Washington State Massage Therapy Association CPP News

Filing a Complaint with the OIC

WSMTA — Tue, 24 Feb 2026 20:04:29 GMT

By Dagmar Growe, LMT

“The Washington state Office of the Insurance Commissioner protects insurance consumers and oversees the insurance industry. We make sure insurance companies follow the rules and people get the coverage they've paid for.” (from the OIC website).

WSMTA has in the past recommended that practitioners encourage clients to file complaints with the OIC for a couple of reasons. We have as an organization worked with the OIC to advocate on behalf of our patients. This article is going into more detail on when and how to file a complaint.

It is important to understand that the aim of the OIC is consumer protection. They are not interested in contractual disagreements between providers (LMTs) and insurance companies, unless it affects patients directly. It is also important to note that the OIC deals with a huge number of complaints and is chronically understaffed. So, unless there is an easy resolution or a lot of squeaky wheels, complaints will likely not generate much of a response.

Payments denied: Complaints are easy to file through the OIC website but need to be filed by the patient, not the provider. Since many patients have a difficult time understanding why the claim has been denied I may provide a written explanation to the patient and authorize them to quote it or attach it to their complaint. The standard process for these types of complaints seems to be to forward them to the insurance company with a request to comment. Claims will either be paid upon review, or a more detailed denial can be the basis for further appeals.

Patients unable to obtain treatment: LMTs frequently receive calls from frustrated patients who are trying to find a provider who is accepting their insurance and has appointments available soon. When we cannot accommodate these patients, it is important to redirect their frustration. This is a question of network adequacy and could be one way to have a possible effect on inadequate insurance payments. If enough patients file a complaint, (the squeaky wheel), with the OIC about being unable to obtain services that are part of their insurance benefits, we hope that in time the OIC will address the issue with the particular insurer. If the insurer cannot provide an adequate network because LMTs are not willing to sign contracts at certain rates, insurers would be forced to increase rates to increase their network. This is not a quick fix, but at this point we know that the OIC is aware of the issue of inflated provider directories, and we suspect that recent rate increases may be connected to complaints about insufficient networks.

Here is a sample letter for these patients which you can adapt to your business:

Dear …

Thank you for contacting our office. We would love to work with you but unfortunately, (pick one of the issues below),

— we are no longer contracted providers with your insurance company. The low reimbursement rates we were receiving in exchange for offering high quality care were unsustainable for our business.

— we are unable to accept new patients because the low reimbursement rates we receive for insurance work make it impossible to find and hire enough licensed massage therapists.

We encourage you to consult your insurance company’s provider directory to find available appointments at another office. We also suggest that you document the number of calls you have to make and the responses you get. Should you be unable to obtain care within a reasonable timeframe, we further suggest that you file a complaint with your insurance company and with the Office of the Insurance Commissioner (OIC). Complaints with the OIC are easy to file and here is a link to the OIC’s website https://www.insurance.wa.gov/file-complaint-or-check-your-complaint-status

We hope that you will find the care you deserve.

Sincerely

Why Cash-Only LMT's Should Care about Insurance Rates, Contract Fairness, or Network Adequacy

Amy Thomason — Sun, 12 Oct 2025 16:47:30 GMT

From CPP

We’ve been asked why cash-only massage therapists should care about insurance rates, contract fairness, or network adequacy. The answer is simple: insurance practices shape the entire profession. When reimbursement undervalues massage, it drags down public perception of our work, restricts client access, and weakens massage’s place in healthcare. It also influences what becomes accepted as “standard” or “reasonable” rates across the field—including for cash-based practices.
We’ve also been asked why current clients are the most effective voices for completing and sending the form letter we’ve developed, when those most impacted are often the ones who can’t get in for care. The truth is, regulators pay closer attention when people who already benefit from massage speak up. Their letters demonstrate both the value of massage and the barriers that keep others out, making the gap visible and pressing for change.

Record Keeping For Short Duration Massage by Robbin Blake

Chelsea DeSouza — Mon, 12 May 2025 20:38:53 GMT

RECORD KEEPING FOR SHORT DURATION MASSAGES

(Corporate Chair Massage, Event Sports Massage, Free Give-Away Massage & More)

By Robbin Blake, WSMTA Government Relations Director

Since July 30, 2017, regulations have been in effect for massage therapists, to include record keeping. If done well, the paperwork needed for shorter duration massage situations does not need to be time consuming or complicated.

