Medical Massage is being defined by insurance companies
Medical massage is already being defined by insurance companies. If we don’t step up and define it someone else will do it for us. It is evident in the laws too regarding massage therapy as I see from the research I have been doing for my site www.massagetherapycareers.com.
This is from an application form from American Whole Health Network credentialing application for therapists in WA State.
“Clinical Massage Practitioner Application”
Application Checklist for
Clinical Massage Practitioner
Applicants may qualify as a Clinical Massage Practitioner, with the
following documentation:
X Valid State or local license as Massage Therapist/Practitioner
X Entry level certification by the National Certification Board for
Therapeutic Massage and Bodywork, or
equivalent State Exam *
X Attestation to at least 60 hours of documented continuing education
course work in massage in past 4 years
X Copy of certificate of completion of at least one advanced massage
training program of 25 contact hours or
more
X Documentation of at least two calendar years in active clinical
practice
X Two Professional Reference Evaluations from health professionals
attesting to personal and clinical practice
characteristics, at least one of which must be from a referring or
supervising MD, DO, DC, PT, RN or from
an AWHN credentialed clinical massage practitioner who has supervised
your practice.
PLUS
X Certification by a recognized national advanced clinical massage
certification exam
OR
X Documentation of supervised contact hours** performing clinical
massage
500 contact hours required for applicants with only a basic 500-hour
massage education
OR
250 contact hours required for applicants with 1000 hour basic
massage education that includes clinical assessment,
clinical pathology, and clinical charting,
OR
Postgraduate clinical training equivalent to 250 contact hours after
their basic 500-hour education
With submission of verification documents for any postgraduate
course, fellowship, preceptorship, or
clinically supervised practice
Please submit the following materials (obtain the forms at
www.wholehealthpro.com):
X Completed AWHN network covered benefit and discount contract with
signed agreement to business and financial
contract terms. If you are employed by an institution or group, your
employer must contract for you as an associate.
X Completed AWHN credentialing or recredentialing application for
clinical massage, this includes your online profile
listing for the AWHN web directories***
X Applicable credentialing fee
X Copy of your Published Fee Schedule
X Copy of your current professional liability (malpractice) policy
face sheet
(At least $200/500,000 limits are required, GHC contracted
practitioners must have 1Million/3Million)
X Copy of your current unrestricted state license and/or NCBTMB
certificate
X Copy of the AWHN Attestation for Specialty Training and Experience
form with supporting documents
X Send the Professional Reference Evaluation forms to your
professional references to submit directly to AWHN, note
the names of the professional references on your credentialing
application
* States with equivalent exams:
AL,AK,CT,DE,DC,FL,IL,IA,KY,LA,ME,MD,MS,MO,NE,NH,NJ,NM,NC,OR,RI,SC,TN,
UT,VA,WV,WA,WI
** Supervised clinical experience means a) session hours treating
persons presenting with clinical problems in a setting
involving some combination of assessment, treatment planning,
documentation of status and progress notes, and b) the
availability of mentoring and clinical supervision by one or more
experienced massage, physical therapy, medical, or
chiropractic practitioners. Can include practice sessions during
advanced training or preceptorship/apprentice programs.
Documentation includes affidavit by practitioner and/or statement of
completion by employer/supervisor/referring
practitioner.
***If you are listing other professional health services outside of
the scope of massage practice, you must have an AWHN
contract covering the licensed profession involved and meet AWHN
credentialing standards.
Please call the AWHN Network Development office if you have other
questions or need assistance in the
application process.
March 21st, 2007 at 4:25 am
While I am not for any of these requirements, I’ll say that these requirements are not unique to massage therapists. Chiro’s, MD, DO’s all have similar requirements when joining–it ain’t pretty!
The plan in question looks like a managed care plan of some sort, either HMO or PPO, just by the fact there is a crendentialing fee required.
During the first insurance billing class I ever took by Melissa Kerley who actually had a degree in Billing & Coding, I remember her being a proponent of accepting insurance for massage therapy services in general, however, she explictly stated in a humorous way, “HMO = No, No,No!”. She stated that in every case she’d ever worked on showed being a part of an HMO contract put the provider on the short end of the stick. She went on to say, “If you join an HMO, your going to end up losing, especially if you’re a massage therapist. You bascially have to pay to join, be under constant intense scrutiny, all for what? A payment check that doesn’t resemble anything from the bill you submitted. Then once you decide you can’t survive on an HMO contract, you’ll find it nearly impossible to get off that HMO’s literature as a network provider, constantly getting calls from people expecting you to accept their HMO as payment”.
Her feelings for PPO’s were similar, basically only a step up from an HMO.
Regards
Sean
http://www.a-body-for-living.com/