Q. If a law gets passed allowing massage therapists to bill in my state or across the US, does it mean that I will have to take insurance?
A. Not as far as I know. Here in WA you choose whether or not to get on the provider panels and bill insurance. It will always be optional as far as I know right now.
Q. How much extra paperwork and time is involved?
A. Things are so much easier today than they were when I first started 30 years ago. Everything is done electronically. Checking benefits and verifying coverage are done through portals like www.onehealthport.com and www.availity.com
Filling out the CMS 1500-2 and submitting it to insurance companies is done through clearing houses which are free or low cost like www.officeally.com
Charting is usually a simple process when you have the right form. I still use a paper form and it takes me a minute or two after the appointment. There is also online charting systems like www.handshealehr.com that are making it easier and easier.
Payments are deposited right into my checking account and I check online for the Explanation of Benefits to see who the payment was for.
Q. Does health insurance cover wellness/relaxation/preventative massage therapy?
A. No not in WA at least and it probably won’t for awhile. It works just like Physical Therapy. When people have an injury or condition that massage therapy can help, doctors will prescribe massage therapy. Insurance plans all have a definition of medical necessity which usually reads something like this.
Q. Won’t taking insurance limit what I can do with a client/patient as far as the work I do and the care I provide?
A. Not really. Someone using their insurance will have a prescription with the diagnosis. You can do what work you feel is needed as long as you can chart what you do and show that what you do is working.
Q. What will they pay per session? Health insurance won’t pay much so it isn’t worth taking.
A. That is an issue. In WA State though we were paid very well ( $80- $120 per hour) for about 15 years until the carriers started reducing the allowable fees. The main issue is that the carriers set their fees based on a formula that includes the cost of the work being done in a session. This information should be provided by our professional associations but it has never been provided to my knowledge so they carriers use what information they have.
Q. Most people using their insurance don’t value massage. They are the first ones’ to not show up, show up late or are the most difficult to work with.
A. Just like your other clients, having policies in place will help you limit no shows and late arrivals. The client will have to pay this, not the insurance so it helps educate clients about the importance of sessions.
Q. The healthcare system is so broken. Why would we want to be a part of this?
A. Yes it is. But it is what we have. We should also be working on other things like how about a health insurance plan for Integrative Care providers that is fair. How about a union or a way to negotiate contracts with carriers including allowable fees?
Q. Is the ability to bill insurance coming whether we want it or not…whether we are a part of it or not?
A. I have been watching this issue since my first edition of the Massage Insurance Billing Manual in 2005. At first my main goal in writing the book was to just share what I know. I had not intended to do anymore editions but in 2012, I saw that Affordable Healthcare Act come to be and thought for sure that the language would help to make this so. Our professional associations have not done anything to help make it so especially AMTA who claimed that 51% of their members did not want it to be covered. What about the other 49%?
Since then, many things have been happening that are pointing to massage therapy being more accepted by insurance, legislators, doctors and hospitals. The thing is that we are not at the table with the powers that be so that they will dictate benefits and coverage without us. Even though the system is broken, it is what it is….why not be at the table and create what we want in what ways we can rather than letting others dictate to us leaving the massage profession to react to the many challenges rather than work to create what WE want for the profession.
My current edition of the book Massage Insurance Billing Manual, just released in 2019 now covers the history of WA State and how we have had the ability to bill health insurance since about 2000 and the challenges we now face mainly because we have not had the support from our associations to help us with the many issues.