During the course of attending massage school at A New Beginning School of Massage, students are given a number of assignments that requiring research and writing. Some of these assignments result in very insightful and well thought out information and decision-making outcomes. I am happy to share some of their assignments for you to enjoy.
I came across an article titled “To Bill or Not to Bill,” written by Irene Diamond and published in the Jun 2015 edition of Massage and Body. This article really appealed to me as I am considering expanding my business and working with chiropractors and physicians. Physician referrals can increase business, as you will be introduced to new clients who otherwise you may not have met. With this comes insurance and billing insurance.
Some factors to consider; Will insurance cover the therapy? Also payment will not be received at the time of service. Not only that, but it may take up to sixty days to receive payment and you may need to resubmit during that time. I found it interesting that there must be a medical necessity for the massage, that the doctor must write a prescription for the massage, your treatment must follow that prescription and there must be improvement in the client’s status to receive payment. Insurance companies want documentation of client improvement and return of normal function is clutch if you want payment. It is important to have clear and concise documentation, and detailed S.O A. P. documentation. Be aware that insurance companies may want you to send in your S.O.A.P. documentation with the claim. If you are only doing maintenance care, insurance will most likely not pay, as there must be improvement based on the diagnosis and prescription ordered.
When insurance is involved with payments it can get complicated. Knowing the types of coding involved, being well versed in HIPAA and attention to detail is a must. Clear communication between the physician, client and therapist is necessary. Setting expectation of payment with the client prior to treatment is imperative, setting the expectation that if insurance does not cover the cost the client will be responsible. The positive side to this is that you may be able to assist the healing of individual who otherwise may not be able to see you.
Personally, for me to consider insurance and billing I find myself needing further education on the subject. I tis import to consider if your business is ready to take the steps for incorporating insurance billing. I believe it is also important to familiarize yourself with the different insurance companies, CPT and ICD codes and what they cover.
I think overall working with physicians and the clients they refer can be very rewarding. It can increase your business and connect you with new clients. You will be working as a health care provider with massage therapy which can be very rewarding. However, to be successful with this, it is a must that you research insurance, become will versed with the codes and consider where your business is currently and what direction you would like to take it. Ask yourself, is the outcome worth the time requirement involved? If you find yourself saying yes, then this is definitely a path to walk!