MEDICAL INSURANCE BILLING

Take full advantage of your health insurance benefit for your regular mind-body maintenance.

Your health insurance plan may cover massage therapy,

you can verify your benefits by calling your insurance provider. 

Exciting news!

Some of our practitioners are now

In-Network with selected Insurance providers!

You can check which insurance they're In-Network via the Practitioners page. 

Or simply go to Booking and select Medical Massage (specified insurance provider)

*not all insurance plan has massage therapy as their covered benefits,

please check with your insurance provider before booking an appointment. 

We are also accepting Out of Network insurance from these insurance carriers:

  • Blue Cross Blue Shield

  • Pacific Source 

  • Providence 

  • MODA

 

Personal Injury Protection/Motor Vehicle Accident Coverage 

  • GEICO

  • Progressive

  • State Farm 

Be sure to verify that your plan has coverage for "out of network" providers.

Once you have verified with your insurance provider, 

please bring your insurance card on the day of service, as well as a valid picture ID.  

Health Insurance Coverage 

How to get started: 

 

  • If you would like to use your health insurance to cover your massage therapy, please call us in advance to verify if your insurance covers our services. 

    • When you call us please be ready with the following information: 

      • Name of your Insurance Provider

      • Your Insurance ID

      • Insurance Company’s phone number 

      • Your full name 

      • Your birthdate 

      • Your home address 

      • If you are a spouse or dependent of the primary insurance holder, please give us the primary insurance holder’s name and birthdate. 

 

  • There will be a $5 verification charge to check your insurance coverage. We will do our best to verify your coverage for manual/massage therapy, however, we strongly urge you to check with your insurance provider to make sure your plan covers massage services before making an appointment with us. 

 

***Verification of your benefits eligibility is not a guarantee of payment. 

 

If you like to verify yourself, you can find the customer service number on the back of your insurance card. 

 

When you call, here are key questions to ask your insurance provider: 

  1. Does my insurance plan cover In-Network or Out of Network services? 

  2. Does it cover manual therapy (CPT code:97140)? 

Our Medical Massage Services are considered as Manual Therapy. This code may be shared with physical therapy and occupational therapy. Please verify if you have enough visits left under manual therapy.   

  1. If I have coverage, do I need prior authorization? 

  2. Do I have any limitations on the number of visits or length of time for each visit?

  3. Has the deductible been met? 

  4. Is there a copay or coinsurance for the visit? If yes, how much? 

  5. What is the maximum amount payable per policy term?

  6. What is the Out of Pocket maximum?

 

Medical Massage Billing Rates:

                                                                Insurance Billing Rate*

    45 min Appointment                       $105

    60 min Appointment                      $125 

    75 min Appointment                       $152

    90 min Appointment                      $162

    120 min Appointment                    $204

 *Rates subject to change, rates may differ by the insurance carrier. Last updated 2/27/2021. 

 

If your insurance plans require prior-authorization, a referral, or a prescription for bodywork from your primary care physician. Please consult your primary care physician to obtain the necessary documents before booking an appointment with us. We do not provide prior-authorization at TeaScape. 

 

Once you have verified with your insurance provider, please book an appointment under

Medical Massage Services


 

Personal Injury Protection/Motor Vehicle Accident Coverage 

If you have been injured in an automobile accident, your auto insurance may cover medical massage therapy for injuries related to the accident.

 

How to book Massage service with MVA coverage: 

  1. Verify with your insurance carrier if massage therapy is covered.

  2. In most cases, you'll need to obtain a prescription for massage therapy. Talk to your primary care physician that you wish to add massage therapy to your injury recovery care. 

  3. Provide your insurance information to us including: 

    1. Name of the responsible insurance company

    2. Address, phone, and fax number of the insurance company 

    3. Adjustor’s name and contact information 

    4. Claim number 

 

Health Savings Account (HSA) or Flexible Spending Account (FSA) 

 

We accept HSA/FSA cards!

 

Before your visit please verify: 

  • Are Manual Therapy/Massage therapy covered? 

  • Do you need a prescription from your physician? 

  • Is there a limit to how much you can use for Manual Therapy/Massage Therapy? 

