SOMI and our readers greatly appreciate Laura Newton’s articles to help therapists learn the ropes to begin networking with hospitals and medical insurance. This article is Part III in her series, preceded by Parts I and II, which can be found in the following links:
Part I: https://www.scienceofmassage.com/2024/03/medical-billing-simplifying-a-complex-issue-part-i/
Part II: https://www.scienceofmassage.com/2024/08/medical-billing-simplifying-a-complex-issue-part-ii/
Laura’s generous sharing of information with therapists is important from multiple perspectives. First, working with the VA Administration allows therapists to help desperate patients who need treatment but may lack financial resources.
Secondly, it gives therapists new sources of income, contributing to the financial stability of their clinics.
Thirdly, successful treatment and elimination of somatic pain and dysfunction will encourage new patients to come to the clinic as referrals from the veterans that the therapists helped.
Fourthly, the opioid crises and bureaucratic obstacles placed on physicians to prescribe opioids, even for the patients who need them, greatly complicate the work of doctors and hospitals. Thus, medical clinics and hospitals are looking for treatment options to replace opioids. If a therapist successfully works on veterans within the VA system, it opens doors to becoming an approved provider for commercial health insurance.
Don’t miss the opportunity to apply with the VA administration!
Dr. Ross Turchaninov
JMS Editor-in-Chief
MEDICAL BILLING – SIMPLIFYING A COMPLEX ISSUE,
Part III
Laura C. Newton, BS, ED, LMT, NMT
CAQH Follow up
Once you have a CAQH number, you must confirm every 90-120 days that the information in your file is still accurate. You will receive an email notification from CAQH informing you when this is required. You can then revise your current address, add new locations as needed, or input any other necessary changes.
If you do not complete this process, your CAQH number will expire, and insurance companies will not be able to see your information. You will continue to receive emails until the process is complete.
VA Credentialing
Once your credentialing with the VA is complete, it is important to ensure that your information is in the Community Care Network system, where veterans find providers in their area. You can look up community care providers and fill in your discipline and location so you will be among the listed therapists. If your facility does not come up in an initial search, then you will need to contact the customer service number, ensure they have your information, and complete any other online forms they may require.
It is also important to contact the VA facilities in your area and speak with a community care representative in the massage therapy referral department. As a provider, you need to ensure that they have all your information so they can access it quickly when making massage therapy referrals. All necessary facility details will be in the online system, but it is helpful to make sure that you let them know you are active and taking new referrals.
Important notice: Once a massage therapist is credentialed with the VA, they can add additional therapists under already approved credentials. It can be another important avenue for the clinic growth.
SOAP Notes
It is imperative that you keep detailed SOAP notes for every session attended by all clients, especially any VA clients or those who will be asking for reimbursement from their insurance companies. Massage Book has a section for SOAP notes, but if you aren’t using Massage Book or another online scheduling system, you can find a downloadable PDF of the Soap note format online for a one-time charge.
Insurance Billing
Clients often ask if I bill insurance other than the VA at my facility. I do not bill other insurance providers, but I inform my clients of how they can turn in a superbill from my facility along with a letter of medical necessity from their primary care provider and request reimbursement. In this case, my client pays for the massage during service.
A superbill for insurance is an invoice or statement specifically designed for clients seeking reimbursement for medical massage sessions. The superbill is an itemized list of all services provided to a client, showing charges and payments for those charges. Unlike a standardized invoice, a superbill will have additional information with more detail that an insurance plan needs to know about the session to determine if they will cover the service, like ICD diagnosis codes and CPT codes. Most insurance companies will also require a letter of medical necessity for massage therapy from the client’s primary care physician.
Health Savings Accounts (HSA) can also cover medical massage therapy services. Some insurance providers allow HSA participants to put a set amount of money into the account to be used throughout the year to cover expenses not covered under the current insurance plan.
If readers have any questions about the information in this article or the other two articles, please get in touch with me at 912-687-9101 or www.integratedmassageservices@gmail.com
My name is Laura Newton, and I live in Statesboro, GA, with my husband and two teenage children. I graduated from the University of Georgia in 1995 with a B.S.Ed. Degree with a major in Exercise Science. I graduated with my Master’s in Physical Therapy in 1998 from the Medical College of Georgia.
I started my business, Integrated Massage and Bodywork, in 2022 and became certified with the National Certification Board for Therapeutic Massage and Bodywork (NCBTMB) as a continuing education provider. In late 2022, I also became an approved Veterans Administration provider for massage therapy.
My business focuses on medical massage and therapeutic outcomes. I offer Medical Massage Therapy, Neural Reset Therapy, Quantum Alignment Technique, Pre-Natal Massage, Baby Bodywork, and Manual Lymphatic Drainage.
Category: Medical Massage
Tags: 2024 Issue #3