I am in network with Kaiser and Aetna but I am not accepting new insurance clients at this time.
Out of Network:
Regardless if you are using primary or secondary insurance for out of network billing, I charge a flat $150 per hour treatment rate. It is the client's responsibility to pay any outstanding balance not covered by insurance.
If you are a Kaiser member with Secondary Insurance that is not Kaiser, you have three options:
* Contracted Kaiser rates will be accepted and any co-pays and co-insurance are due at the time of treatment.
* If you want me to bill your Secondary Insurance, I must forego the Kaiser contracted rate and charge at the $150 an hour treatment rate. It is your responsibility to know what your Secondary Insurance covers, as you will be billed for any remaining balance not covered by insurance.
* If you prefer to follow up with your Secondary Insurance, I will accept the Kaiser contracted rate, and provide you with the necessary paperwork to follow up and bill your Secondary Insurance on your own.
Insurance Companies' and Massage Therapy
In the current health care environment medical massage is treated as short-term physical therapy to correct a specific condition or injury. Most policies strictly state that massage therapy for prevention, maintenance, relaxation or stress reduction is not covered. If you are seeking my services under your medical insurance policy please refer to your policy for specific information regarding coverage.
Also note that if you are receiving massage services through your medical health insurance policy all treatments are viewed in terms of functional gains (e.g., you were unable to reach the top of your head to shampoo your hair at the start of treatment and after treatment you can). If you are able to perform a movement, even if it questionable in terms of efficiency, insurance may not pay for “fine-tuning”.
Some examples of insurance companies policies related to coverage of massage therapy are listed below:
“Massage is covered for rehabilitation when recovery of function is expected in a reasonable time. Regular or ongoing care to maintain or support current level of function, or that only provides short-term relief between treatments, is not covered. Nor is massage covered for longer term treatment of chronic pain or chronic conditions, for stress reduction or relaxation.”
“Charges for therapy are covered only when the services are for treatment of an acute condition. Short-term rehabilitation is therapy which is expected to result in the improvement of a body function which has been lost or impairment due to an injury or disease. Therapy shall be expected to result in significant improvement of the personʼs condition within 60 days from the date therapy begins.”
I encourage all to fully understand their personal insurance coverage. Check with your provider regarding all details pertaining to any Massage Therapy treatment.
A Word About Quality Of Movement and Third Party Payment
People develop altered movement patterns in response to injury; often keeping those patterns once those injury symptoms have faded. These altered patterns may create secondary--and tertiary--problems if not properly addressed. Should your movement be considered “functional”, insurance coverage may not pay for further improvements, even though you might benefit from continued treatment. You may end up coming to see me with a different set of problems down the road.
Make Lasting Changes
Massage is great for body awareness, relaxation, pain reduction, improved range of motion and overall health promotion, but if you want sustainable and lasting changes, massage alone is not enough. In order to keep your body balanced and healthy, it is important to engage in exercise or activities that keep you moving. Whatever you choose should challenge your balance and maximize stability and mobility in your body. Pilates, yoga, dancing, hiking, biking, even walking, are a few examples of activities that can help to keep you active and healthy.
My goal is to work with you individually to find solutions specific to your interests and abilities to make lasting changes in your movement quality. Ultimately, the responsibility for your health and happiness lies within you. Working together we can plan to recover your vitality, energy, and expressive movement so that you can enjoy life more fully. Reclaim your ability to perform everyday activities with ease such as walking with your friends, picking up your grandkids, gardening, and dancing alone or with your partner!
Affordable Care Act (ACA)
Officially implemented in January 2014, The ACA (aka ʻObamacare”) appears to be an attempt to move from a disease management to a health promotion system for healthcare. The ACA lists 10 Essential Health Benefits that need to be a part of any plan. These include Rehabilitation (#7), Prevention and Wellness Services (#9) and Mental Health (#5) including treatment for anxiety and depression. While the ACA includes a statement of non-discrimination with respect to licensed providers working within their scope of practice, there is no guarantee that massage therapy will be covered under these plans. If you purchase insurance through the healthcare exchange you will need to ask if massage therapy is a covered benefit and if so, under what conditions.
The AMTA (American Massage Therapy Association) WA chapter in response to a request from the Office of the Insurance Commissioner (OIC) commissioned and funded a document entitled “Summary of Evidence: Massage Therapy is an Integral Component in the Affordable Care Acts Essential Health Benefits”. This document is the reference for all other states that want to include massage therapy in their health care plans. How this will play out is anyones guess as all health care providers jockey for position on the playing field. There will be increasing pressure on all health care providers to provide evidenced based research that any given intervention successfully treats what it claims to treat.