54 m a s s a g e & b o d y w o r k m a y / j u n e 2 0 1 5
Sending the Bill
Specific procedures for billing should be outlined
in your provider contract with the insurance
company, or you can call the company directly
and ask what they need from you. You will
most often use a standard form for billing. The
current form is the HCFA /CMS 1500, last
revised in February 2012. Basic information
you will provide on the form includes:
• Your name, address, contact information, and NPI
• Your client's personal and contact information
• Date of injury/onset of illness
• Name and NPI of referring physician
• ICD-9 or 10 code(s)
• CPT codes
• Dates of service
• Complete prescription from referring physician
This link has a tremendous amount of
information to help you understand the intricacies of
the form: www.cms.gov/Outreach-and-Education/
Medicare-Learning-Network-MLN/MLNProducts/
downloads/form_cms-1500_fact_sheet.pdf.
Many insurance companies now require
electronic billing rather than mail-in. You may
need to purchase software that contains the proper
CMS 1500 format and capacity to submit bills
electronically. If you want or need to use electronic
billing, there are many companies offering medical
billing software to assist you. Many have free
plans, as well as paid plans. Four examples are
Free Medical Claims (www.freemedicalclaims.
com), Office Ally (www.officeally.com), Practice
Fusion (www.practicefusion.com/medical-billing),
and Practice Suite (www.practicesuite.com).
Some insurance companies require that you
submit your documentation (chart notes or progress
reports) in addition to the form. Be sure to check
where to send the documentation and billing, as
addresses are not always the same for each piece.
If you will be submitting claims via fax
or mail, it is strongly recommended you use
a Tax ID number rather than your social
security number, and include your NPI.
WORKING WITH LEGAL CASES
If you have a client whose injury or condition
means attorneys are involved in the case (for
example, a motor vehicle accident), prepare to
Need More Information?
• Active myofascial therapist and business-success coach
Irene Diamond works with therapists who want to grow their
practices, make more money, and have more happiness.
Massage & Bodywork readers can request a free audio
CD in which Diamond interviews three other experts in the
massage profession about their secrets to success. For a
free seven-day course, "Get One New Client A Day Marketing
Blitz," visit www.massagesuccess.org. For more information,
visit www.irenediamond.com.
• Body Well Therapy is an LMT-owned and managed
massage-services company, specializing in massage for
injury victims through insurance (primarily auto and workers'
comp claims). Body Well offers therapists who don't
want to handle their own insurance billing the opportunity
to work with these clients as a Body Well independent
contractor. Body Well directly coordinates and bills therapy
services. Clients may request any specific qualified
massage therapist they wish to provide their therapy.
Requested therapists not already under contract can be
easily contracted by Body Well to provide the prescribed
services at a specified frequency, and at a guaranteed rate
of pay per session. Services can occur at a client's home
or in a massage establishment. Services are available
in all states that license massage therapists. Therapists
can learn more at www.bodywelltherapy.com/accept-
insurance-massage, or call 888-929-9355, ext. 3.
• Vivian Madison-Mahoney, LMT, has been educating
massage therapists about massage insurance billing and
marketing for 25 years. For more information, visit
www.massageinsurancebilling.com or call 865-436-3573.
