Insurance Billing for Massage Therapists: Resources for Credentialing and Billing In WA & OR
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 email@example.com.
*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:
Where to send your Packet
Email credentialing packet to: firstname.lastname@example.org
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: email@example.com
Reliant Behavioral Health -
Email credentialing packet to: firstname.lastname@example.org
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.
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
Storing patient records in Oregon
Insurance Billing Learning Resources
Massage Practice Builder website
Workers Compensation Fee Schedule
Billing Workers Compensation in Oregon
Here are common pain codes:
ICD-9 to ICD-10 translator
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.
Insurance Verification Checklist
Use this guide when verifying client benefits
Step by step checklist for verification:
Verification Questions to ask the insurance company/adjuster:
*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:
Add a new insurance company in Practice Mate
Insurance Billing Tips
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
Medical Billing Specialists
Efficient Medical Billing Service
Integrity Billing and Consulting
Insurance billing knowledge checklist
I thought it might be helpful to have a checklist of things you need to have skills in before you begin billing insurance. This should serve as a helpful guide to learning what you need to know to bill insurance successfully. I offer individual coaching, small group coaching, and classes in all of these areas if you need help! Feel free to email me for more information: email@example.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.
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.
A quick guide for billing health insurance companies for massage services
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 firstname.lastname@example.org to find out if I am the right fit for your practice:)
Thanks for reading and happy billing!
Build a thriving massage practice: client retention
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!
Appointment flow for client retention
Greet your client as if they are an honored guest in your home
Plan your session with your client to set their expectations and effectively meet their needs
Offer a clear treatment plan and a path for re-booking
Welcome and empower your client with information
Record the details of your session so that you can customize future sessions
Remind your client that you care beyond their visit
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!
Steps for getting credentialed with insurance companies in Oregon:
Individual Insurance Company Information
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.)
Oregon Health Co-op
Application: email: email@example.com or call us at 503-765-1676
Julie is the former owner of Written on the Body Massage and Acupuncture Studio located in the beautiful city of Portland, OR. She started her business in 2010 and has enjoyed learning from her many successes, failures and challenges along the way. Julie has a passion for business and loves helping her fellow Massage Therapists build their dream practices. She currently shares her skills, experience and knowledge with fellow Massage Therapists through 1:1 coaching sessions and small group classes. Julie and is eager to help shape the future of our profession by empowering Massage Therapists in Portland, OR and all over the U.S.