We are required to maintain records for all massage performed, regardless of venue or duration. The new rule can be found by clicking on this link: https://app.leg.wa.gov/wac/default.aspx?cite=246-830-565. The record keeping WAC has flexibility in what information is required for charting depending on the type of massage performed. Here is the opening section of the WAC:

(1) A massage therapist providing professional services to a client or patient must document services provided. Documentation should be appropriate to the venue, the type and complexity of those services and, when applicable, in sufficient detail to support and enable anticipated continuity of care.

The key to what is required is in the above bolded section. The type & complexity of the massage and venue determine the level of record keeping. For short duration massage, in which you generally do not see repeat clients/patients, do not have treatment-oriented massage, only minimal record keeping is required, such as:

(a) Client or patient name and contact information or name and contact information of a parent or guardian if a client or patient is a minor;

(b) Age of client or patient;

(c) Health history sufficient to ascertain if there are cautions or contraindications to safe application of massage therapy, and an update of the current health status at each session;

(d) Date massage therapy is provided and the duration of treatment;

(e) The types of techniques and modalities applied;

(f) The location or areas of the body that received massage therapy;

(g) Written consent to treat;

(h) If breast massage is performed, an additional written consent to treat per WAC 246-830-555, and documentation of a therapeutic rationale;

(i) If breast massage of the nipples and areolas are involved, documentation of the prescription or referral per WAC 246-830-555 (3)(a), or an additional written consent to treat per WAC 246-830-555 (3)(b);

(j) Documentation of any written consent or any modification in coverage and draping as required by WAC 246-830-560; and

If you don't do breast massage or undrape the breasts/gluteal cleft area in these short massages, then you can put aside section (h), (i) and (j) from above.

Before you roll your eyes at what is listed above, the next section shows how to make it simple.

The key to making the record keeping easy, is to: a) have it mostly preprinted out in advance and b) have the client/patient fill in the paperwork for you as much as possible.

Included at the end of this article is a sample record that you can modify to fit your own needs. It and versions of it has been used at a variety of events for many years. Here are suggestions on what you can do to adapt the form and make it more useful to you based on your own situation

Company Name -- There isn't much space on this form, so unless you have a small, horizontal logo, considering just including your business name.

Event Name -- If knowing which event/corporate client a client record is associated with, then include the event name/corporate client on the document. If you don't care and want to use the date or only have one gig, then don't include it.
- Events that change constantly -- if you work numerous different events throughout the year, you can choose to handwrite the event out so that you can have form pads printed out in bulk and save money from having to throw away unused forms that you've pre-printed out for an event with the event name on it but never used.
- Repeating events -- If you go to the same location or only have several events/locations that you work, just leave it off and go by date.
LMT -- If there are multiple LMTs working a gig, then require each therapist to print their name since signatures are not necessarily identifiable. If you run your own business and it's only you, leave it off.
Name and Contact Information -- Name, Phone, Address, and City/State/Zip are listed on this form, but the WAC only states "name and contact information". "Contact information" is up for debate on what this means. It could be interpreted to mean just phone number, or just email, or just street address. It's up to you to decide what to do. If you want to cover all bases for liability reasons (or to follow up in case of any payment issues), then ask for all of it.
Age -- Required.
Intake -- "Do you currently have any health issues that could affect today's massage?" Most clients/patients won't know. You may need to ask them more specific questions based on what type of venue you are in and the event you are doing. If possible, have the receptionist ask the client to put down as much information as possible, or have the LMT ask questions while taking the client back, or while the client is getting ready to get on the table/chair. Or, you can create a large print document that is easily readable, that stays at the front desk, telling clients/patients to indicate on the form if they have any of the listed conditions.
List the body areas you would like to have massaged --
- Smaller volume events -- if you don't have a large volume of clients registering at the same time, the form can ask them to list out the body areas they want massaged. Most people will put legs, arms, etc. If you need to be more specific, in case you might see them again, then go back and write in more specific details, but in general, have the client list the body areas.
- Higher volume events -- Eliminate the handwriting and include the small anterior/posterior SOAP chart body on your form instead. Ask them to circle the body areas. To create space for the body graphics, move the signatures to the backside of the form. Just know, it's been our experience that clients often get anterior and posterior legs confused when they circle legs, so you need to clarify this with the client before the massage. However, using preprinted bodies saves times compared to writing out parts. Also, clients can get more specific about the areas they want worked on.
Massage techniques used -- If you do only one or two techniques over and over, list them. If you do more than several, then list them and circle those that apply.
Disclaimer/written consent to treat -- Put whatever disclaimer/consent here that you want
Payment Policies: If you accept checks, you might want to state your insufficient fee policy. Put any payment policy here that you want.
Payment Reconciliation: Depending on how sophisticated you are with payment, you may want to leave all of these payment options, or take most away. If you work larger events with multiple LMTs, this line can help you to reconcile the money collected. The numbers at the right end of the line are number of minutes of this massage. You could put dollar amount here, but somewhere on this document the duration of the massage has to go. Since generally the same price is always charged per period of time (e.g., $17 for 15 minutes), unless you're charging different prices for the same number of minutes, you don't need to include price because you know the price based on the minutes of the massage. Also, short duration massage is often done in set amounts of time, so only list what your options are and circle the correct number. This can either be done by the client, or the receptionist if it's a larger event, or the therapist. But generally, whomever is collecting money and whomever is doing the massage should make sure that the number of minutes is accurate as generally this is how LMTs get reimbursed for their time if they are contractors (and clients don't like to be shorted on their time).
Parent/Guardian Permission: have the guardian fill this section out.
Extra space on back. If you have any kind of draping exceptions -- often men take off their shirts at sporting events -- you can put a quick statement about the WAC requirements on breast draping and a signature line. You can make a statement about this line being available for men only as only men can expose their chests in public without consequences (in most places).

