New Insurance Clients: Please Read before scheduling.
WA State is one of two states in the US that allows massage therapists to bill health insurance for massage services. What allows massage therapists in WA to bill is something called the "Every Category Law" WAC 284-43-205
To effectuate the requirement of RCW 48.43.045 that health plans provide coverage for treatments and services by every category of provider, health carriers shall not exclude any category of providers licensed by the state of Washington who provide health care services or care within the scope of their practice for conditions covered by basic health plan (BHP) services as defined by RCW 48.43.005(
More states are willingly paying and more insurance companies in other states are starting to pay. The Affordable Care Act also has provisions for massage and getting it covered by insurance. Section 2706 is the part of the act that says:
(a) Providers- A group health plan and a health insurance issuer offering group or individual health insurance coverage shall not discriminate with respect to participation under the plan or coverage against any health care provider who is acting within the scope of that provider’s license or certification under applicable State law. This section shall not require that a group health plan or health insurance issuer contract with any health care provider willing to abide by the terms and conditions for participation established by the plan or issuer. Nothing in this section shall be construed as preventing a group health plan, a health insurance issuer, or the Secretary from establishing varying reimbursement rates based on quality or performance measures.
(b) Individuals- The provisions of section 1558 of the Patient Protection and Affordable Care Act (relating to non-discrimination) shall apply with respect to a group health plan or health insurance issuer offering group or individual health insurance coverage.
Here in WA State, billing health insurance requires that you sign up with the various health insurance companies as providers and go through a process called credentialing. Credentialing is all done online now through www.onehealthport.com or Provider Source
Start at each insurance companies website to also find out more about their company. You will need to find out if they are accepting applications and also find out how you let them know when you have completed your online application.
There may also be other insurance companies in your area that you can become a provider with. These are just the larger ones in WA State.
You can also bill auto insurance policies for massage when someone was in a collision with a car/vehicle. In WA State, Personal Injury Protection is required or they may also choose not to have that protection if they can prove they have health insurance that will cover the massage up front. The problem with that is that many of the health insurance companies have limits to the number of sessions that can be done and their allowable fees are usually lower.
To learn how to bill for motor vehicle collisions you may need to take a class. There are many attorneys in WA State who will teach these classes to massage therapists. Adler Giersh is one of the most popular and they are a big supporter of massage here.
You can also learn some of the basics of billing insurance in my Book - Insurance Billing 101 for massage therapists available on my other site - www.massagepracticebuilder.com
I also have a meetup.com group that meets regularly to talk about various issues and offers short classes on various topics like massage insurance billing in WA State.
If you are billing insurance in WA State, especially health insurance you will want to be a member of the American Massage Therapy Association WA Chapter. It is really because of this group that we are able to bill insurance. Each year they work to protect our right to bill and are working to keep ahead of the many changes that occur in legislation and with insurance issues.
People who are hurt at work may be able to start a worker compensation claim. Massage Practitioners in WA State are able to bill for work related injuries. You can do that through the WA State Labor and Industries. Injured workers are allowed an initial 6 sessions and then require approval for any additional sessions and the limit is 12 sessions of massage. (Please check with them for the latest updates.)