Insurance and Forms
As of January 1st, 2018, all insurance reimbursements are up to the client to collect. Payments must be made in full at the time of the appointment.
An invoice will be provided before leaving each appointment if you choose to submit for a reimbursement. Please use the links for your insurance reimbursement form on the right and submit it per their directions, along with the invoice provided, for your reimbursement. Reimbursement rates will vary depending on plan. Please contact Amber if you need to provide any further documentation. See the FAQ’s if you have other questions.
A Few Notes About Collecting Insurance Payments
Since Seattle Massage Pro will be out-of-network with all insurance companies starting in 2018, the reimbursement amount will depend on whether or not your plan has out-of-network benefits and the out-of-network deductible must be met. If the deductible isn’t met yet, I encourage you to still submit the claims. This will lower your deductible in case you or a family member needs to use an out-of-network service later in the year. So not only do you receive great massage, but it can be applied towards the deductible.
In-network: a medical provider that is contracted with an insurance company to provide services at a discounted rate to the policy-holders. In-network providers are not allowed to collect the full amount for the massage from the clients and have to agree to settle for the copayment plus whatever the insurance company wants to pay for treatment, which is always significantly less than what is billed. Providers agree to be in-network to gain access to helping more clients and are willing to accept less income to do so. Providers also must follow very strict and ever-changing criteria and detailed paperwork and submit all claims on behalf of the clients.
Out-of-network: a medical provider that has not made contracts to accept less pay in order to gain access to a billion dollar company’s client list. Out-of-network providers do not have to follow the strict paperwork criteria and are allowed to collect the full amount of their services rendered. Many insurance plans will not pay for out-of-network services, and if they do, it is at a different reimbursement rate and has a separate deductible. The client is responsible for submitting the forms necessary for a reimbursement and paying the provider at the time of service.
Deductible: the amount that must be paid out-of-pocket by the client before the insurance benefit is in effect.
Copay: the amount the client pays the in-network provider at the time of service once the deductible is met. This is a set dollar amount regardless of how much is billed and paid out by the insurance company.
Coinsurance: an amount the client is responsible for at the time of each service. This is a percentage of the amount the insurance company is willing to pay the provider for the specified service, and therefore can not be known in advance of the first visit. On some plans, there may be a copayment plus a coinsurance plus a deductible that all must be paid by the client before the insurance company pays any reimbursement, and each plan’s septic amounts are different.
PIP: Personal Injury Protection. In Washington State, it comes standard on all auto insurance policies, but may be removed at the client’s written consent in order to save some money on their policy. This is mostly from on-line choose-your-own-price policies, so be aware of it’s usefulness and please do NOT cancel your PIP coverage! PIP can be used to pay medical bills in an auto accident. It’s best to have extended PIP coverage, since medical expenses can really add up once ambulance, X-rays, MRI’s, and all various rehab treatments are factored in. If you need an insurance consultant to explain it further and review your policy to make sure you have the best PIP option, please inquire–we have agents we recommend to protect you.
LNI: Washington State Department of Labor and Industries. This is a work-related injury claim.
Out-of-pocket limit: the maximum amount each individual and family member is allowed to pay out of pocket annually for their private insurance plan.