Getting in network with insurance companies and billing insurance can feel overwhelming. I hope these resources will help simplify the process for you a bit! I do offer one on one training sessions and small group classes as well if you decide that you need more help. Please feel free to email me with questions anytime at massagebusinesscoach@gmail.com.

Credentialing Information
*This information is the latest that I have on where/what to send to insurance companies to get in network with them.

Step 1: Create your credentialing packet
You will need to create a credentialing packet to send to insurance companies.
*Hand sign and date each document right before you send them

Here is what you will include:

• Oregon Practitioner Credentialing Application
• Therapists license
• Liability insurance cover sheet
• 147C letter verifying the tax ID from the IRS
• W-9

Where to send your Packet

Regence -
Email credentialing packet to:  regence_credentialing@regence.com

American Specialty Health Network -
*Health Net, Providence, Cigna

1. Fill out the online application: CAQH

2. Fill out the online interest form: Here

MODA Health -
1. Fill out online pre-application:  Here

2. Email credentialing packet to:  credentialing@modahealth.com

Reliant Behavioral Health -
Email credentialing packet to:  providerrelations@reliantbh.com

Of course there are other insurance companies that you could get in network with that are not listed above. I have included the list of those that are most commonly accepted by Massage Therapists.

The credentialing process typically takes around 90 days from start to finish.

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Insurance Billing Resources
The following are a list of resources for your information.

Personal Injury Protection in Oregon
This site gives you a breakdown of the law
http://www.oregoninsurancelaw.com/oregon_pip_law.htm

Storing patient records in Oregon
http://www.oregon.gov/omb/Topics-of-Interest/Pages/Patient-Records.aspx

HIPAA Resources

Information
http://www.hhs.gov/hipaa

HIPAA Training
http://www.medscape.org

Insurance Billing Learning Resources

Massage Practice Builder website
http://www.massagepracticebuilder.com/massage-insurance-billing/

Workers Compensation Fee Schedule
http://www4.cbs.state.or.us/ex/wcd/maxpaycalc/

Billing Workers Compensation in Oregon
http://www.saif.com/medical/billing.html

Here are common pain codes:

• Shoulder — M25.511 (R), M25.512 (L)
• Upper Arm — M79.621 (R), M79.622 (L)
• Elbow — M25.521 (R), M25.522 (L)
• Forearm — M79.631 (R), M79.632 (L)
• Wrist — M25.531 (R), M25.532 (L)
• Hand — M79.641 (R), M79.642 (L) (excludes fingers)
• Hip — M25.551 (R), M25.552 (L)
• Thigh — M79.651 (R), M79.652 (L)
• Knee — M25.561 (R), M25.562 (L)
• Lower Leg — M79.661 (R), M79.662 (L)
• Ankle — M25.571 (R), M25.572 (L) (excludes foot/toes)
• Foot — M79.671 (R), M79.672 (L) (excludes toes)
• Thoracic Spine — M54.6
• Low Back Pain — M54.5
• Neck Pain - M54.2

ICD-9 to ICD-10 translator
https://www.aapc.com/icd-10/codes/

Financials for Insurance Billing
Insurance billing cost analysis spreadsheet
Please make a copy of this document for yourself after opening by choosing “file”-”make a copy” or download into excel or other software.
https://docs.google.com/spreadsheets/d/1TYdRoBxxzL_Sto9AwjrIlFRpEiJdZiY9doD5ldlF1ek/edit?usp=sharing

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Insurance Verification Checklist
Use this guide when verifying client benefits

Step by step checklist for verification:

1. Send the client an insurance intake form to get the required information, along with the HIPAA agreement and financial agreements to sign. Get a credit card on file on or before their first visit.
2. Get the client’s member ID or claim number, full name, birth date, address, phone number, name of adjuster or insurance company, contact information for adjuster or insurance company, main complaint and date of accident (if applicable).

 Verification Questions to ask the insurance company/adjuster:

• Is the client covered for massage therapy by a licensed massage therapist?
• If so do they need a prescription?
• Do they need pre-authorization?
• Do they have a deductible and has it been met (for health insurance)?
• What is the patient financial responsibility ie. copay/coinsurance?
• How many visits do they get per year and is it shared with other providers? How many have they used? (for health insurance)
• What CPT/Diagnosis codes can you bill for, is there a limit on the number of units per visit?  What is the rate of reimbursement for the CPT code(s)
• What is the preferred way to bill the insurance company.  *always get a name/ref number of the person you spoke to

*Record this information so that you know what the client is covered for, what their co-pay is etc… also let the client know.

