As a long time advocate for billing insurance as a way to keep your practice full during any kind of economy, I am officially announcing I am not taking any insurance in my personal practice anymore. After 34 years of taking insurance, the time has come to move my business to a totally cash practice. Covid has taken it’s toll on my business that is in the heart of Downtown Seattle, where my corner has now become the heroin dealing corner of Seattle. Workers were sent home to work 18 months ago and are not returning. Tech workers were my main clients.
I stopped taking PIP (car accidents) about 5 years ago and stopped taking Workers Comp probably 10 years ago. I was only on 2 health insurance panels and got off of them last summer. Why?
Mainly the frustrations of billing finally got to me….the lack of professional support and advocacy on many of the issues with insurance:
- Insurance carriers telling clients that they don’t need a script when they do.
- Insurance carriers adding things like prior authorizations that limit the number of sessions based on some spinning alogrithm rather than patient needs/doctors orders.
- Accident chasing lawyers padding bills to get higher settlements.
- Benefits being reduced each year.
- Lack of increase in allowable fees with health insurance carriers – most have cut their allowable fees. When I started, the average was $100-$120 an hour and most now are about $60 on average of what they will pay.
- Increase in office rent, PPE supplies, cleaning, paying for parking (I used to take the bus but don’t want to because of covid and safety issues) and having to put 30 minutes between sessions for cleaning and I also have to go downstairs to meet my clients at the front door to let them in as it is now locked for security reasons.
Basically, the numbers just don’t make it profitable for me to take insurance anymore. You can do the math and figure out if taking insurace will help make your business more profitable by figuring out your cost per client.
Should you take insurance/bill?
Here is the thing…more and more associations, legislators, laws (No Pain Act), and states are wanting massage therapy to be covered by health insurance. Sure as the sun rises, massage therapy is on it’s way to being covered by health insurance for medically necessary conditions for paind and stress.
What we are lacking is a powerful organization that will advocate for us. We need to get to the table! and here are some of my ideas on how to do just that. I even helped start a new WA State organization in hopes that we could do something and work with insurance carriers, but was greatly disappointed. I would do things differently in that arena and have often thought of creating another new association but I am not sure that is the answer either.
Learning to bill insurance is a very challenging and demanding of time and energy to learn the ropes and deal with carriers, clients, doctors and the system. Starting with taking just one or two cases can help you learn just what the big picture is and what support and advocacy is needed in the profession, so that you can get involved in creating the future of the massage profession. Currently carriers and legislators are defining the profession without input from the profession.
My Book – The Massage Insurance Billing Manual will take you step by step through the various processes so that you can start billing and find out what the particulars are for the plans in your state. ( I can’t give you that info, but I can help you learn the processes so you can ask the right questions to the people who manage claims, lawyers and others involved in cases.)
You can join my Facebook group – Massage Insurance Billing too!
Take insurance and learn about insurance if you want more difficult and challenging cases. You can learn to weed out cases that you know will be more challenging to bill and get paid for after doing a few cases. Take insurance to help stabilize your business through any economic downturns as people who are having their sessions paid for by insurance will continue to come in until they are better. Take insurance if you want to be a part of creating the future of the massage profession.
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