Our suggestion is to print out your forms and try them at several events first and then change anything that doesn't work before you go to a printer (if you have high enough volume) and ask them to make your form into form pads. This way, you're not stuck with a lot of forms that don't quite work that you have invested a bit of money into.

To see the Event SOAP sample, click here.

Federally regulated Health Plans and Massage Therapy, by Dagmar Growe, LMT

Chelsea DeSouza — Wed, 16 Apr 2025 12:00:00 GMT

By: Dagmar Growe, LMT, WSMTA Support Group Moderator

There is a lot of confusion surrounding federally regulated health plans. The Every-Category-of-Provider statute requires that insurers

must not exclude any category of providers licensed by the state of Washington who provide health care services or care within the scope of their practice for services covered as essential health benefits (WAC 284-170-270). Since this is a state statute, it does not apply to anything which is regulated by federal law. This means that massage therapy benefits can either be excluded by federally regulated health plans, or be limited by any number of arbitrary rules the plan chooses. Because the customer service representatives are generally not very forthcoming with information, it is easy to end up with unpaid claims.

This article aims to shed some light on the different types of federally regulated plans and what to be aware of.

Federal Employee Health Plans (i.e. US Postal Workers Health Plan): These never cover massage therapy. However, I have been told otherwise by a customer representative, just to be told later “only if performed by a PT”.
Self-Insured Plans: Large employers or associations like trade unions may opt to create a trust fund for health care expenses, rather than to buy coverage from an insurance company. However, they may then hire an insurance company to administer the trust fund. The best-known example of this is Uniform Medical, which is a self-insured plan for WA State employees that is administered by Regence Blue Cross. Many Premera plans also fall into this category. These plans are regulated by ERISA (Employee Retirement Income Security Act of 1974, a federal law that sets minimum standards for most voluntarily established retirement and health plans in private industry to protect individuals in these plans). These plans may opt to provide massage therapy benefits, likely because of customer demand, but then apply additional rules that are generally not volunteered by customer service representatives. Here are some examples: “Yes, we cover massage therapy, but only if performed by a PT; but only if billed through a chiropractor, PT or MD office; but only if part of a PT treatment plan and the PT has to bill first”. Additionally, these plans may offer ridiculously low reimbursement rates or limit the number of units covered per treatment to less than 4.
Military Healthcare: Tricare started offering massage therapy benefits a few years ago. This is a voluntary benefit. Other military healthcare systems do not cover massage therapy to my knowledge.
Medicare: Medicare does not cover massage therapy. However, many Medicare Advantage plans will, although it seems the number of plans that do is declining. Do not assume that because a patient had massage benefits last year, they will this year! It is standard practice for Advantage plans to require a medicare denial before covering remaining expenses. The large insurance companies generally know that massage therapy is never covered, and that massage therapists are unable to obtain a denial, and do not ask for this. Some insurances (or some of their staff) do not understand this, and insist on the denial. In this case filing a complaint with the Office of the Insurance Commissioner will be helpful.

