Issue link: https://www.massageandbodyworkdigital.com/i/494122
F r e e S O A P n o t e s w i t h M a s s a g e B o o k f o r A B M P m e m b e r s : a b m p . u s / M a s s a g e b o o k 51 # Massage therapists tend to focus on pain relief; however, functional gains are the key to reimbursement. You must clearly document the client's condition and symptoms at the start of your care, as well as your massage treatment and the outcome of each session. Use of the accepted SOAP (Subjective, Objective, Assessment, Plan) documentation process is recommended. It is essential to identify specifically how your client is limited by his or her condition or symptoms and formulate a therapy plan to address it through massage. Each session must be documented. Some insurance companies require you to submit your notes along with each claim. Remember, you are treating with the intention of improving function, reducing pain, or achieving a clinical outcome, based on the diagnosis. Typically, insurance companies will not reimburse for palliative or maintenance care that is not working toward improvement or resolution of a specific, diagnosed condition. Diana Thompson's book Hands Heal (Lippincott Williams & Wilkins, 2011; www.lww.com) is a tremendous resource for client intake processes and documentation, and includes specific forms and strategies for documenting treatments to be billed to insurance companies. Another solid resource is Vivian Madison-Mahoney's Manipulate Your Future manual available at www.massageinsurancebilling.com. Verifying Coverage Confirming, or verifying, insurance coverage is when you contact the insurance company on your client's behalf to confirm they have coverage. If you perform services not covered by the client's insurance, the client is ultimately responsible for paying the bill (unless it is a workers' compensation case). Your NPI Number Since 1996, health-care providers have been required by the federal government to have a National Provider Identifier (NPI) number. Getting your own NPI number is a free, simple process that includes providing your state license number. If you are in a state that is unlicensed, you may want to call the toll-free number below to ask if you may use a national certification or another method to verify your qualifications. Contact the NPI Enumerator program via any of the following methods: • Phone: 800-465-3203 • TTY: 800-692-2326 • Email: customerservice@npienumerator.com • Mail: NPI Enumerator, PO Box 6059, Fargo, ND 58108-6059 • Online: Go to https://nppes.cms.hhs.gov/NPPES/Welcome.do, click on "Apply Online," and follow the steps. Most of the registration process is straightforward. When you get to "Taxonomy," select "22: Respiratory, Rehabilitative & Restorative Service Provider," then scroll down to "Massage Therapist." QUICK LIST OF TERMINOLOGY Claim: A bill you submit to the insurance company, usually printed on HCFA claim form 1500. Adjustor: The insurance company representative assigned to handle the case. DOS: Date of Service. This is the date you provided service, and is included on the claim. EOB or EOR: Explanation of Benefits or Explanation of Review. Received with the payment, it explains how the claim was paid for each DOS. UAC: Usual and Customary. This refers to the amount an insurance company usually pays for a specific procedure or modality in your zip code.