The Step by Step Manual on how to bill insurance for workers comp, car insurance and health insurance and Get massage covered by health insurance in your state.
In most states you can bill massage therapy services for car accident claims (PIP, No Fault, Third Party) and get paid. You can also bill for work related injuries in most states through workers compensation/labor and industries. (I have been collecting a list of states and what insurances you can bill but it needs filling in.)
Learning the very basic concepts of how insurance companies work and start taking insurance clients in your massage business in this easy to read book. Once you understand the basic concepts and the process, you will be able to start asking the right questions to the right people and learn what you need to do to bill correctly and get paid by insurance companies!
These basic concepts include:
- Figuring out what to charge for your massage services.
- Understanding HIPAA and why all massage therapists should move toward being HIPAA compliant even though they may not be a ‘covered entity’. HIPAA basics, HIPAA NoPP forms, HIPAA Risk assessments, HIPAA compliant forms, Electronic Health Records/Electronic Medical Records.
- Learning about what forms you need to collect the correct information in order to bill insurance.
- Learning how to fill out the basic billing form
- Learning what CPT codes to use and how to use them.
- ICD 10 codes and how to interpret them and use them.
- Learning the process of billing and what to do if you don’t get paid.
- Creating a referral network of physicians, health care providers and lawyers to get more clients.
As a result of learning the basics of billing and actually billing cases, you will be able to start telling which cases will require more time, energy and have more risk of not getting paid so you can focus on taking cases that will take less time and energy to bill AND get paid.
Working with people who are injured and in pain usually means that clients will come in once or twice a week for a few sessions or for many months depending on the severity of the injury or condition. That means regular weekly/monthly clients until they are better and usually a regular weekly/monthly client after they are better and the case is settled.
If you decide to accept the challenge and open up more income opportunities and help put the ‘care’ back into healthcare, here are some of the things that you will need to know :
- You will need to know what to ask the client when they call asking if you take insurance and analyze the case so that you can decide if you want to take it or not.
- You will need to know the lingo and how to work with lawyers, doctors and insurance companies.
- You will need to know how to do extensive chart notes so that you can show how massage has improved the functions that were impaired due to injury and various conditions.
- You will need to know how to promote yourself to doctors and other health care professionals.
- You will need to know what forms you will need and how to fill out the forms correctly so that you get paid.
- You will need to know what to do if they don’t pay and what to do if they ask for money back!
Here is the full Table of Contents:
| Table of Contents | |
| Acknowledgments | 4 |
| Contents | 15 |
| Preface (READ ME) | 16 |
| Introduction | 19 |
| Is It Medical Massage or Clinical Massage? | 21 |
| Step-by-Step Guide to Billing Insurance | 27 |
| Will Billing Insurance Help Your Massage Therapy Business? | 31 |
| The Prescription, Referrals, and Medical Necessity | 38 |
| The Codes: ICD-10 and CPT Codes | 45 |
| Setting Your Fees for Billing Insurance | 57 |
| Screening Clients, Verifying Benefits, and Intake | 64 |
| Documentation | 68 |
| CMS-1500—The Billing Form Explained | 76 |
| Personal Injury, Workers’ Compensation, and Other Payment Options | 83 |
| Health Insurance and Massage Therapy | 92 |
| Health Care Law | 100 |
| Health Insurance Portability and Accountability Act (HIPAA) | 106 |
| Billing Health Insurance | 118 |
| Building Your Clinical Massage Business | 125 |
| The Art and Science of Massage Therapy | 133 |
| Research and Evidence-Based Massage Therapy | 150 |
| Health Care Integration—Getting Massage Therapy Covered by Health Insurance | 153 |
| Call to Action | 159 |
| Forms | 164 |
| Glossary | 172 |
Learning to bill is very complex to start with and also each state is different, each plan is different making it quite a challenge. No one person can really tell you how to bill or if you can bill because it is so different in every state and within each insurance company and with thousands of plans out there. It is also complicated by the type of injury and who is at fault.
When billing insurance, it means that you will be faced with many challenges. Insurance companies dictate what they will pay and the number of sessions they will allow in their plans. The one thing that they do not understand is that massage can save them money in other areas such as eliminating the need for surgery and drugs for many conditions. If massage therapists want to be more accepted in the medical profession and respected, we will also need a strong, cohesive group to help lobby politicians and to make stands against insurance companies low pay rates. The more people who understand the process of billing, the more people we will have to be able to do just that. Even if you choose not to bill, it is important to know what is going on in the world of insurance billing. We need more massage therapists billing insurance and getting to the table with the insurance carriers right from the start so that we can have a say in what happens.