*Record detailed SOAP notes with progress reports and a clear treatment plan after each client visit.

Step by step checklist:  Billing with Office Ally
Office Ally is an online insurance billing platform that makes billing on behalf of your clients quick and easy!

Billing through PracticeMate:

1. Create an Office Ally and Practice Mate account (this is a process that will likely take more than one day)
2. Login to Office Ally and click on the link to go to Practice Mate
3. Click on the “claims/billing” tab
4. Click on the “Add a new claim” link then choose the “cms 1500 2/12 new” link
5. Use the grey box with ellipses to search for and auto fill client and insurance company info.
6. Complete the CMS 1500, refer to the sample guide I sent you via email if you need help
7. Choose “update” at the bottom the page when you are finished
8. You will see the claim at the top of your list of claims. Click the arrow under “submit” to submit electronically, or “print” if you plan to fax to mail the claim yourself.

Add a new patient in Practice Mate

1. Choose “manage patients” tab
2. Choose “add new patient”
3. Fill in client name, DOB, address, phone in the “patient data” tab
4. Click “insurance” tab and fill in insurance information
5. Choose “add patient” at the bottom of the page

Add a new insurance company in Practice Mate

1. You will do this from the claims section on the cms 1500 in the box where the payer goes:
2. Click on ellipses
3. A new box will open, in that box, click “add new”
4. Another new box will open, choose “browse”
5. Search for and add the insurance company there

Insurance Billing Tips

• Bill insurance companies at least one time per week, Record billing date and amount billed
• Follow up with insurance companies around 60 days after billing if you have not been paid, record every interaction with a name and reference number for the call
• Record payments as you get them.
• Don’t forget to check Office Ally weekly for repairable claims, and ASHlink and Availity for EOB’s.

Insurance Billing Companies
If you decide that you do want to bill insurance companies yourself, here is a list of reputable companies that might be able to take it off your plate:)

LD Billing, LLC

• https://ldmedbilling.com/

Medical Billing Specialists

• www.medicalbillingspecialists.net

Efficient Medical Billing Service

• http://www.efficientmbs.com/

Integrity Billing and Consulting

• https://www.integritybillingconsulting.com/
  
  

Keep clients coming back  and grow your massage practice with these great tips

Here are my favorite ways to keep clients happy and improve client retention in your massage practice! Combine these with your high quality services, educational newsletter, blog posts, and social media strategy and wallah! Your practice is booming and your clients are feeling incredible. win. win. win.

Become the master of customer service
             
Being an amazing Massage Therapist is about so much more than just bodywork. It is an adventure in relationship building that begins before the client enters your door and lasts well beyond their visit. Make sure that you are intentionally creating each part of this experience for your clients to ensure that they always feel happy during their interactions with your business.

Be detail oriented

Did your client mention that they have a sick family member or an anniversary coming up? Make a note of it in their file so that you can ask about it on their next visit or send a special message letting them know you are thinking of them. Little touches like these let your client know that you are listening and that you genuinely care.

Listen carefully

When you are chatting with a client pre-massage make sure that you are using active listening skills to ensure that you both understand what will take place during the session and the outcomes that are expected. Summarize the issues that the client has shared with you and let them know the plan of action for the session. You can even ask "does that sound like a good plan to you" just to make sure that you are on the same page.

Create a treatment plan

After the clients session recommend a treatment plan that would work best for their particular goals. You could share this with them verbally and then move into booking them for their next session based on the plan you created. If they aren't ready to book you could write it down on a branded thank you card to send home with them. Or send them an email the next day expressing your gratitude for their business, a summary of your recommendations, and your next available appointment times.

Stay in touch

Clients are busy and are most likely feeling better since their last session with you. This means they need to hear from you to be reminded to book their next appointment. Many clients will wait until they are in pain that inhibits their daily lives before they reach out to you for help. An important piece of client education is helping them understand that they can stay pain free by getting regular massage. Send an email, text, or snail mail to let them know you are thinking of them and would like to help keep them feeling awesome. You can use the free recall template in my store as a guide if you like!
 
