I am a credentialed provider through a central credentialling agency for health insurance providers.
My purpose in becoming credentialled is to make my services more available. And yet, as I have only so much time in a day, so my services are offered with the following guidelines:
- I require payment from my patients at the time of service.
- I will provide you with a superbill once each month, with the Prenatal Massage & Education necessary codes and other required information.
- It is the patient’s responsibility to submit forms to their health insurance company for reimbursement.
- Coverage is solely dependent upon your health insurance provider plan.
I accept cash, check, credit cards, excluding American Express, at our session, and online.
My experience so far with reimbursement is that it varies greatly. There appears to be little rhyme or reason involved.
Four Good Reasons Not to Use Insurance
PRIVACY: An insurance company becomes a third party to treatment, complicating the therapeutic relationship. The privacy of the therapeutic relationship, so important to building the trust necessary to discuss and deal with painful and sometimes embarrassing problems, is compromised. Some insurance companies are less intrusive than others, but all want to know the client’s diagnosis and reasons for needing treatment. May reserve the right to audit the practitioner’s records of treatment.
CONFIDENTIALITY: not only does the insurance company know abou the client’s problems, but it passes on information to the Medical Information Bureau, a centralized computer databank used by health, disability, and life insurance companies, and sometimes prospective employers. As computer experts know, no computer system is immune from intrusions; even the Pentagon’s computers are accessed over a hundred times a year by unauthorized personnel (hackers).
CONTROL OF TREATMENT: It takes time for clients to trust their practitioner, and for their practitioner to know and understand their clients. And although a thorough study by Consumer Reports showed that clients felt more benefit from longer periods of treatment, many insurance companies heavily limit how many visits clients may have, and with whom. In addition, should a client’s emotional difficulties stem from a physical problem, which is always a possibility, insurance companies tend to heavily discourage the use of adequate diagnostic tests.
COST: Many studies have indicated that bodywork is highly cost-effective in terms leading to lower use of other health services and to higher work productivity. Insurance companies operating to boost short term profits often deny adequate bodywork coverage; the client pays the price in emotional and physical suffering and lost productivity/wages. In addition, the diagnosis your practitioner is required to share with your insurance company for reimbursement is used by health, disability, and life insurance companies to inrease premiums or deny coverage altogether, and sometimes by employers to screen employees and deny employment.
Get all agreements to cover treatment in writing from your insurance company
Consult with your employer’s Personnel/Human Resources Department
Consult with Union representatives
Contact the Insurance Commission for the statee where your policy was issued
Contact your congressperson and legislative representatives
Retain legal counsel
Avoid using insurance