avoid billing mistakes

To complement “From Survive to Thrive: Insurance Billing Made Easy” in the March 2015 issue of MASSAGE Magazine. Summary: Accepting insurance provides an opportunity for massage therapists to earn consistent income—provided they avoid common pitfalls associated with the billing process.

Time and again, I have seen that the people who complain about billing insurance, quite simply, either haven’t been brave enough to try it or are doing it wrong. There are several billing mistakes I’ve seen repeatedly made by massage therapists when dealing with insurance.

Avoid these six simple mistakes, and you’ll find yourself making more money and with more freedom in your massage practice than you ever thought possible. 

1. Thinking you can’t bill insurance in your state.

You may be blocked out of billing one type of insurance in your state, but not all of them. You can bill Personal Injury Protection Insurance in all states where massage therapists are licensed or certified by the state, except Florida, currently. Yet, I hear repeatedly from massage therapists, “I can’t bill insurance in my state.” Yes, you can. 

2. Treating all types of insurance as if they are equal.

When it comes to how much energy is required in the billing process, versus how much reimbursement you will receive, insurance types most certainly are not equal. One of the biggest mistakes people make when starting out billing insurance is accepting clients with health insurance before having a well-rounded understanding of which types of insurance pay what and when, and what effort is required for each.

PIP is my most favored; Workers’ Compensation is a nice supplement; and health insurance is commonly a hassle—but better than nothing in a downturned economy. Be sure to choose the type of insurance to bill with your eyes wide open, rather than taking every case that comes your way, without discretion. 

3. Failing to be proactive.

We must take care to prescreen our clients. The initial phone call provides you an opportunity to learn much about the client’s accident and previous treatments, and will give you an idea of whether or not she has already burned through her insurance benefits with previous providers. Take the information you’ve collected and be proactive by next calling the client’s insurance claims representative. Verify all the information the client gave you is true, and get permission to begin treatment.

Ask the representative to give you an idea of how much money is left in the account, without breaking privacy laws by telling you the actual number. The point is, ignorance is not bliss in the world of insurance billing. Accept your clients and bill based on facts, not wishful thinking, to become one of the massage therapists who gets reimbursed consistently.

4. Making it complicated when it should be simple.

The simpler you keep the billing process, the better. Develop a system that works, and stick to it. When billing, use Centers for Medicare and Medicaid Services (CMS) form 1500, unless the company insists otherwise. Use billing CPT codes 97124 (massage therapy) and 97010 (hot pack or ice pack) only. These are the two codes that will ensure you get paid. For years I’ve seen massage therapists argue that another, fancier code should be used other than 97124, and when I push them further, I find out they rarely get paid in full. I have been paid in full within 30 days, 100 percent of the time, for more than 15 years. Keep it simple.

5. Charging ridiculous prices.

Not only are there laws to abide by in setting your insurance prices equivalent to your cash prices (or at a rate up to 30 percent higher, depending on your state law), it’s also astonishingly bad business to charge customers something you wouldn’t post on your wall. Likewise, undercharging is not ideal either. Be proud of being one of the few massage therapists who bills insurance, and set all your prices to a level you deserve.

6. Waiting before submitting bills for payment.

Do you want to be paid in a timely manner? If yes, then send your bills in on time. If you wait, before you know it the money meant for you could be paid to someone who sent his bill in on time, and there could be nothing left for you. Don’t let this happen to you.

Throughout my career as a massage therapist, I billed insurance as a major part of my practice. I vividly remember a massage therapist asking incredulously, “Why would you bill insurance when you already have a VIP clientele that pays you handsomely? 

“You have the dream career we all wish for,” she added. “Why waste so much time with the hassle of insurance billing? 

My answer, as always, was, “It’s not a hassle. It’s very easy once you understand how to bill properly, and it’s the only niche of our business that is recession-proof.”

The recession hit two years later. Billionaire clients tightened their belts; celebs and CEOs, even the basketball teams I worked with stopped coming through my city due to cutbacks. Because I protected myself with a solid-base business structure, I had reimbursement checks I could count on like clockwork every month. Insurance billing saved me at a time when I could have lost everything. It can help you, too.

About the Author

Meagan Holub IMeagan Holub, C.M.T., author of the The Magic Touch: How to Make $100,000 Per Year As a Massage Therapist series, is currently expanding her company, The Love Lab, across the nation. She’s been featured at The Grammy Awards®, on CBS and VH1, and in Men’s Health and Cosmopolitan. Find her continuing education classes at www.meaganholub.com.