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:
Healthcare Management Administrators (HMA)
Regence Uniform Medical
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.
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.
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:
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.
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.
- 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)
-BridgeSpan WA Limited Network
- Health Management Administrators(HMA)
- Kaiser Permanente (PPO Plans ONLY)
- Blue Cross/Blue Shield (some plans, please call to verify)
*If your insurance is not listed above, we do not accept at our clinic. Thanks*
INSURANCE BILLING POLICY.
Massage therapy is not covered by all insurance plans. While a large number of plans do provide coverage for it, it is lumped into a category called “Out Patient Rehab” services.
This means that while you have massage therapy services, you also have speech, cardiology, naturopath and chiropractic services – and they all share this large umbrella.
Therefore, if you have 16 visits of this type allowed per year, all of the services under this umbrella count toward those 16 visits.
Explanation of Benefits: Every time you use your health insurance, your insurance company will send you one of these. It is important to go over it to ensure that you understand how your benefits are being used. While these are not bills or statements (as they say they’re not right on the top!), they will show you when a service gets applied to your deductible – which means you are responsible to pay the deductible at the time of service. We DO NOT send out paper bills to collect payment (electronic invoice only).
Below is a list of common health insurance terms that could make this all a bit easier to navigate:
Benefits – covered medical services to which you are entitled to providers in your network.
Out of Network Benefits –some plans allow medical services to be performed by providers, not in your network. Deductibles and co-payments/co-insurance are usually higher for out-of-network benefits.
Deductible – the amount of money you must pay every year to providers before the insurance company will begin paying for medical expenses – not the same as your premium or co-payments/co-insurance.
Co-payment – a specific amount of money you must pay on each visit to Evergreen Massage & Wellness
Coinsurance – the amount of money you must pay on each visit to Evergreen Massage & Wellness, based on a percentage of the total bill.
We will use the insurance carrier's online portal or telephone services to verify your benefit information as soon as possible prior to your appointment. Insurance phone services are only available Monday - Friday.
Evergreen Massage & Wellness only submit claims to Primary Insurance (no dual insurance billing service). Patients will have to submit to their secondary insurance for reimbursement.
Evergreen Massage SUBMIT INSURANCE CLAIMS IN A BUNDLE, we will submit bundle claims each month, and we do not send them to claim per visit. (If your visits are towards the end of the month, they will be billed together with other visits in the following month)
Evergreen Massage only allows the patient to schedule NO MORE THAN TOTAL OF 6 VISITS AHEAD, including the pending unpaid visits. Even if you have many visits on your insurance, we DO NOT ALLOW any insurance clients to build up many unpaid visits or large outstanding balances. (The client can continue to schedule additional visits once their claims have been processed and paid.)
For patients with pre-authorization required insurance, we DO NOT ALLOW to schedule more than the approved visits by your insurance.
If we are unable to verify these benefits due to unforeseen conditions and you choose to keep your appointment be advised that you are still responsible for payment.
We will use your verified insurance information to calculate any co-pay, coinsurance, or deductible amounts - these amounts are due at the time of service.
We will comply with your insurance company’s requests for your medical information as long as we have a current HIPAA release form that states we have permission to do so.
The verification of benefits does not mean your plan will cover the treatment. Final payment determination will be made when your insurance company processes your claim. The client is responsible for the full payment of the appointment if insurance denies your claim.
Keeping track of insurance benefit limits, prescriptions, and/or referral status is client responsibility. You may receive courtesy phone calls or emails to warn you of potentially non covered appointments. Unfortunately, we do not have the resources to manually oversee every client’s benefit limits and requirements so these warnings are not guaranteed.
If for any reason payment is denied either by my insurance company or by my attorney, you are financially responsible to pay for all massage therapy treatments.
NON-PAYMENT- In the event that I failed to make payment at the time of service, Evergreen Massage & Wellness has the authorization to either charge your credit card on file or send an electronic invoice to your email. All overdue bills accrue interest at 3% monthly and may be sent to debt collection if the client failed to make a payment after 30 days