Massage Insurance Billing

Insurance Billing 101 for Massage Therapists

Massage Insurance Billing

AMTA Statistics show that more people want insurance coverage and that more doctors are referring to massage therapists!

Get more clients when you learn Massage Insurance Billing!

Now you can learn 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!

In most states, you can bill insurance for car accidents and for work related injuries.  With the new Affordable Care Act, it is now the law that health insurance companies must cover massage.   Don’t be left behind!  Now more than ever, learning to bill insurance for massage services can help you to build your massage business.

 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 solid income in any economy!

Before you decide if you want to get involved in billing insurance for massage, you really have to analyze your business model and your financial status to see if taking insurance will help your bottom line and help your business become more profitable!  You can do that by figuring out your cost per client and then assessing what your earnings potential will look like if you take a few cases or even decide to have a full medical massage practice/clinic!

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!

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.

To make things even more challenging:

On March 23, 2010 President Obama signed HR 3590, the Patient Protection and Affordable Care Act into law. As it stands now, here is the excerpt from the health care reform bill passed:

The provider non-discrimination provision (Section 2706) to be enacted into law reads in part:

‘A group health plan and a health insurance issuer offering group or individual health insurance coverage shall not discriminate with respect to participation under the plan or coverage against any health care provider who is acting within the scope of that provider’s license or certification under applicable State law.'”  (read more on the new law and massage)

That basically means that health insurance companies will have to pay for massage if massage therapists are licensed as health care providers in your state but it isn’t quite so simple.  You will need to find out what is going on in your state and get  involved in the process of making it happen.   Each state will need to have massage therapists involved to make it happen.

When billing insurance, it means that you will be faced with many challenges like being asked to reduce your fees and having laws created locally that will try to stop you from billing for massage (as currently is happening in FL with MT losing the ability to bill for car accidents).  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.

That is why I have written this book.   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!

Insurance Billing 101 for Massage Therapists

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  1. says

    If every state has different regulations of therapists, and what is/is not covered by insurance, how can we know if we are approved providers within our own state?

  2. says

    Hi Lisa – no it has been delayed – probably by the end of the year. Not much different really – the basics are the same. I will just be adding info on HIPAA and also on the ACA and expanding on the basics in this book.


  3. Michael Redline says

    What’s states can medical insurance cover massage and how much can we charge the insurance. Cause I know it can take weeks months or even years to get paid from the insurance company

  4. says

    Only WA and FL have laws that allow MT’s to bill health insurance. In each state, some insurance companies are starting to ‘willingly pay’. Actually they pay quite fast depending on the company but as a provider, I usually get paid within 2 weeks – direct deposit into my checking account. It takes years when it is a auto collision and they don’t have PIP or have used up their PIP and then you have to wait until the case is settled which could take years. You charge the insurance the same as your cash rate for your massage service otherwise it is insurance fraud (but you can add on a fee that you would have to pay an insurance billing person to do the billing – like if you hire a billing person and they charge you $15 per bill and you charge $65 for your massage you can charge $80. You have to charge the same rates for the same services. It is explained more in the Book!

  5. Chelsea says

    I’m an LMT in Oregon. How are the insurance billing laws here? If I do bill insurance can I still create a nice soothing ambiance in my massage room (candles, music, etc)? If I buy the book I will get the updated version for no additional charge when it becomes available?

  6. says

    You have to find out what the laws are in your state and the rules for billing. You have to find out on your own if you can bill specific insurance companies. You can do whatever you want with your room. Billing depends on how you work with people and if you work with them in a way that improves their condition (diagnosis). Yes If you get the PDF version of the ebook (it is only for the PDF version which you download to your computer NOT the paperback or kindle), you will get the next edition.


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