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MASSAGE THROUGH INSURANCE.

Our massage therapists are not a doctor or a physical therapist. They are a 'Licensed Massage Therapist' that aims to provide excellent integrative bodywork and self-care education to their clients. Evergreen Massage & Wellness accepts insurance as another form of payment. The quality of massage will not be different from the self-pay client. 
 
We are currently in-network providers for the following carriers:
Regence BlueShield
Healthcare Management Administrators (HMA)
Regence Uniform Medical 
Kaiser PPO
BrigeSpan

In addition, we also see clients who have Personal Auto Injury Protection Claims (PIP) or
L & I WA (on-the-job) injuries.
 
If your carrier is currently out-of-network with us but your plan includes out-of-network benefits, it is possible that you may have coverage for our services. We will gladly verify your benefits when we confirm your appointment. Please note that the process of benefit confirmation may take up to 5-7 business days, depending on your plan.

(*note: Insurance only covers the session fee, does not include any add-on services or gratuity to the therapist.)

To use your health insurance

Please follow these steps to schedule Massage at Evergreen Massage & Wellness using health insurance:

 

1. Before making an appointment – get your specific massage benefits verified by Your Insurance Company

When you decide to come in for medical massage make sure to call your insurance member service to confirm your benefits.

 

Evergreen Massage & Wellness can assist you by uses the insurance carrier's online portal or telephone services to verify your benefit information as soon as possible prior to your appointment. However, the online system does not show all benefit details and Insurance phone services are only available Monday - Friday. It is best to call your member service and find out the exact massage benefits before you make an appointment. Evergreen Massage & Wellness is not responsible to verify your insurance benefits.

 

Please provide your legal name and date of birth, the name of your insurance carrier, your member ID number, your Group number and the Customer Service phone number on the back of your card. We need to confirm your benefits in advance.

 

Please Note: Verification of Benefits is NOT a guarantee of coverage. Final payment determination will be made when your insurance company processes your claim. The client is responsible for full payment of the appointment if insurance denies your claim.

 

2. For Massage Through Insurance, Have a Prescription or Referral

In order to receive massage therapy, it is required that you obtain a prescription or written referral from a licensed medical professional in the State of Washington who is authorized to diagnose physical ailments. This prescription must be on file with us prior to the start of your treatment. You may have your provider fax a copy of your prescription directly to our secure fax at (425) 697-6100.

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In compliance with insurance regulations, we are required to keep records of prescriptions on file for audit purposes. All patients must have a valid prescription before scheduling an appointment. Please be aware that if you fail to provide a valid prescription during your initial visit, the claim submission may be delayed due to the lack of a diagnosis code, and you will be held responsible for the entire cost of the visit if we are unable to bill your insurance.

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While some insurance policies may not require a prescription, we still need a diagnosis code to bill your insurance company. This code can be found on the prescription or referral.

 

Information required for prescriptions/referrals:

  • Date Issued

  • Diagnosis and ICD-10 code

  • Number of massages prescribed and duration ( i.e.: 6 visits at 1 visit per week)

  • Provider name and physical or electronic signature

 

3. Schedule Your First Appointment

Once you have confirmed your insurance benefits, you may proceed to schedule your first appointment. To ensure that the practitioner you are seeing is covered under your insurance plan, please call our office to schedule your appointment. When scheduling subsequent appointments, please remind the scheduler of your insurance carrier.

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4. Complete Our Insurance Paperwork

Please arrive at least 15 minutes early for your visit to complete the needed insurance paperwork or complete our online intake forms. You will need to do so even if you have been to the clinic before as a cash client. Please click here to complete the online intake forms required at your first insurance visit.

 

Bring a copy of your driver’s license, your insurance card, and your prescription/referral if it has not already been faxed to us. Provide these and your insurance paperwork to the front desk before your appointment starts.

 

You can expect a thorough intake session with your massage therapist before your treatment begins; together, you will formulate a treatment plan that follows your provider’s referral.