Bonus tip: Don't forget the most obvious way to get clients to come back...invite them to re-book with you before they leave from their appointment. LOL. seems obvious but sometimes the most obvious is the most overlooked;)

Thank you for reading! Have other ways that you love to keep clients coming back? Please share! I love learning how to keep my practice thriving and clients feeling great. 

  Create a system
      To bill effectively you will need to make it a routine and you will need to be organized, this means creating a solid system that works for your particular needs. I use a spreadsheet to keep track of each clients insurance information as well as dates and amounts that are billed and paid. You will also want to have a plan for verifying client benefits prior to allowing them to use their insurance with you. Checkout my Insurance Billing Tool Kit for help with all of this!
     As far as actually billing the insurance companies, many people are using Office Ally to bill and store information online. This is a free software that allows you to create client profiles and store information so that you don't have to re-enter it every time you want to send a bill. Office Ally offers free training over the phone and is fairly easy to learn and manage. The alternative is using the CMS 1500 form and sending it directly to the insurance company yourself via their individual online systems, fax, or through old fashioned snail mail. If you choose this route you will need to contact each insurance company to find out their preferred method for billing.

Know your codes
     CPT codes-These are numeric codes that are assigned to the type of treatment given to a client. The most commonly used code by Massage Therapists is 97124 which generally covers most massage modalities. Some insurance companies will also pay for 97140-myofacial release but many will not. Sometimes it takes a bit of trial and error to find what works best with each company. If you are denied for 97140 try resubmitting for 97124 and you will likely get payment. CPT codes are billed in 15 minute increments which means you would bill 4 units of 97124 for a one hour massage session.
     ICD-10 codes-ICD-10 codes are numeric codes assigned to a diagnosis or are codes that reflect areas of pain and tension.  You will need to pick codes that reflect each clients issues when billing their insurance company. Here is a great resource for commonly used ICD-10 codes for Massage Therapy.

Bill and follow up in a timely manner
Best practice is to bill weekly, in fact, I find it easiest to schedule my billing for the same day each week so that it becomes very routine and I never miss it. Record the amount and date you bill for each client as well as their co-pay. Record the date payments come in and the amount you received as well. I make it a practice to review each clients account monthly and if I have payments that are outstanding for more than 60 days I call the insurance company to see if there is an issue with the claim.

Create clear policies regarding insurance practices and payments with clients
I have a packet of digital documents that I have clients fill out prior to using their insurance with me. These include an insurance information form to share their member ID, date of birth, address, and name so that I can verify their insurance information. A HIPAA information sheet and signature page which is required by law for you to have on file. An assignment of benefits which gives you permission to bill the clients insurance company. And finally, a financial agreement which details my terms in the case of a denial of payment from an insurance company. In other words the financial agreement gives me permission to charge the credit card on file after a denial from the insurance company for a client.

Billing insurance companies is not difficult once you know the drill, set up a great system, and make it a regular routine. If you want to learn more please check out the insurance billing class I offer at the Oregon School of Massage. Looking for someone to get you credentialed or bill insurance companies for you? I do that too! Please send me an email at massagebusinesscoach@gmail.com to find out if I am the right fit for your practice:)

Thanks for reading and happy billing!

If you are like me and most of the therapist's in our field you have probably come to realize that building a thriving practice in this field is more difficult than expected.  It takes time, consistency and perseverance to find enough clients that fit your personality and skills to fill your schedule.  This is the first installment of a series of steps I have used over the past five years to help my practice grow. I hope these tips will make the journey just a tiny bit easier!

Greet your client as if they are an honored guest in your home

• Your client has already enjoyed an easy and excellent experience booking with you and have just entered your door for their appointment.  Greet them right away, welcome them to your space with a smile and usher them to where they need to be, offer them something to drink, ask them how their day is, let them know where the restroom is and how long they will be waiting for you to take them in for their appointment.  (of course have them fill out any paperwork needed if they are new).