The ability to bill and get paid by health insurance is coming no matter if you want it to happen or not.
I have been billing insurance of all kinds since about 1990, when I started my massage business in WA State. I have taken every class I could and read every book and article on billing insurance that I could find.
In WA State, massage therapists have been able to bill health insurance for over 20 years because of a law created by Deborah Senn, who was our insurance commissioner at the time. In the beginning and for over 15 years it was great with carriers paying between $80-$120 per hour with little restrictions. Currently we are getting thrown to the wolves by the carriers because of our lack of representation at the table with insurance carriers. For the longest time, I have recommended that other states work on getting massage covered by health insurance, but am changing my tune. We just do not have the leadership, advocacy, legislative power or negotiating power to stand up to the insurance carriers. My book though, explains what has happened here in WA and what we need to do across the US to be stronger as a profession.
I want to share what I know about billing and help teach you the basic concepts of insurance and billing so that you can learn what to ask the various companies, doctors and lawyers and get paid!
This book is not just about Billing… It is a Call to Action for YOU and the massage profession. I have added a Chapter on How to Get Massage therapy covered by health insurance and a Call to Action with 42 Action Steps that We need to start taking as a whole. I want to create a grassroots movement to bring awareness to massage and create the attention that it deserves to take it’s rightful place in healthcare.
$24.99
Back to Main Site | About me! | Contact Me with any questions. Schools discounts available and preview copy.
Notice: This book is designed to provide information on the general principles of insurance billing only. This information is provided and sold with the knowledge that the publisher and author do not offer any legal or other professional advice. In the case of a need for any such expertise consult with the appropriate professional. This book does not contain all information available on the subject. This book has not been created to be specific to any individual’s or organizations’ situation or needs. Every effort has been made to make this book as accurate as possible. However, there may be typographical and or content errors. Therefore, this book should serve only as a general guide and not as the ultimate source of subject information. This book contains information that might be dated and is intended only to educate. The author and publisher shall have no liability or responsibility to any person or entity regarding any loss or damage incurred, or alleged to have incurred, directly or indirectly, by the information contained in this book. You hereby agree to be bound by this disclaimer.
Billing insurance is done at your own risk. Results will vary. It is your responsibility to use this information and to do your own homework in finding out who you can bill, how to bill and how to get paid. You are responsible for knowing the laws and regulations in your state. You may need to obtain further legal counsel or accounting opinions in order to bill and get paid.
Become an affiliate and make money when you refer someone who purchases the eBook.
Julie Onofrio says
The new book should be out this weekend. I don’t know the specifics of what is going on in DC/Virginia area, but the book will cover the basics of billing insurance. I will also have a group you can join for an additional fee where you can ask questions and get my help for the many issues. It will take a lot of work to start implementing The ACA 2706 section that makes it a law that massage must be covered by all health insurance. I have some ideas outlined in the new book. Thanks
Julie Onofrio says
Facebook is free but I can limit who I want to join a group and control who joins a group. Yes I have to approve membership into the group. The group is where people can ask me questions about the content of the Ebook and about the billing process. I will also be using it to get people working on implementing 2706 in their state. Facebook is often used for this purpose. I am charging you for the ebook and if you want to join, you have to buy the ebook and want to learn about how to bill insurance.
Thanks
Julie Onofrio says
Hi LJ
No it doesn’t go into those programs. They come with their own help and resources. They are usually pretty straight forward. They do have training available too usually for those portals like here is the page for one health port- http://www.onehealthport.com/content/training-center .It does cover how to get an NPI number and it does give basic directions on how to bill L&I. You can see the table of contents in the post above. Let me know if you have any other questions. Thanks.
Julie Onofrio says
I can’t tell you if you can bill insurance in MI or what the laws there are but the book covers the basics of how to fill out forms etc. You will have to find out what insurance companies are paying and find out what exactly they want in order to get paid. Each state/each plan is different so there is no way I can know that. I am working on collecting that info from people who buy the ebook and from people in my Facebook group but it is slow going.
Thanks
Julie Onofrio says
The ICD 10 codes are out now and they will need to be used starting Oct 1. There is a link to some common codes. There won’t be any updates until the ICD 11’s come out which won’t be far behind. The code info is freely available online.
Julie
Julie Onofrio says
This one has updated information and you will get the latest information especially on topics like when the CPT codes change in 2018 or so. When you get the PDF, I add your email address to a mailing list to send you the updated information. Hands Heal is great and you will need that more for the SOAP charting part. This has the latest CMS 1500 02/12 form instructions too. Thanks very much.
