PIP & Workman’s Comp

Holistic Massage & Wellness Clinics does treat clients/patients for injuries for personal injury claims, such as automobile accidents (PIP) and work-related injuries (workman’s compensation claims). When you meet specific criteria, your medical massage services may be billed directly to your insurance.

What you will need:

• a prescription from a physician, naturopathic physician or chiropractor
• the prescription must include a diagnosis code (or codes) for billing purposes
• a claim number from your auto insurance company (PIP)
• the name of the claims representative from your auto insurance company who is handling your claim

Q: I was recently in a car accident, will my car insurance pay for massage treatments?
A: Yes you usually will have Pip benefits from your auto insurance policy. You will need to have your benefits verified and submit a prescription form a Doctor or Chiropractor
 

Q. What is medical massage?

A. Medical massage is clinical massage based on a physician's prescription, and performed with a specific goal for functional outcome. It is generally prescribed as a series of visits over a specified period of time - such as twice a week for six weeks, with work only to the diagnosed area. It is sometimes paid for by a third party, such as an insurance company.

Auto Accidents (PIP) and Workman’s Comp

All that is needed for Automobile Insurance (PIP), and Worker's Compensation Insurance is a prescription and the verification of your benefits from your insurance company.

            You fill out our verification of benefits form

            You provide us with a prescription from a Doctor or Chiropractor

After your benefits are verified, the insurance company will be invoiced directly for treatments so you do not have to pay out of pocket or submit any forms.

            We submit all the forms for you.

(Click here to print out our PIP & Workman’s Comp verification of Benefits form)

Fax completed Verification form to (954) 476-3598 or call (954) 476-6401. 

The Prescription

You will need to have the following information on your prescription.

Diagnosis codes

Frequency of Treatments
Total Number of Treatments
Name and UPIN# (Doctor's ID #)
State That Massage Therapy is Medically Necessary.

Once Holistic Massage & Wellness Clinics has received the verification of benefits form you filled out, we will contact your insurance company and ask for pre-approval along with your insurance company's coverage guidelines.

EXPLANATION OF TERMS

Please read the explanations about the terms used and gain helpful advice in gathering information about your massage therapy benefits:

Deductible: The initial amount that must be paid out-of-pocket before insurance kicks in. 

Co-Pay: An out-of-pocket fee to be paid to your service provider at the time of each service. 

Coinsurance: After a deductible has been met, there is a coinsurance percentage. This number tells you what percent of the service your insurance company will pay for (up to an allowable amount). Many insurance plans will cover 100% after you've received a certain dollar amount in services (this is called a stop loss).

Allowable amount: This is a predetermined amount that your insurance is willing to pay for any given service.

Out-of-pocket expenses: This is a general term for anything left unpaid by your insurance company, including: deductibles, co-pay, and coinsurance.

Preferred Provider: This is what insurance calls their contracted providers. In order to become a preferred provider, health care practitioners must fill out an application and go through a rigorous screening process.

In-Network: This is another term for a preferred provider, meaning that the given provider is working in that insurance company's network.

Out-of-Network: This is a term for practitioners who are not preferred providers, or rather who have not been contracted your insurance company. Many insurance companies allow for their members to receive treatment from out-of-network providers under certain plans.

Explanation of Benefits (EOB): Whenever your provider bills your insurance company for a service, your insurance company will send you an explanation of benefits. This paper briefly explains what has been billed and how much was or was not covered and why.

PIP and Workman’s Comp 
With a PIP and Workman’s comp claim, you'll have an adjustor assigned to your case. The adjustor is the person in charge of managing your claim, and whom we'll work with directly in order to make sure you get the paid treatment that you need. Most PIP and Workman’s comp claims will remain open until you've reached the dollar limit for treatment, you are no longer affected by your injuries, or your claim becomes dated.

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