Insurance FAQs

Frequently Asked Questions

We know insurance can be very confusing and frustrating to work with! We hope this page will shed light on some mysteries.

Why do I need a Prescription for Massage Therapy? I didn't need one before / I was told I don't need one

There are two answers for this. Firstly, we are not able to bill your insurance company without a diagnosis, and no one in our clinic is licensed to make diagnoses; massage therapists are only allowed to treat soft tissue issues, never diagnose. Some clients may have come from other clinics where a chiropractor, naturopath, or other physician was able to work with an on-site massage therapist to make diagnoses, but we only have massage therapists. Other times, a client is told by insurance representatives that they don't need a referral to seek specialist treatment, but most specialists are able to make a diagnosis.

Secondly, Insurance companies will pay only for services deemed "medically necessary," and a prescription goes a long way to proving necessity.  Insurance companies can reverse payments up to 3 years afterward, so it is important to have documentation at the outset and to confirm its renewal at appropriate milestones of your treatment plan.

What is Preauthorization? How do I know if I need it?

Pre-authorization is when an insurance company decides to cover a service based on the ordering provider's documentation; it's an extra hoop to jump through before services can be rendered. If a contracted provider sees a client without pre-authorization but the client's plan requires it, then the provider does not recieve payment for that visit because they did not obey contract protocol.

Our front desk agents are usually able to discern whether your plan requires authorization, but not always; we don't have access to every client's full benefit information. You can know if your plan requires authorization for massage therapy by checking your full insurance contract or contacting your insurance directly. All of Kaiser Permanente's Self-Funded HMO and Medicare plans require authorization for massage therapy. 

Can I bring my Prescription with me on my first visit, or do you really need it beforehand?

There are three ways to get your prescription to us: fax, a hard copy, or email. We prefer fax and hard copies, because emails are not secure without end-to-end encryption and referrals and prescriptions usually contain your name and date of birth, among other protected information, which are powerful tools to those with malicious intent. However, if that is a risk you are willing to take, you can email your prescription to us at bodyrec@gmail.com.

Our fax number (425-670-0940) is one digit off from our regular number (425-670-0970), so be careful when passing it on to a physician's office!

You may walk in a hard copy the day-of your appointment, but if you arrive without it, you will be charged $85 for your visit (our standard hourly rate), or $75 to cancel. The charge for a visit can be credited, applied, or refunded retroactively if we later recieve a valid prescription. 

What's the difference between a spa massage and a therapeutic treatment massage?

When people hear ‘massage,’ most think of a traditional full-body Swedish relaxation or spa massage, which is a "protocol massage" because the therapist follows a set protocol with little to no deviation.

A therapeutic massage is geared towards injury recovery, focusing on the problem are, and is often therapeutically painful, since it often involves applying deep pressure or repeated strokes to a tense area. Relaxation is a side benefit, not necessarily the goal, unless the diagnosis is anxiety or something similar. The therapist tries out a variety of techniques to find what works best for your body or injury and must document everything they did and found; they are not providing the exact same treatment to each client.

Insurance companies are stringent about “treating to the diagnosis,” which is to say that our therapists are contractually obligated to work only on the body parts indicated by your referral, or to be ready and able to justify how working elsewhere affects the injured area, unless they would like to invite legal trouble upon themselves.

Because of the extra work involved, both in method but in the documentation and billing side as well, a therapeutic massage costs more than a protocol massage.

I've never had a massage before. What can I expect?

For your first appointment, plan to arrive 10-15 minutes early to fill out some paperwork. These forms collect information about you, your medical history, any current health concerns, with some additional paperwork for insurance information if that's your payment method. Please come clean and free of perfumes, colognes, essential oils, or other strongly scented products (deodorant OK).

After completing your intake paperwork, you are lead to the treatment room. Your the therapist does a short intake of their own, and then they step out and close the door. You undress to the level of your comfort—a lot of people leave underwear on or only undress the area to be worked on, and it's fine if you are not comfortable undressing at all; the therapist can work through clothes or sheets, though perhaps not as effectively. If you’re nervous, you can ask the therapist to narrate what they’re going to do before or as they do it.

Presuming you undressed at all, you get on the table beneath the drape, which is an opaque sheet. When you let the therapist know you’re ready, they'll step back in. The draping is modest; only the body part(s) being worked on is uncovered at any time. From there, the therapist will begin to assess you and manipulate tissue.

If you ever feel uncomfortable or like the therapist isn't listening to you, verbalize it; say “Stop,” and "I am uncomfortable," "This is not effective for me," and the therapist will take their hands off you. You can end the session there and the therapist will step out, or you can tell them what to adjust to make you comfortable. People have different levels of comfort, so you will not offend anybody by making your needs known. We want you to recieve the care that you need, not suffer in silence for any length of time!
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