Comments on: Relaxation vs Medical Massage

By: Julie Onofrio

Julie Onofrio — Sun, 22 Apr 2007 00:21:01 +0000

Reply to comments:

Feeling justified in charging more does not really matter. You can not charge more for paperwork and phone calls. It is considered a part of doing business.

The issue really is can you prove this in a court of law if and when you are challenged by an insurance company.

Focusing on building a cash practice is a big part of the solution.

While we once had out of network benefits for many insurance companies, they are now eliminating those benefits or making it impossible to collect. I for one have a $2000 deductible on my out of network benefits and that is separate for my regular deductible and the number of sessions of treatment are being reduced to make it a number below that deductible anyways. There also is one company here that has a few out of network benefit policies and if you charge the UCR for Seattle which is about $132 you would get paid more for out of network than you would if you were a provider in network which really does not make any sense.

Thanks for participating!!

Julie

By: Liz Larson Massage Therapy Student

Liz Larson Massage Therapy Student — Sat, 21 Apr 2007 23:27:29 +0000

Hi all!
I wanted to post a comment regarding insurance billing. I am a certified medical coder with years of experience in insurance billing. I am currently enrolled in a massage therapy program. I am new to the profession but I am not new to the insurance world. I have seen it grow to a great concern for the entire medical community! All insurance companies have gone to medicare reimbursement guidelines or a little bit higher. It was no surprise to read the previous post about the Chiropractor selling his practice. They cannot live on what insurance companies pay them. But in order to build a practice think that the need to participate with insurance companies and sometimes in the medical world this is true but not always!
That is the key I believe that a massage therapist should never participate with a insurance company. A client can go out of network and recevie out of network benefits. They will have to pay more out of pocket, but if they value you as a therapist they will still come to you. I know of several Dentists that have gone to a fee for service practice due to insurance companies lack of payment and I strongly believe massage therapist should do the same. Everyone just needs to be educated regarding the pro’s and con’s of insurance billing.

Just thought I would offer some of thoughts.

Liz Larson, Massage Therapy Student and Certified Medical Coder

By: Jody Hutchinson

Jody Hutchinson — Tue, 17 Apr 2007 16:01:00 +0000

The downside of working with insurance companies in California.

I just ran into a chiropractor friend who I had not seen in a while. He is about 5 years out of school and is selling the practice he bought about 3 years ago and going back to work for his father’s construction business. He said that ” insurance is killing me and the patients are killing me.” It’s really sad that this is the end of the line for him and he may barely pay off his loans from school by selling his practice.
I shudder to think of the future of “medical massage” where we will be forced to take what the insurance company gives us and try to make a living. It’s nice to be unlicensed at this time and be able to pick and choose patients- not be forced to.
I work with many cases that are referred by PTs and MDs. I will give the client a receipt, HCFA or whatever they need. Yes, it takes some more time and it empowers the cllient to take care of their own health care needs. My rates are a little higher than most in my area but not by more than $5-10. After almost 19 years in the biz, I feel like I’m doing the best I can and able to earn a living.
As far as “medical vs. relaxtion massage” goes- I won’t use the term “medical massage,” even after taking several classes from one of the big proponents. This is going to split the profession and divide therapists so that the industry can make $ teaching classes, giving certifications, etc. When I had over 40% of my practice billing insurance, I noticed two things.
1. No adjustor ever asked if I was certified in “medical massage.”
2. I had to work one and one-half times as hard to collect fees from an insurance company versus a cash patient.
I don’t want to see MTs going broke like my chiro friend because someone says insurance billing is the future. BS. Just ask any PT, DC, or MD about their experience. They wish they could have a cash practice.
My 2 cents,
Jody Hutchinson, NCTMB
free range massage therapist

By: Lisa

Lisa — Sun, 01 Apr 2007 07:38:33 +0000

I’d like to comment on your statement of massage therapists charging insurance companies more that their cash clients. For one thing, only Aetna ever pays more than our cash clients do. All of the other insurance companies we are contracted with pay us less than cash clients no matter what we bill them. There are several reasons behind why they are billed at a higher rate. One of them is that you have to take the time to fill out the hcfa form, send soap charts, progress reports, etc… There is a bit more work and time involved in insurance claims. Another reason is that you have to wait anywhere between 6-8 weeks to even see your money from a massage that long ago. So, I completely feel justified that insurance companies are charged more than cash clients as there is alot more work involved.
Lisa