Labor and Industries
Motor Vehicle Collisions
Personal Injury Protection Plans and 3rd Party Billing
Classes from Adler Giersh Attorneys
Billing Health Insurance
Apply to become a provider with each insurance carrier. At this point, none of the carriers are accepting new providers. Check once in a while in your area. Apply anyways and wait for openings. Here are a few of them:
Healthways/Whole Health Networks covers Cigna, Aetna, Group Health and Corvel which is a combination of auto insurance companies.
United Health Care – Use CAQH.org to credential http://www.caqh.org/overview.php
Regence Blue Shield
Preauthorization for Regence Blue shield required through Evicore.com.
Read your contracts. Billing Health insurance has many different nuances that you will need to know.
You can use www.officeally.com for free to bill these companies directly electronically.
Receive EOB’s through officeally.comIn order to receive ERAs (Electronic Remittance Advise) through Office Ally you would want to complete the ERA pre enrollment forms for each payer. To find the ERA enrollment forms you will want to go to Resource Center > Payer Enrollment Forms. On the Payer Enrollment forms you will see the link for Electronic Remittance/ ERA/ 835 Enrollment forms which will take a you to a list of alphabetized payers and their instructions for ERAs.https://www.officeally.com/resourcecenter.aspx?id=76
Receive Payments through direct deposit. Contact each company to set this up.
Some carriers are moving to using Availity as their clearing house.
Chapter 19.68 RCW REBATING BY PRACTITIONERS OF HEALING PROFESSIONS
WAC 246-08-400 How much can a health care provider charge for searching and duplicating health care records
RCW 25.15.045 Professional limited liability companies. Massage Therapists must create a PLLC (not a LLC).
RCW 18.100.050 Organization of professional service corporations authorized generally — Architects, engineers, and health care professionals — Nonprofit corporations.
WAC 246-830-040 Equipment and Sanitation -http://app.leg.wa.gov/WAC/default.aspx?cite=246-830-040
Scope of Practice (6) “Massage” and “massage therapy” mean a health care service involving the external manipulation or pressure of soft tissue for therapeutic purposes. Massage therapy includes techniques such as tapping, compressions, friction, reflexology, Swedish gymnastics or movements, gliding, kneading, shaking, and fascial or connective tissue stretching, with or without the aids of superficial heat, cold, water, lubricants, or salts. Massage therapy does not include diagnosis or attempts to adjust or manipulate any articulations of the body or spine or mobilization of these articulations by the use of a thrusting force, nor does it include genital manipulation. http://app.leg.wa.gov/RCW/default.aspx?cite=18.108.010
IC/Employee for WA State
Summary of Evidence (PDF from AMTA-WA website) – How Massage Fits into the Essential Benefits of the ACA.
Heal-wa.org – Great free resource for licensed massage therapists in WA State. Find research papers, CPT code books and more.
Massage Insurance Billing Manual
I have written the 4th edition of my book on Insurance Billing. While it is not specific to WA State, it will help you to understand the process of billing and learn to ask what questions to what parties in order to bill and get paid.
It is available in PDF, Kindle and Paperback through my other website www.massagepracticebuilder.com