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Insurance Billing Manual
Please also check the
insurance billing manual updates and the
blog for more information.
2. What to Charge For Your Services- The Issues and Ethics of Setting Fees for Services Figuring out what to charge insurance companies for your services is a challenge. I have asked many leaders (Vivian Madison-Mahoney, Diana Thompson and many massage therapists) in the field about the discrepancy in fees that massage therapists charge and I get different answers from each of them. Most massage therapists think that you will be able to charge more than your usual fee because it takes more time to process the bills, do the chart notes, talk to the insurance companies and everything else that goes along with working with injured clients and their insurance companies. Most automobile insurance companies will pay more for each session, but that does not mean that you can charge more necessarily. The issue lies in setting your fees to begin with. Charge what you need to make for each session. The insurance company will pay you per unit of massage, which is a 15-minute increment. So if you charge $60 per hour, your fees would be $15 per unit (4x15=60). There is something the insurance industry has created called the Usual, Customary and Reasonable (UCR) fee. They take surveys of what massage therapists are being paid by different companies and average them out per area. As I see it, this is part of the problem. The allowable fees are based on statistics of insurance companies paying higher amounts because massage therapists will (and do) bill higher amounts than their regular fees BECAUSE THE INSURANCE COMPANY WILL PAY IT! So this sets the UCR higher than the average fee that an average massage therapist will charge! In my opinion, this charging more for our services is hurting the profession and adding to the problem of high insurance rates! We are becoming part of the problem! I have actually heard that it is illegal to charge more than you charge your cash (no insurance) clients to insurance companies, but no one seems to be able to agree on that. If you think you need to be charging more for your services because you are worth more, than I feel that you should be charging that to everyone – cash clients or insurance companies. I think the problem lies in how we value ourselves. Massage Therapists who charge in excess of $140 per 1 hour massage to insurance companies who will pay it, don’t feel that they can ask that of someone paying cash. As far as setting fees higher because of the idea that there is more to do with each insurance case – I don’t really believe it. It takes 1 minute to do a chart note after a session while someone is getting dressed. How much time and money did it take you to get that cash client? So part of the problem I see, is that we are hesitant to charge what we need to make to be successful and make a great living. The way to set your fees is to determine what you need to make each month and then looking at how many massages you want to be doing each month and divide. So if you need to be making $5,000 a month and the average number of clients you want to see in a month is 75 (that is about 18 a week) then your hourly fee should be around $65 per hour.
Please also check the
insurance billing manual updates and the
blog for more information.
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