Insurance Suggestions
I would like to share with you some of my experience with insurance
companies. First, you need to know some general guidelines about medical
coverage.
- Car insurance’s medical coverage usually is $10,000, also called
PIP.
- If you get injured at work, your L&I covers up to 12 or 18 visits
of massage therapy.
- If you are very lucky to have massage therapy coverage in your
health insurance it normally covers somewhere between 12 and 20
visits, or even up to 60 visits per calendar year.
Once you are eligible for one of the plans above, it is very important
for you to remember that this is YOUR money. It is NOT FREE. You have to
be very careful how you spend your money because it is limited either by
the amount, visits, or time period. For instance, if you get involved in
a car accident, whether it's your fault or not, you usually have $10,000
of medical coverage. Then you go to see a medical doctor or a doctor of
chiropractic. They take X-ray’s, then refer you to have an MRI done if
it is necessary. You may also be referred to a physical therapist,
massage therapist, acupuncturist and/or naturopathic doctor. All of the
treatments that you receive will come out of this $10,000. In six to
twelve months your $10,000 of medical benefits might have run out. If
you are totally recovered that’s great, but what if you aren’t? You can
choose to pay for the treatments yourself until you recover, or choose
to end treatment and live in pain. If you don’t see significant
improvement in your symptoms within 4 weeks, then you should consider
another opinion regarding your treatment options. Once again, don’t
forget that your benefits are limited by time and amount, so be careful
how they are used.
ADVICE: You always need Doctor's Referral
or Prescription for Massage Therapy regardless what the insurance rep or
your coverage says. To protect the Therapist getting paid and
prevent you from paying later on with your own money if the insurance
company denies and many times they will and here is why. For a
real example, you are using your medical insurance card and your
insurance coverage paper and insurance rep say that your plan is a PPO
plan and you don't need Doctor's Referral. It's true that you
don't need Doctor's Referral. But one thing that they will never
tell you (not even many healthcare providers know) is you need
Doctor's Prescription. What is the different between Referral and
Prescription? Referral - Tells exactly for how many visits per
treating period with specific details of the conditions such as 1-2
visits per week and up to six weeks with massage therapy for the right
shoulder strain/sprain. Prescription - on another hand, only
describes the problem such as neck pain and/or back pain (this is all
you need).
The insurance company wants to know why you visiting the massage
clinic. They don't pay for maintenance, relaxation, stress
reduction, sore and tightness muscles. Since Massage Therapists
are not doctors, we cannot diagnose what the problem is. That is
why you need someone such as Medical, Naturopath, or Chiropractic Doctor
who can diagnose with the condition. Then Massage Therapist can
look and translate the condition into the medical code. Without
the medical code/s, the insurance company will refuse to pay and they
have the rights not to pay.
NOTICE: At Master Massage Clinic, our policy is if someone
using any kind of insurances, the person must have Dr.'s Prescription or
Referral or we cannot see them. And if they forget or don't have
the referral or prescription, they have to pay up front with the cash
special discount rate.