I accept Regence Blue Shield and Premera Blue Cross. Both Companies require that you have a pain condition AND a loss of function.
That means that you MUST also have some degree of not being
able to sit, stand, walk, stair climb, lift, work, personal care, drive, or sleep because of or in addition to your pain.
Each has different requirements and benefits that you will need to know and be responsible for. Please read more at these pages: Regence Blue Shield and Premera Blue Cross
ALL Plans require that massage therapy be medically necessary and each plan has their own specific definition of what that means. Check your policy. Here are some sample definitions of medical necessity.
All insurance claims must have a prescription from your doctor with a diagnosis in order to be processed, no matter what the insurance company says. A prescription is different from a referral. Some plans will say that you do not need a referral, but you still will need a prescription. A prescription will provide a diagnosis code and a treatment plan stating the number of sessions the doctor is prescribing and the duration. (Example: 1x a week for 6 weeks)
You will be allowed 6 sessions to be completed without prior-authorization. After that, your insurance requires that I obtain a prior-authorization from a company they have hired called eviCore, before completing more sessions.
Insurance will only cover
massage if there is an injury or condition that makes it medically
necessary to get a massage. Medically necessary massage therapy is done once or twice a week depending on the prescription and condition.
It does not cover massage just for stress, anxiety or depression.
It does not cover maintenance or preventative massage. Each insurance company has their own definition of maintenance massage. I define it as massage therapy done once a month, every three weeks or every other week. Massage must be done (time allowing) once a week for massage to give the best benefits. I have to show that there is improvement in your condition.
It does not cover soreness due to exercise.
Some of the conditions that massage can help and that your health insurance will cover are:
Use this handy insurance verification form (PDF) if you call your insurance to investigate your massage therapy benefits.
Triggerpoint therapy works out the' knots' from long hours at the computer, athletic training, recovery and prevention of injuries and pain. The style of triggerpoint therapy I do is just working out all of the knots as compared to other types of triggerpoint therapy that base their work on referral patterns.
Triggerpoints are caused by repetitive movements or lack of movement in an area that result in the muscle becoming a tightened band of muscle and connective tissue which results in a lack of circulation to the area, causing pain and restricted movements.
When other types of massage fail to remedy the situation, triggerpoints are often the cause. Read more about triggerpoint therapy.
Deep Tissue Massage therapy is working with the deeper muscles of the body to help them to relax so they can do their job of holding you upright.
It doesn't necessarily mean that it needs to or will hurt. The pain or discomfort you might feel during a session is really telling more about how tight the muscles are.
The depth of the pressure has
little to do with the results you may or may not feel. Many are
prescribed to the notion that no pain means no gain. That is not really
the case with deep tissue massage therapy. Working with you to get the
pressure just right to get optimal results will be the focus of our