 

Accepted Insurances

- All Auto Insurances – also called Personal Injury Protection or P.I.P. (we only accept 1st party auto insurance claims)

 

- L&I – on-the-job injury insurance, covered by the employer’s Labor and Industry insurance.

 

- Private Worker’s Compensation Insurance

 

- Regence WA (some plans)

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-BridgeSpan WA Limited Network 

 

- Health Management Administrators(HMA)

 

- Kaiser Permanente (PPO Plans ONLY)

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- Blue Cross/Blue Shield (some plans, please call to verify) 

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*If your insurance is not listed above, we do not accept at our clinic. Thanks*

INSURANCE BILLING POLICY.

Massage Therapy Insurance Coverage and Payment Information

Massage therapy is not covered by all insurance plans. While many plans offer coverage, it typically falls under the "Outpatient Rehab" services category. This umbrella includes other services like speech therapy, cardiology, naturopathy, and chiropractic care.

If your plan allows 16 visits per year for outpatient rehab services, all services under this category (including massage therapy) count toward that total.

 

Explanation of Benefits (EOB)

When you use your health insurance, your insurance provider will send an Explanation of Benefits (EOB). It's important to review the EOB to understand how your benefits are being used. EOBs are not bills (as noted at the top), but they show when a service applies to your deductible. You’ll be responsible for paying this deductible at the time of service. Please note: We do not send paper bills—only electronic invoices.

 

Key Insurance Terms

  • In-Network Benefits: Covered medical services from providers within your insurance network.

  • Out-of-Network Benefits: Some plans allow services outside the network, though the deductibles and co-payments/co-insurance may be higher.

  • Deductible: The amount you must pay each year before your insurance starts covering medical expenses. This is separate from your premium or co-payments/co-insurance.

  • Co-payment: A fixed amount you pay for each visit to Evergreen Massage & Wellness.

  • Coinsurance: A percentage of the total bill you pay for each visit to Evergreen Massage & Wellness.

 

Insurance Verification and Claims

We verify your insurance benefits using your provider’s online portal or by phone before your appointment. Note that insurance phone services are available only Monday through Friday.

  • Primary Insurance: Evergreen Massage & Wellness only submits claims to your primary insurance provider. If you have secondary insurance, you are responsible for submitting claims for reimbursement to them.

  • Bundled Claims: We submit bundled insurance claims monthly. If you have visits at the end of the month, these will be grouped with visits from the following month.

 

Scheduling and Visit Limits

  • Maximum Visits: You can schedule up to 10 visits ahead, including any pending or unpaid visits. Once a claim is processed and paid, you may schedule additional visits.

  • Pre-Authorization: If your insurance requires pre-authorization, we will only allow you to schedule visits up to the approved number.

  • Unverified Benefits: If we are unable to verify your benefits in time for your appointment, you will still be responsible for payment if you choose to proceed with the service.

 

Payment Responsibilities

  • Co-pays and Coinsurance: We will use your verified insurance information to calculate any co-pay, coinsurance, or deductible amounts. These are due at the time of service.

  • Medical Information Release: We will comply with your insurance company’s requests for medical information, provided we have a current HIPAA release form

  • Final Payment: Verification of benefits does not guarantee coverage. Final payment is determined after your insurance company processes the claim. If your insurance denies the claim, you are responsible for the full amount of all accumulated fees.

 

Client Responsibilities

It is your responsibility to keep track of benefit limits, prescriptions, and referral statuses. While we may provide courtesy calls or emails to alert you about potential uncovered appointments, we cannot manually monitor each client’s benefits.

If payment is denied by your insurance or any third party, you are responsible for the payment of all services.

 

Non-Payment

In the event of non-payment, Evergreen Massage & Wellness may charge your credit card on file or send an electronic invoice to your email. Overdue bills will accrue interest at 5% per month and may be sent to collections if not paid within 30 days.

 

Thank you for understanding our insurance and payment policies!

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