Delegating the research regarding plans to patients will not work, as it is important to ask the right questions. It may be helpful to ask if patients have had massages covered by their insurance before, but it will not be a guarantee that a claim will be paid.

Have questions or just want to understand more about how these programs impact your

work? Join WSMTA Support Groups! It's a welcoming space to connect with fellow massage therapists, share insights, and get the answers you’ve been looking for. Whether you're new to the field or a seasoned pro, you're not alone—we’re navigating it together.

Update On BOI Reporting for 2025

Chelsea DeSouza — Mon, 06 Jan 2025 19:43:47 GMT

Below is a summary of the latest developments surrounding the CTA and the steps required for compliance:

As you may know, On December 3, 2024, U.S. District Judge Amos Mazzant in Texas issued a nationwide preliminary injunction, temporarily halting the enforcement of the CTA. This injunction was granted on the grounds that the plaintiffs demonstrated a significant likelihood of success in their claim that the CTA violates the Tenth Amendment by infringing upon states' rights (Reuters). Following the decision, the U.S. Department of Justice filed an appeal on December 5, 2024, indicating its intent to challenge the court's decision.

On December 17, 2024, The National Small Business Association (NSBA) successfully secured a one-year delay in the implementation of the CTA’s Beneficial Ownership Information (BOI) reporting requirements. This postponement was achieved through a provision in a Continuing Resolution spending bill signed into law that day, funding the government through March 14, 2025.

On December 23, 2024, the Fifth Circuit Court of Appeals reversed the District Court's nationwide preliminary injunction. This decision reinstates the requirement to file Beneficial Ownership Information (B)I) reports. Businesses would have until January 13, 2025, to complete their filings.

On December 26, 2024, the Fifth Circuit Court of Appeals vacated its earlier decision, reinstating the nationwide injunction. This decision effectively halts the enforcement of the CTA until further notice.

Finally, on December 27, 2024, FinCEN announced that businesses are no longer required to file BOI reports at this time. While voluntary filings may still be submitted, mandatory compliance is suspended pending further guidance

Because the BOI reporting requirement seems to be changing, almost weekly, due to court challenges, WSMTA suggests that you sign up for alerts directly from FinCEN. Click the link below to see recent Alerts as well as sign up to receive alerts.

https://fincen.gov/boi

WSMTA is committed to Advocating for Massage Therapy in Washington State. To stay informed with essential news for this profession learn more here.

A Little More Cash (maybe) in Your Pocket: The New Federal Filing Update on BOI Reporting

Chelsea DeSouza — Thu, 19 Dec 2024 23:18:35 GMT

Yet another update to the required BOI reporting with FinCEN!

Updated January 6th, 2025 - In light of a December 23, 2024, federal Court of Appeals decision, reporting companies, with a few exemptions, are once again required to file beneficial ownership information with FinCEN.

Because the BOI reporting requirement seems to be changing, almost weekly, due to court challenges, WSMTA suggests that you sign up for alerts directly from FinCEN.

Please follow this link and you can see the recent Alerts as well as sign up to receive alerts.

https://fincen.gov/boi

This season, small business owners can breathe a sigh of relief (and maybe keep a little more cash in their pockets) thanks to a new federal filing update. Reporting companies are currently not required to file Beneficial Ownership Information (BOI) with FinCEN, nor are they subject to liability for failing to do so while this order remains in effect.

On December 3rd, the U.S. District Court for the Eastern District of Texas issued a nationwide preliminary injunction against enforcing the Corporate Transparency Act (CTA). This ruling questioned the constitutionality of the CTA and highlighted its potential impact on small businesses. The Department of Justice, on behalf of the Department of the Treasury, filed a Notice of Appeal on December 5, 2024.

Why Was FinCEN Started in the First Place?

The Financial Crimes Enforcement Network (FinCEN) was created in 1990 as part of the U.S. Department of the Treasury. Its goal? To act as a bridge between law enforcement, financial institutions, and regulatory agencies. By gathering and analyzing financial information, FinCEN helps detect and prevent financial crimes like money laundering and terrorist financing, both within the U.S. and globally.

What Does the CTA Require of Businesses?

Under the Corporate Transparency Act (CTA), certain businesses—mainly corporations, limited liability companies (LLCs), and similar entities registered to operate in the U.S.—Were required to report Beneficial Ownership Information (BOI) to FinCEN. This meant disclosing details about individuals who own or control the company.

