Identify a condition or injury that can benefit from medical massage. In order to prove medical necessity for a massage, you must have a recognizable health condition that may respond to massage in a positive way.
Check insurance rules. Before proceeding with a request for a physician referral for a massage, check to see what the actual rules are for your insurance policy. Consider whether or not a referral will result in coverage. Often, even if you have a referral, other coverage limitations may apply. Read the policy document thoroughly to make sure that this is not the case. Understand any exclusions or limitations specifically mentioned in the policy. Another stumbling block for getting medical massage covered is when it is included in exclusions, along with chiropractor visits and other specific types of treatment.
Talk to your primary care provider. In many HMOs and other health plans, this doctor is the one who must authorize the referral. Discuss medical necessity with the doctor. Figure out how that medical professional will diagnose a condition that can formally necessitate medical massage. Ask the doctor about what kinds of other treatments go along with medical massage. One way to get a better chance of successful coverage is to combine medical massage with other types of treatments. Ask about how a holistic treatment plan can help provide better rehabilitation or recovery while legitimizing the use of medical massage within a greater context.
Obtain a referral. Make sure that the primary care physician's office releases the referral, either to you or directly to the specialist and the insurance company.
Keep records carefully. If the insurance company comes back in the future to ask for the referral or other facts such as a date range, keep that document on file to be able to provide that information and streamline any coverage or eventual payment by the insurance company.
Comments
0 comment