In this post: Insurance billing for massage therapists can be a tricky subject to navigate! Let me help you set out on the right foot.
As you move along in your practice, you may want to consider accepting insurance.
Insurance in regards to massage has come a LONG way over the years!!! Pioneers like Vivian Madison-Mahoney and Herb Levin paved the way to make it more possible for therapists like us to get reimbursed for our services.
But, despite all these advancements, the decision to accept insurance is not something to take lightly.
Pros and Cons of Insurance Billing for Massage Therapists
Pros
- Help people with a real need for the work we provide, which can be rewarding.
- People get on a regular program, which almost guarantees repeat business.
- Specializing in insurance work can be a great segway for hiring staff. Because clients are more apt to continue to see a therapist regardless of whether or not they like their work when it is being paid for through insurance, it is easier to outsource this type of work to staff. A common struggle when hiring staff is finding clients who are willing to try a new therapist. So, if you have aspirations of growing bigger than just yourself, you may want to consider insurance work.
- You can charge a higher premium – though be careful – while there is extra work involved with insurance clients, thus it is appropriate to charge more, don’t charge such an exorbitant fee that you ruin it for others. The massage therapists before us worked hard to get us recognized as providers; if we abuse this, we could easily start getting denied.
Cons
- Detailed record-keeping.
- Extra time. From the initial setup, to record-keeping, to submitting and possibly resubmitting claims… also injured clients need extra care and consideration, which again means more time, energy, and effort.
- You will have to wait and potentially fight for your money. I have waited over a year to be reimbursed in the past.
- You cannot charge for no-shows. It’s not legal.
- Coding and filling out the forms can be tricky. If you don’t do it exactly as you are supposed to, it can quickly get rejected.
One thing that I have gotten into the habit of doing recently is connecting with an insurance agent for each client I am considering taking on as an insurance client before their first treatment. To get verbal confirmation that I will indeed be reimbursed.
NPI#
One of the things you can do to legitimize and exopodite the reimbursement process is to get an NPI#. An NPI# is a National Provider Identifier. While it is not necessary to have to start accepting insurance clients, not having one could tie up your claim for longer periods of time.
If you choose to obtain a NPI # you can do so by:
Calling – 1-800-465-3203 or 1-800-692-2326
or
Applying online at http://nppes.cms.hhs.gov
Tip: After you click on Create or Manage Account – most of the prompts will be pretty straightforward. But, when you get to TAXONOMY, go to 22-Respiratory, Rehabilitative, and Restorative Service Providers and then scroll down to Massage Therapist.
Health Insurance Claim Form 1500
Okay, so digging in. Let’s say that you decide to proceed with insurance clients. To get reimbursed, you will need to fill out a Health Insurance Claim Form 1500. You can purchase these forms on Amazon.
Now, the most important piece to make sure that you are getting reimbursement is to make sure you are filling out the forms correctly. If you mess up one tiny detail, your claim could get denied. Then you will have to resubmit it and wait even longer to get paid. It’s important to carefully look over the form before submitting it to the insurance company. I would highly recommend taking a continuing ed course specifically designed for insurance billing!
The insurance company is going to ask you to send the form via fax. If you don’t have a fax machine, you can always mail it in. It will just slow down the reimbursement process.
Another option, you could work out something where the client pays you directly, and then they submit the paperwork to their insurance provider, and they collect reimbursement. This would still mean extra paperwork, but you wouldn’t have to wait to get paid.
If you decide to proceed, I suggest starting with just a few insurance clients to ensure it works for you before you dive in full force.