Insurance Questions

How do I know if my plan covers massage?

Each health plan is unique. In order to confirm if your health insurance plan covers massage, please call your insurance company directly. In the event your massage is not reimbursed under your plan, you will be billed directly for our services.

What questions do I ask when calling my insurance company?

• Is Massage Therapy (97124) or Manual Therapy (97140)  covered under my plan?
• Do I need a referral or pre-authorization?
• Will massage or manual therapy  apply to my deductible ?
• What is the copay ?

If I was injured in an auto accident and would like to receive medical massage, how does that work?

Prior to coming to see us for an auto accident related injury, you will need to first see your primary care provider, an urgent care provider, or a Chiropractor to be assessed for any serious conditions that would be contraindicated for massage therapy.

Medical massage is clinically proven to speed healing time, reduce pain, and improve treatment outcomes after soft tissue injuries such as whiplash and soft tissue sprains and strains.

Insurance information to bring with you to your first appointment or email us prior to your visit:

• Insurance company name, address and phone number.
• Letter of referral from your prescribing provider. If required under your plan.
• Incident claim number
• Adjustor’s name and phone number.

What service should I schedule if I'm billing insurance?

Medical massage and Manual Therapy are the services that we offer that are covered by insurance. These sessions are up to 60 minutes in duration and are billed at $125 for 60 minutes. Therapists offering medical massage have advanced training to offer the most effective care. These claims include writing and submitting chart notes to your insurance and coordinating with other health care practitioners as needed.

At Body Aware we are committed to providing transparent and fair pricing to our clients. We work to educate our clients on navigating the insurance system to improve treatment outcomes and minimize insurance denials.

IF you would like to upgrade your session you will be charged separately at the time of services for your add-ons. We do, however, offer the CBD massage oil to our medical massage clients at no extra charge.

Please remember these things when you schedule a medical massage.

• Some health insurance plans and all MVAs require a referral from a MD, ND, DC, NP or PA.
• If you have a deductible you may need to pay out of pocket until your deductible is met.
• If you are in doubt we can always bill your insurance and reimburse you if the session is covered.
• It is your right to choose the LMT you would like to see. If massage is recommended, you are not under any obligation to go a specific clinic.
• Additional time beyond 60 minutes session is paid for at the time of service and isn't covered by insurance.

What is a deductible?

Your deductible is the amount of money you have to pay for your health care before your health insurance plan will start to pay for medical services. In other words, your health insurance plan “kicks in” only afteryou’ve paid the amount of your deductible out of your own pocket.

For example: Your health plan has a deductible of $100. That means that you need to spend $100 of your own money on health care before your health insurance plan will start to pay for things.

Some types of visits do not apply to your deductible, like office visits with your PCP. Our services will apply to your deductible on some plans and not others, so it is important to ask. 

If our services are applied to your deductible you will be billed at the reimbursement rate we have contracted with your insurance company. This is different for each insurance company. It is usually between $80-$100 per session. 

What is a pre-authorization? 

Some insurance companies require a pre-authorization for massage to be covered. This means we would call and request from your insurance a pre-authorization. Contact us to request a pre-authorization. Other insurance companies will require a pre-authorization after a certain number of visits. Each insurer is different and it’s important to check ahead of time if a pre-authorization is required. Please keep in mind, a pre-authorization is not a guarantee of payment and charges may still apply to the deducible.   

What is a  copay vs coinsurance? 

Generally, copays are a fixed amount and coinsurance is a  percentage of the total cost of the service. Copays can be taken at the time of service but coinsurance will be billed after payment is received from your insurance company. 

What is an EOB?

An EOB is an explanation of benefits. It is sent to you from your insurance company. It explains what was charged, how much was covered, and what the balance is. 

Fees are charged to insurance in 15 min units. So a one hour massage is 4 units. Our medical massage and manual therapy sessions are normally 60 mins in duration. 

How long will it take for me to get a bill for my deductible or copays? 

We send our insurance billing to an outside billing company, Efficient Medical Billing Services located here in Portland. It make take up to 6 weeks before you receive a bill. You will receive a bill from EMBS and an email from us.

When will you charge my card on file if I have an unpaid balance? 

Allow up to 6 weeks for bills to be paid by insurance companies. If you have an outstanding bill for your copay, coinsurance, or deducible you receive an EOB (explanation of benefits) by email. We will charge your card on file 24 hours after you receive the bill. If any charges are incorrect please let us know right away. 

Is my card information safe? 

If you would like to add an upgrade or extend your session beyond 60 minutes, this will not be covered by insurance, and must be paid directly to your therapist at the time of service. CBD oil included at no extra cost (by request).

Why do you charge more for medical massage? 

Medical massage requires advanced training and skills. It also includes an initial evaluation, detailed chart notes, and range of motion tests when appropriate. Along with the massage time we spend additional time to submit your charges to insurance, coordinate  with other care practitioners, and submit records to your attorney when appropriate. * Requests for health records require written authorization from you, and will be sent directly to your attorney. There is an additional $30 records fee billed to your attorney.