Julie Onofrio says
No NCBTMB doesn’t have anything to do with anything. That you would have to ask the insurance companies. No it isn’t covered in the book. With the PDF book you get to join the Facebook group and ask questions. If you get the paperback book, you can purchase entry into the Facebook group with for an additional fee through a link in the book.
This is more a general overview of everything about billing. Details like that have to be asked of the insurance company you are working with.
Julie
Julie Onofrio says
Did you order the paperback or the PDF?
If you purchased the paperback, there is a link to order access to the Facebook group. The price on the paperback is lower and I make less per book through amazon and there is no way to track sales from amazon so I had to set it up a different way for people to access the group and to be able to get people’s email address to be able to send the updates.
Let me know if you have any more questions
thanks
Julie
Julie Onofrio says
I am not sure why the law would not apply to massage therapists. The codes come on the prescription anyways so you will have to use them. If you have someone on progress with a script that has the ICD 9 codes, it is best to call the doctors office and get the new codes. There are some free online converters, but they don’t always work well.
Julie Onofrio says
You have to find out what insurance you can bill. In most states you can bill for car accidents on Personal Injury Protection and for work related injuries. You have to contact your worker comp. division and find out what you need to do and if you can bill. You just call insurances when you get someone who wants to bill their insurance to find out if they have benefits.
Julie Onofrio says
The information is not specific to WA but it gives an overview on how to bill and what questions you need to ask in order to bill and get paid by insurance. Most of the health insurance lists are closed in WA – but you will have to check on that to see if you can become a provider.
Julie Onofrio says
yes of course.
Viki says
Hi Julie, thank you very much. When 2019 vision will be publish?
Julie Onofrio says
I am shooting for April 15 or so! Soon! very soon!
Tiffany says
Is this the same book just updated as medical insurance billing 101…putting the care back into health care? I have to buy that for my daughter’s school but I don’t see it. But I see this one just came out last month. Thx.
Julie Onofrio says
Yes – the new edition. What school does she go to so I can let them know the new edition is out. thanks
Mindy Daehn says
I’m looking for the 2019 Ed. Book not an ebook. I can’t find it.
Julie Onofrio says
There is not one yet. Only the PDF version. Paperback out maybe by September. Thanks
Julie
Toby says
Hello,
I was wondering if your “Massage Insurance Billing Manual” is the same or similar to Vivian Mahoney’s, “Massage Insurance Billing Manual”?
Also, do you provide CEU’s?
Thank you so much. Stay Safe, Happy and Healthy..
Toby
Julie Onofrio says
Hi the Massage Insurance Billing Manual was just updated last year so it is the latest information on billing. I believe Vivians was written in 2009 or so and hasn’t been updated that I know of and hers includes the basics on starting a business. Mine just focuses on billing and also focuses on how we can get massage covered by health insurance in every state.
Julie
Vivian M Mahoney says
Julie I’ve been on your site for a little while and I cannot tell you how impressed and proud I am of you for all of this history stuff that you have written I’ll bet not many besides Judi Calvert that knows so much about the history as you do. And if you don’t mind me making a little comment I just want to say that my manual was last updated May 13th just a week before our accident. I haven’t had the energy time or wherewithal to do anything with it since then however everything about insurance is up-to-date what isn’t is on my website for them to download or to look at for free under Doc’s U Need. And the book is about I would say 70% Insurance related. The information about taxes, independent contractor versus employee, practice building, terminology for legal medical and insurance, and so much more is in there as a main source for the home study course which covers a review of the manual in addition to the testing. So I just wanted to clear that up I know a gentleman named Toby asked you and you and I haven’t talked lately so I understand why you didn’t have the information. Life is flying by too fast and furious anymore. You stay healthy and well Julie stay safe most of all out there. As I am here in a major tourist area that has over a million people a month come through . Thank God we know the back ways.
Viv
Vivian Mahoney says
Sorry, that was to have read since May 1st. 2014. The accident was May 14, 2014. Seems like yesterday.
I also NEVER stop researching, keeping up on insurance issues, as you do as well. One day we’ll make that mountain move so ww are recognized, respected and reimbursed by all insurance everywhere.
I look at it this way for the little bit of training we have in hours compared to all the other Healthcare practitioners we are so very very fortunate to be able to do this in the first place and to have done it as long as we have been doing it. I took my very first Insurance case about December 23rd 1984. It seems we go five steps forward and four steps backwards. Let’s talk some day when we get a chance okay?