Insurance
Medical Insurance
This page was created to serve as a reference for understanding your massage therapy benefits
- In the case of an auto-related accident, 2 Hands Healing bills the auto insurance company directly.
- I am no longer an in network, preferred provider for Insurance Companies. However, I can provide you with a Superbill, for an additional fee, that you can submit to your Insurance for possible reimbursement. Usually reimbursements are possible only if your plan allows out of network providers. NOTE: Insurance companies only reimburse a percentage of total massage fees and usually only allow for 1 hour treatments.
- You are welcome to use your HSA card to pay for your massage. This is a great tax free way to set aside funds for self care.
Explanation of terms:
Deductible: The initial amount that must be paid out-of-pocket before insurance kicks in.
Co-pay: An out-of-pocket fee to be paid to your service provider at the time of each service.
Coinsurance: After a deductible has been met, there is a coinsurance percentage. This number tells you what percent of the service your insurance company will pay for (up to an allowable amount). Many insurance plans will cover 100% after you’ve received a certain dollar amount in services (this is called a stop loss).
Allowable amount: This is a predetermined amount that your insurance is willing to pay for any given service. Some insurance companies that claim to cover 100% of a service, will only do so up to an allowable amount. That amount could be lesser than the cost of the service, therefore still leaving you with out-of-pocket expenses. We encourage you to research allowable amounts when choosing insurance plans and health care providers. Things aren’t always as they seem.
Out-of-pocket expenses: This is a general term for anything left unpaid by your insurance company, including: deductibles, co-pay, and coinsurance.
Preferred Provider: This is what insurance calls their contracted providers. In order to become a preferred provider, health care practitioners must fill out an application and go through a rigorous screening process.
In-Network: This is another term for a preferred provider, meaning that the given provider is working in that insurance company’s network.
Out-of-Network: This is a term for practitioners who are not preferred providers, or rather who have not been contracted your insurance company. Many insurance companies allow for their members to receive treatment from out-of-network providers under certain plans.
Explanation of Benefits (EOB): Whenever your provider bills your insurance company for a service, your insurance company will send you an explanation of benefits. This paper briefly explains what has been billed and how much was or was not covered and why.
PIP:
Auto Insurance Personal Injury Protection (PIP) claims. The process for these are a little bit different. With a PIP claim, you’ll have an adjuster assigned to your case. The adjuster is the person in charge of managing your claim, and whom we’ll work with directly in order to make sure you get the paid treatment that you need. Most PIP claims will remain open until you’ve reached the dollar limit for treatment, you are no longer affected by your injuries, or your claim becomes dated.
You always need a prescription for medical massage, even if your plan says you can self-refer. Here’s why. It’s not in my scope of practice as a massage therapist to diagnose, yet the insurance billing forms require a diagnosis code before they will pay. So, I always need a prescription from your doctor before commencing medical massage treatments.