Insurance

Urban BodyWorks is in-network and accepts:

  • Providence Health Plan
  • Regence BCBS
  • Pacific Source
  • Workers Compensation
  • PIP (personal injury protection)
  • FSA and HSA
  • No Insurance
  • Financial Hardship

HEALTH INSURANCE:

The services of Myokinesthetics and Amma Therapy at Urban BodyWorks falls under massage therapy and/or manual therapy codes for insurance billing purposes. We are proud to be in-network with Providence Health Plan, Regence Blue Cross Blue Shield and Pacific Source.

Information requirements for benefit verification:

  • Full legal name (as shown on insurance card)
  • DOB
  • Phone Number
  • Mailing Address
  • Insurance company name
  • Member ID
  • Group number

 

**Urban BodyWorks can verify your benefits for you at the cost of a one time $5 fee. This is refunded back to you after a completed first session at Urban BodyWorks. This fee covers the expense to the experienced outside billing company that is used for the most accurate benefits verification.

 

For those who want to self-check their eligibility, please read carefully!

It is important to note that individual health plans differ despite being from the same carrier. It is strongly advised for you to contact your insurance company to verify that massage therapy and/or manual therapy is covered by your specific plan. If you are scheduled for a session before benefits are verified it is expected that full payment will be due at the time of service. It is possible that despite being told that your individual health plan is covered for massage therapy and/or manual therapy they can deny payment to the practitioner after the time of service. It doesn’t happen often, but it can happen. You will be billed for the full cost of service in these rare occasions.

 

Below is helpful information to know when calling your insurance carrier:

  • Massage is often covered by group plans but not individual plans.
  • Some plans will only cover massage if done in a Chiropractor’s office.
  • Some plans don’t need a prescription or are not subject to the deductible.
  • Plans can change every year.

 

Below is the information needed from your insurance carrier:

  1. Does my insurance cover massage therapy? Can the massage be done by a Licensed Massage Therapist (LMT) who works independently (NOT working with a physical therapist or chiropractor)?
  2. What is my copay or coinsurance?
  3. Do I need a referral/prescription or pre-authorization?
  4. Is massage therapy subject to the deductible? What is my deductible?
  5. How many visits do I have for massage? Is this shared with other disciplines ie: physical therapy, chiropractic.

 

WORKERS COMPENSATION: 

Injured employees receive a certain portion of their wages while they are off work for the treatment of such injury or illness, depending on state rules. States also establish their own rate of compensation when an employee loses a member, is permanently disabled or dies as a result of the work-related accident.

Employees who are injured on the job receive a certain portion of their wages while they are off work recovering and receiving treatment to heal. Oregon establishes their own rate of compensation as stated below from https://www.saif.com/medical/billing.html website:

“Payment for compensable medical treatment of an injured worker is made according to the Oregon fee schedule, MCO contract rate, or another negotiated rate, whichever is less.

Payment for services related to workers’ compensation is governed by the Workers’ Compensation Division (WCD) Medical Fee and Payment Rules, Chapter 436, Division 9.”

The following information is needed to begin:

  1. Claim number/subscriber ID
  2. Date of Injury (DOI)
  3. Referral and name of health care provider who wrote the prescription
  4. Adjustors name and phone number

 

 

PIP (PERSONAL INJURY PROTECTION):

Motor Vehicle Accidents (MVA) in Oregon:

In the state of Oregon we have “personal injury protection” which allows $15,000 towards medically needed massage. Your automobile insurance will cover your

massage therapy in full regardless of who is found at fault for the car accident. 100% of massage that is deemed medically necessary is covered IF you have an Oregon auto insurance plan. This coverage allows you to be treated for your sustained injury with a referral from the following: medical doctor, acupuncturist, naturopath or chiropractor.

You can ask your health care provider for a prescription for medical massage. A typical prescription is 1-2 massages per week for 3-8 weeks depending on the chronicity and severity of symptoms. Discuss with your health care provider on what the best plan is for you.

 

The following information is needed to begin.

  1. Auto insurance company’s name, address and phone number.
  2. Adjustor’s name and phone number.
  3. Accident claim number.

 

Please note that medical massage is NOT a full body massage. It is area specific with the goal to decrease pain, restore range of motion and balance posture using manual therapy techniques. It is very effective in dealing with specific complaints ie: migraines, whiplash, low back pain etc resulting from the car accident.

Manual therapy techniques include myofascial release, myokinesthetics, trigger point, soft tissue mobilization, lymphatic drainage, restorative range of motion techniques and non-mechanical traction.

FLEXIBLE SPENDING ACCOUNT (FSA), also known as “FLEX PLAN”:

A FSA account is a great opportunity for those who are eligible to be fully reimbursed for the money they spent on massage and/or manual therapies.

Some plans require a letter of medical necessity for the IRS. Using you FSA saves you money by lowering your income taxes. The money you contribute to your FSA is deducted from your pay before Federal, State or Social Security Taxes are calculated. This means a decrease in taxable income and an increase in your spendable income. Most plans cover massage but it is best for you to call your benefits administrator to see if massage is an allowable expense and/or if you need a letter of medical necessity.

*please note that attaining a quote of benefits and/or authorization does not verify eligibility or gaurantee payment. Payment of benefits are subject to all terms, conditions, limitations and exclusion of the member’s contract at the time of service.

Please call your benefits administrator for any questions for your specific plan.

 

HEALTH SAVING ACCOUNT (HSA):

A HSA takes pre-tax money from your paycheck and puts it in an account that is approved for medical spending. You will not pay taxes on this money which means you can save big on qualified expenses. Most HSA’s cover massage therapy but it is best for you to call your benefits administrator as each HSA can vary. Ask if you require a doctor’s letter of medical necessity before massage is covered.

An HSA takes pre-tax money from your paycheck and places it an account for approved medical spending, and in most HSA’s, massage therapy is covered! Because you never pay taxes on this money, you get a significant savings on qualified expenses. You can use your HSA debit card to pay for your treatments. You can also use already set aside money for massage.

*please note that attaining a quote of benefits and/or authorization does not verify eligibility or gaurantee payment. Payment of benefits are subject to all terms, conditions, limitations and exclusion of the member’s contract at the time of service.

Please call your benefits administrator for any questions for your specific plan.

 

NO INSURANCE OR FINANCIAL HARDSHIP

Insurance companies are billed per unit (15 minutes) which can make the cost vary depending on treatment and length of time working on the client. The current rate is

$45.00 per unit.

Not everyone has access to insurance or have the right insurance for the service they need. Not everyone can afford to pay for insurance when their job doesn’t offer it.

Sometimes the deductible is so high that it’s unrealistic to pay it before using your insurance. We understand this.

Urban BodyWorks wants to make our services more available to those who need it and don’t have access. We offer a flat rate of $75.00 for first time assessment and

$70.00 for follow up appointments for those who qualify. Payment is due at the time of service. Please call or email with any questions.

www.urbanbodyworkspdx@gmail.com

503.395.7179