Plan your session with your client to set their expectations and effectively meet their needs

• Lead your client to the treatment room and chat about how they are feeling and what their needs are.  I usually plan for 5-10 minutes here.  My goal is to find out:  how my client is feeling today, what area's of the body they would like to focus on, expectations and anything else I need to know to customize their session (heat on table, music choice/level, type of massage, pressure, things to avoid etc..).   Then I summarize things for my client before I leave the room ie.  "It sounds like we need to do a mixture of hot stones and deep tissue work with focus on your neck and low back today to help you find some relief.  And depending on how you feel after, we may need to schedule a few weekly sessions to (work on your forearms and feet) or (to help you become fully pain free from these issues).  This is a good place to educate your client and a good selling moment because next you could say something like "We offer packages and memberships that make it easy to get the treatment you need." Your client may want more information in that moment or you can chat with them about it again at checkout. 

Offer a clear treatment plan and a path for re-booking

• After the appointment ask the client how they are feeling and give them a moment to share their observations.  Share your findings ie. hips are tight and need more work but hamstrings and adductors on left side are also very tight and will require focused attention etc...  Suggest a treatment plan "I think a massage a week for the next month would help you get to where you need to be and then you could most likely go to monthly for maintenance.  If you decide to do that I would focus on your hips, hamstrings and adductors on your next visit and then we could go from there.  I have this time available again next week if that works for your schedule?"  A good tip from one of my most successful colleagues is to let your client know that they should just get on your book so that they can get the time they want and if they are feeling like they don't need the massage they can always cancel or reschedule-within your allotted cancellation policy of course.  Usually the client will feel ready for the massage when the time comes and will be happy they scheduled.  If they decide not to rebook I thank them and let them know how they can rebook on their own if they choose to do so (online, text etc...). 

Welcome and empower your client with information

• As your client leaves give them a welcome packet.  A welcome packet could include a branded card with a short note that welcomes them to your space, some information about booking and pricing options, a little blurb about what makes you/your practice unique (why you love what you do, what you do in the community, how you want to help them) and thank them for choosing you.  You could also include a small coupon to use on their next visit, cards for sharing with friends and postcards for any type of event or specials.  This could all go in an envelope or folder with your logo on the front.

Record the details of your session so that you can customize future sessions

• After your client leaves record notes for their next visit about your findings, what techniques you used, what things they like/don't like, anything important you spoke about and your suggested treatment plan so that you are on top of it for their next session. Clients feel special and considered when you remember the details and it will allow you to take your sessions to a whole new level by building on the work you have done.

Remind your client that you care beyond their visit

• If your client is new, write a thank you card right away regarding your findings in their session, your suggested treatment plan and where they can find info about your pricing options and re-booking (or whatever information is appropriate for each client).  Mail this within a week of their session.   This shows that you care, you want to see them again and it keeps your business fresh in their minds.
  

I hope you find these tips helpful!  If you have helpful tips to share regarding client retention I would love to hear them.  Please feel free to share in the comments or on my Facebook page:)
Sign up for my newsletter for tips on building your practice and keep an eye out on our blog for more in this series.  Thanks for reading and have a great day!

Insurance companyInformationApplication
Regence
Information:  https://www.regence.com/web/regence_provider/credentialing
Application:  https://eapply.or.regence.com/logon.aspx

ASH
Information:  https://www.ashlink.com/ASH/public/Providers/Network/join.aspx
Application:  To begin the process call: ASH Practitioner Recruitment department at 888.511.2743, option 1. Representatives are available to assist you Monday - Friday, 8 a.m. - 5 p.m. Pacific Time.

CAQH (Cigna, Optum, United as well as many others (see full list here.)
Information:  http://www.caqh.org/solutions/caqh-proview
Application:  https://proview.caqh.org/PR/Registration

Kaiser
Information:  http://www.chpgroup.com/prospective-providers-faqs
Application:  http://www.chpgroup.com/request-an-application

Lifewise
Information:  https://www.lifewisewa.com/provider/join-our-network/
Application:  https://www.lifewisewa.com/documents/010207.pdf

Moda
Information:  https://www.modahealth.com/medical/credentialing/overview.shtml
Application:  https://www.modahealth.com/medical/credentialing/forms.shtml

Pacific Source
Information:  http://www.onehealthport.com/provider-source
Application:  https://identity.onehealthport.com/OHPIdentity/Workflows/Register/default.aspx

Oregon Health Co-op
Information:  https://www.ohcoop.org/providers/
Application:  email:  providerengagement@ohcoop.org or call us at 503-765-1676