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Did Your Insurance Company Forget to Tell You…

With insurance companies constantly changing policies, we’d like to remind you to check with your insurance company about massage benefits.  It is helpful to know the following:

 

Massage Preauthorization

If your health insurance covers therapeutic massage or myofascial therapy, you may be entitled to coverage outlined by your policy. In all but very rare cases, you will need a preauthorization from your insurer or they will not pay anything toward your treatment. If you are hoping to utilize your insurance, you MUST have preauthorization by a PCP (Primary Care Physician — your chiropractor, medical doctor, osteopath, naturopath) before you receive care.

 

What is Preauthorization?

Preauthorization is when a third party company, hired by your insurance carrier, reviews whether your care is medically necessary or not. There are certain guidelines that your needs must meet:

1. Medically necessary based on medical best practices.

2. Needed to prevent, diagnose or treat an injury, condition, or disease.

 

How do you get preauthorization?

You must have a primary diagnosis code from your chiropractor, medical doctor, naturopath, or other accepted PCP. The condition must be treatable by a massage therapist.
You must present a current medical prescription for the services requested by your provider
We will inform your insurer of the information the doctors have provided within the prescription and request approval to begin the ordered care.
In our experience, your insurer will allow a number visits for you over a period time that has little to do with what your doctor has requested.

-Remember: Preauthorizations are NOT a guarantee of payment.