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Medical Billing for Massage Therapists

You have probably heard of medical billing for massage therapists. But you might not know exactly where to begin. The thought sends shudders down the spine of any therapist who devotes time to tending patients rather than picking up papers to make claims to insurance companies.

In plain words: it’s really not as complicated as it feels: all that medical billing requires is defining and recording the services you’ve done so that you can get any insurance company to pay for it. Not only does it make your services available to your clients, it also creates new sources of income for your practice. Come on, let’s take it slow!

Why should massage therapists consider medical billing services? Well, one question first: “Why?” In other words, “isn’t it worth all this trouble?” Good news:

Of Broad Reach: Most probably, these people will not visit any massage therapy sessions because it seems an unaffordable luxury to them. As such, accepting insurance removes the financial barrier.
More Clients: More clients tend to pay visiting regularly due to health insurance coverage of their sessions.
This is advantageous because offering medical insurance billing makes one’s practice stand out, thereby establishing him/her as a serious healthcare provider.

Step 1: Get Credentialed

It is mandatory for health insurance companies to recognize you as a provider before you begin billing against their policies. This is what is called credentialing.

Check State Laws: Medical billing matters from state to state, so make sure your particular state covers massage therapy within the realm of healthcare services.
Obtain an NPI Number: The National Provider Identifier (NPI) number can be considered as a unique ID number for all healthcare providers because it is mainly issued to clinicians without any charge upon issuance. It can be quickly applied online within a few minutes.

Step 2: Learning the different codes in insurance

The types of code types that matter with respect to insurance have been listed below:

CPT (Current Procedural Terminology): these codes are the important ones that the insurance company has to know for the service you provide – for instance therapeutic massage. Most commonly used are code 97124 – massage therapy and 97140 – manual therapy techniques.
ICD-10 codes: This is the diagnosis that the client has in seeking treatment – for example, chronic back pain might have a friend referring someone to you and that one will definitely have an ICD-10 code for billing purposes against it.

Step 3: Referrals.

Actually, most of the time, a physician or other health care provider refers the patient to insurance companies to get coverage on massage therapy. The reason for that is the fact that insurance company-upholds documentation to prove the medical necessity of your services.

How to do this easy:

Networking to Local Doctors: Having Relationships with Chiropractors, Physical Therapists and GP.
Educate the clients: Encourage clients to ask their doctors for a referral, if they feel that massage therapy may assist in their condition.

Stage 4: Select a Method of Payment

There are different ways you can handle medical billing company depending on what works best for you:

Bother Yourself: If you are somewhat comfortable engaging in paperwork, then just learn the procedure, then submit claims yourself.
Hire a Billing Specialist: Prefer to dedicate more time on your practice; you may outsource it to the billing company.
Billing Software Usage: Kareo, SimplePractice-easy tools offer to accommodate that work and lessen the burden of paperwork for such type of outsourcing medical billing services.

Step 5: Submission of Claims

It is almost sending an invoice to an insurance company; here is what you will need:

Patient Information: Their name and insurance ID as well as the patient’s date of birth.
Referral Information: A referral would have to include a doctor’s prescription or referral.
Details of Service: Codes for services received, including dates and times, should be listed.

Once it’s submitted, the insurance company would review the claim to either allow it or ask for further information.

Stage 6: Reason of Denial

There are many cases where an insurance claim gets denied. Shrink your worry-some mind happens alive to everyone. Some very usual causes include:

Incorrect or absent coding;
No appropriate referral;
Due necessity for services when medically not proven beneficial.

Fixing this is:

Understanding a denial letter would point out the problem.
Fix errors and resend that claim.
In case you need to clarify, call the insurance company.

Table of Contents

Tips for Simplifying the Billing Process

Be on top of Things: Document every single session in the client’s condition, referral notes, and details of the service rendered.
Double-Check Codes: The most common cause for denied claims is coding errors. Website coding is very important.
Know More: Enroll yourself in medical billing cost for courses offered online or attend seminars to boost more confidence in your billing prowess.
Net-work: Meet other massage therapists who also bill their patients through insurance; it will serve as a very good resource for support and advice.

Suggestions for Common Challenges

“I can’t digitize so much paperwork!”

Start assuming small things . Just get acquainted with one or maybe even two different insurance providers before fully developing your knowledge.

“My clients are not aware that their insurance insurance may include massage therapy.”

Educate them! In fact, you can hand out short guides or FAQs on the website or at the clinic itself.

“I’m confused about billing software.”

Many offer free trials; and hunt for the right one to suit your needs.

FAQs About Medical Billing For Massage Therapists

Can I bill insurance for every kind of massage therapy?

No, they will tend to pay for massage therapy only when considered medically necessary and indicated for example by injury recovery or chronic pain.

How much time does it take before an insurance company pays?

Or it can be said that, in general, payment by insurance companies is done within 30-90 days, according to the insurance company and how accurate your claim is.

What if my client’s claim gets denied?

You can appeal that decision, add more documentation, or help your client figure out how to navigate the denial.

Final Thoughts

Medical billing may feel like a mountain to climb, but with the right tools and knowledge, it can easily be accomplished. Begin taking small steps: get credentialing, understand codes, and learn one or two insurance companies. Over time the entire process will become second nature, and you will reap the rewards in your practice.

It’s not just about getting paid; it’s about making available your services to a greater number of people. Medical billing services means improving practice and ensuring the clients are given benefits deserved.

So, take that first step today-your future self (and clients) will appreciate you!