided to limit reimbursement for Physical Therapy to $75.00 per visit with a 12 visit per year cap. Many PTs in my area are furious and are considering stopping acceptance of BC patients. </div>
<div>BC has also raised premiums again, some by 39%, citing increasing healthcare costs. What baloney! BC is dishonest. They pay MTs to go to health fairs and do chair massage and yet BC doesn't pay a dime for massage therapy. I have been called several times by a jobber in SF who looks for starving MTs to do chair massage at health fairs-this guy isn't a MT and admits that the pay is terrible. </div>
<div>Also, Anthem BC's CEO is paid $11.2 million per year. How nice.</div>