Self Submission for Insurance Reimbursement 

Even if we cannot bill your insurance, you can bill your insurance yourself to get reimbursed. 

Make sure to check with your insurance carrier massage therapy is covered and they accept self-submission.

If you would like to pay for your service out of pocket and bill your insurance yourself, we would be happy to help you and provide you with the necessary documentation. 

 

With this method, you can book your massage under therapeutic massage. 

Important note:
  • If your insurance carrier does not remit timely and sufficient payment (within 90 days of service) on your claim, you will be responsible for payment to meet the full-service amount charged at the time of your appointment. Once your insurance carrier processes your claim, we will bill you for any remaining patient responsibility deemed by your insurance carrier. 

  • We will send you a billing statement that contains the total cost of your service(s) and the amount due. You may generally expect this billing statement within twenty (20) to thirty (30) days after your insurance company has responded to a submitted claim. 

  • We claim rendered services under CPT code 97140 - Manual Therapy Technique which may be used by physical therapists and occupational therapists. Please verify with your insurance provider and other healthcare providers you see to ensure you have enough visits/benefit limit. 

  • In case of a missed appointment with no prior notification, you are responsible for $50 no-call no-show fee. Schedule change within 24 hours of the appointment will be $25 for a last-minute schedule change fee. Missed appointments and last-minute schedule change, cancellation, missed appointments cannot be billed to your insurance as no services rendered. You will be financially responsible for these fees and charges.

  • We are unable to bill our therapeutic and specialty massage services with your insurance. Please make sure to book your appointment as Medical Massage. 

Financial Policy for Insurance Payments:
  • Please understand that payment of your bill is considered part of your treatment. Fees are payable when services are rendered. We accept cash, check, credit cards, and pre-approved insurance, if applicable.

  • It is your responsibility to know your own insurance benefits, including whether we are a contracted provider with your insurance company, your covered benefits and any exclusions in your insurance policy, and any pre-authorization requirements of your insurance company.

  • We may ask you to make a copy of your ID and insurance card for our records. Providing a copy of your insurance card does not confirm that your coverage is effective or that the services rendered will be covered by your insurance company. 

  • It is your responsibility to fulfill any charge incurred for co-payments, deductibles, and non-covered services, as dictated by your insurance coverage, plus any collection costs for amounts personally owed by you. Please be aware this process generally takes 15-45 days from the time the claim is received by the insurance company.

  • In the event that this visit is based on a Worker’s Compensation claim and your Worker’s Compensation claim is not accepted, you may instruct us to send a claim to your private health insurance company. 

  • To verify your insurance coverage, we may charge $5 verification fee with your consent, you are responsible for the charge before or at your first service. We will attempt to confirm with your insurance provider for the massage services coverage prior to your treatment. It is your responsibility to provide current and accurate insurance information, including any updates or changes in coverage. Should you fail to provide this information, you will be financially responsible for the services incurred.

  • Please understand that not all services provided by TeaScape are covered by private health insurance plans for one or more reasons, including but not limited to exclusions from your specific insurance plan. 

  • Some insurance coverages have Out-of-Network benefits that have co-insurance charges, higher co-payments, and limited annual benefits. If you receive services that are part of an Out-of-Network benefit, your portion of financial responsibility may be higher than the In-Network rate.

  • Any copay required by the insurance company must be paid at the time of service. Any unpaid balance will be considered past due after 30 days and may incur a late fee. 

  • Only Medical Massage Services rendered can be billed to the insurance. Unless prescribed by your physician, we cannot bill insurance for specialty services including but not limited to hot stones, cupping, ashiatsu, Thai, CBD oil massage, structural integration, and/or craniosacral therapy. 

  •  In case of a missed appointment with no prior notification, you are responsible for $50 no-call no-show fee. Schedule change within 24 hours of the appointment will be charged $25 for the last-minute schedule change fee. Missed appointments and last-minute schedule change fees cannot be billed to your insurance as no services rendered. You are financially responsible for these fees and charges. 

If you have any questions or concerns, please feel free to reach us at 503-841-6460 or via email frontdesk@teascapepdx.com