Filing Medical Insurance

Taking clients with medical insurance and filing medical insurance claims with the company for payment can be great for your practice if you would like to increase the number of clients you see.

More and more policies are now covering medical massage therapy. Always call the health insurance company prior to treatment to see if the policy covers this and what the criteria for payment are.

Before beginning treatment, make sure that you ask your client if this was an accidental injury. If so, it may be covered by auto insurance, Worker's Compensation, or a miscellaneous accident policy. If this is the case, the client's health insurance may not be responsible for any of the payment.

Physicians are starting to refer patients to massage therapists for lengthy medical massage treatments as this frees busy physicians to see more patients. A lot of medical insurance policies provide coverage for medical massage if the client was referred by a physician.

Chiropractors and physical therapists are hiring massage therapists to work in their offices. Usually, they will bill or file medical insurance for the massage therapist in these cases. This will cut down on your paperwork as a massage therapist since you won't be filing medical insurance claims for your clients.

Be sure that you are documenting the client charts as your records can be subpoenaed by attorneys if a court case is involved.

Never release records to anyone without obtaining a signed release form from the client. Do not send original documents from client charts. Send photocopies.

When getting ready to send claims in, the address to send the claims to should be on the insurance card. If not, ask the insurance representative while you are on the phone getting coverage information.

Again, to see if medical insurance covers your services, call the insurance company and check the plan involved. The insurance company will also let you know if there is a deductible or copay. They will state to you that what they tell you is not a guarantee of benefits. Always mention this to the client so the client will understand that he/she is responsible for payment not covered by the health insurance.

One other important note about filing medical insurance claims, if you are a network provider, realize that you will not be reimbursed for your entire fee. You will be paid the network reimbursement amount and you cannot charge the balance to the client as part of the agreement when you sign up to be a part of the network. If you are a non-network provider, then you can bill the balance to the client.

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