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.

 

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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.

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• 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)

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• 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.)

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• For patients with pre-authorization required insurance, we DO NOT ALLOW to schedule more than the approved visits by your insurance.

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• 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