How Can a Client Submit to Insurance?

[Cap The Technician]

Hi

I had a client ask if he could submit the cost of a session with me to his insurance (Blue Cross Blue Shield)
I'm not set up for that and really don't want that paperwork and reimbursement hassle. But is it something he can do on his own and if so, how?

 

[Aaron J]

This would depend on the laws in your state and depend on how his policy is written. Usually, it would require that he get a prescription from his doctor (MD or chiropractor) and submit that along with an itemized bill from you using the proper diagnosis and procedure codes. The diagnosis code would come from his doctor and the procedure code would be whichever manual therapy codes you are allowed to bill. For instance, in Florida we used to use 97124 when we billed insurance. It was billed in 15 minute increments.

Angie

 

[Sunrise]

Chances are very slim he'd get reimbursed. Of course he's welcome to try. Just give him a receipt & let him do the legwork. However, most states don't allow massage to be paid through health insurance, unless it's in a doctor's office or PT clinic. I warn my clients that this is usually the case.

 

[Cato]

I use to have BC/BS and a month before I stopped having insurance(divorce) I learned that I could have been getting massages and all I needed to do was send info to them. So yes they can be reimbursed.

 

[Patricia G]

A lot of people also have Health Savings Accounts through their work that they call "insurance" or confuse w/insurance, and they may be referring to submitting receipts for reimbursement through those. If that's the case, just a regular receipt will often do.

 

[Yakov Smirnov]

Thank you!

 

[politically_incorrect]

When we had BCBS, they only offered a discount on massage through providers who signed up with BCBS. I am sure it varies by state.

HSAs often don't cover CAM. We tried to get corporate chair accounts based on employees using their HSA dollars, but nearly every company found that this was not an allowed service. Might be a prescription issue.

 

[iojhyt675]

HSAs often don't cover CAM... Might be a prescription issue.

Yeah, I too have found that this varies, by insurer and by policy, overseen of course by the IRS rules about HSAs overall. We have a lovely one for our family set up through my husband's employer, and through learning about how WE can use it I've been able to pass along info to some of my clients who are confused by the whole concept of HSAs. Ours covers a lot of CAM services that we use, although it specifically excludes MT grrrrrr... t011

 

[carrie_adams19]

I have a BC/BS client who wanted to be covered by insurance. They would not cover it because I work in my own office, not in the chiro's who wanted to write a prescription.

 

[Pompal 09.]

How Can a Client Submit to Insurance?

But is it something he can do on his own and if so, how?

Yes, there is something your client can do, but it does not guarantee payment.

He needs to contact his insurance company and find out if his policy covers massage work. If so, does he need a prescription (some companies require this)? If he needs a prescription, you'll want to write the diagnosis from the prescription onto your "sueforum.xxxill" or statement you provide him. If you don't have a code book, you can look up many of the current code online.

You may not have to write the code on there, but I suggest it to make it a bit easier for the client. But usually the client can just send in a copy of the script (if needed) and the statement (if they will re-imburse.


Also the X4 (mentioned up there somewhere) may also be helpful - 15 min. incriments, if the insurance company requires that.

He'll need to find out the way his insurance company wants the claim submitted and do it their way.

Be prepared that you may receive a check in the mail for the client on occasion (insurance compnaies do mess up). If this happens, contact the insurance company and find out the proceedure to mail it back and have them cut the client a new check and let them send the check directly to the client. It seems like a little extra work, but worth it in the long run.


I will tell you this: I don't submit insurance for my clients, and after they have been through the rig-a-ma-roll of trying to submit it themselves, they no longer hassle me about "why don't you bill insurance", which has been nice.

Here's what our website says regarding insurance:

We will provide you with a receipt for services rendered. Occasionally, insurance may reimburse you, but keep in mind that each insurance company has their own policy when it comes to massage and chiropractic services. Please contact your insurance company to determine their policy.