How to Self-Bill Your Insurance

Please be aware of the following:

• NOT all plans allow self-billing, and Medicare does NOT permit patients to self-bill.

• It is the responsibility of the patient to consult their insurance plan for instructions and appropriate forms for self-billing.

•Contact Esther at Esther@massagetherapy.com if you are planning to bill your insurance and she will prepare the itemized receipt with necessary insurance codes to facilitate self-billing. Provide your prescription for massage that includes the diagnosis code(s) that must be included on your itemized receipt. You may also fax your Rx to (206) 629-6036.

• It is advised to make copies of all forms prior to submitting insurance claims.

• Esther Utley LMT is an Out-of-Network Provider/Non-Preferred Provider who is not contracted with any insurance companies.

Call or go online to your insurance company. It is recommend that you do this before scheduling your first appointment. This way you are sure about your insurance coverage before getting started. 

Tell them that you will be seeing an out-of-network or non-participating provider and you need the self-billing form and instructions on how to bill the insurance company for reimbursement. Please advise your insurance to reimburse you directly as Guiding Star Massage Therapy cannot accept their payments on your behalf. (Often a different billing address is provided for claims that have been prepaid). The entire process and forms used vary according to your insurance company and plan.

Once you have received the form, complete and attach the sales receipt you received from my office. The sales receipt includes the visit code (CPT) and the Diagnosis Code (iCD-10). When it asks for these on the form write “See Attached”. It is a good idea to highlight the codes and the tax ID number to prevent oversight and possible denial by the claims department.

If your claim is denied, contact your insurance administrator and ask why. Sometimes claims are denied mistakenly and require further follow up on your part.

Sometimes insurance companies ask for records before they will pay a claim. If you receive a request for records from your insurance company, email Esther@massagetherapy.com and she will provide you with the necessary supporting information for your claim. Records must be printed and handed off in person due to HIPAA compliance and there will be a $20 administration fee for a records request. Records can not be emailed or mailed.