While the CTA was designed to increase transparency and combat financial crimes, it has raised concerns, especially for small businesses. Many argued that the requirement imposed unnecessary administrative burdens and steep penalties for non-compliance, creating more stress for smaller entities trying to stay afloat. To be clear, there is no fee associated with filing unless a business chooses to hire someone to do the filing for them.

Temporary Relief for Small Businesses

Recently, a court issued an injunction that pauses the enforcement of these reporting requirements. This decision offers temporary relief, allowing small businesses to focus on their day-to-day operations without the added pressure of complying with the BOI filing rules—for now.

The pause gives businesses a breather, but it’s essential to stay updated on further developments, as the situation may change. Although it is not required businesses can voluntarily submit their Beneficial Ownership Information reports.

What does this mean?

Therefore, the CTA, 31 U.S.C. § 5336 is hereby enjoined. Enforcement of the Reporting Rule, 31 C.F.R. 1010.380 is also hereby enjoined, and the compliance deadline is stayed under § 705 of the APA. Neither may be enforced and reporting companies need not comply with the CTA’s January 1, 2025, BOI reporting deadline pending further order of the Court.

To read the statement: https://www.fincen.gov/boi

WSMTA is committed to Advocating for Massage Therapy in Washington State. To stay informed with essential news for this profession learn more here.

FinCEN Reporting Update

WSMTA — Thu, 12 Sep 2024 01:49:10 GMT

By: Elizabeth Jane Brooks, LMT, BCTMB

Recently, there has been some concern regarding whether or not non-participating spouses should be included when reporting at least 25% ownership of a business entity for FinCEN. Since WA State is a community property state, the assets acquired during the course of a marriage are generally acknowledged to be equally owned by both spouses. In light of FinCEN reporting, it is then likely that a spouse, even if they have no participation in a business entity, will need to report being a beneficial owner in the business entity. FinCEN has not yet specifically stated this to be the case, but it is implied and clarity is likely coming in the near future. Knowing this, you may want to include community property ownership as additional beneficial owners.

Full FinCEN Reporting article link from April 21, 2024

https://www.mywsmta.org/CPP-News/13346226

We are looking for a Membership Director

WSMTA — Mon, 24 Jun 2024 12:36:01 GMT

Are you looking for a way to give back to/promote the massage profession in Washington State (and make a few bucks on the side)? If you have skills in marketing, business administration, sales or school admissions, then WSMTA is looking for YOU.

The WSMTA Board of Directors is looking for a Membership Program Director (see position description here, Volunteer Position Descriptions You will be able to help create WSMTA’s Membership Program from the ground up. You will be a primary “face” of the organization, interacting with massage schools, current members and potential members. When certain membership goals are attained there will be a financial benefit for you!

If you are interested in being our Membership Program Director contact Marybeth Berney, WSMTA President, at mberney@mywsmta.org.

If you are curious about joining our band of passionate volunteers in clinical practices, government relations, editing and social media or as a Director– please email info@mywsmta.org and put “volunteer” in the subject line.

What You Need to Know About FinCEN Reporting

WSMTA — Sun, 21 Apr 2024 20:46:19 GMT

By: Elizabeth Jane Brooks, LMT, BCTMB

What is FinCEN?

Originally established in 1990, the Financial Crimes Enforcement Network is a bureau of the United States Department of the Treasury. Fundamentally, FinCEN is a network connecting law enforcement, financial, and regulatory agencies. Its purpose is to both gather and analyze financial information to fight against financial crimes (such as domestic and international money laundering, and the financing of terrorists).

FinCEN reporting went into effect on January 1, 2024 pursuant to the Corporate Transparency Act. It is important to consider whether your business must file this report regarding Beneficial Ownership Information (BOI).

What types of entities must file the FinCEN BOI report?

There are two steps in deciding whether or not a BOI report needs to be filed.

First, determine the type of entity of your business. Domestic companies that are required to report include corporations, limited liability companies (LLCs), professional limited liability companies (PLLCs), limited partnerships, or any other entity created which was filed with the secretary of state or a similar office. In addition, similar entities formed under the law of a foreign country and registered to do business within the United States are also required to file this report. Moreover, under some circumstances limited liability partnerships and business trusts need to file as well—for this, checking with your accountant is advised.

The second step is checking if your entity is one of the 23 types that are exempt from having to file, although the vast majority of massage practices will not qualify for these exemptions. (www.fincen.gov/boi-faqs). FinCEN provides a useful Exemptions Checker Tool to assess your qualification (www.fincenfetch.com/boi-report-exemptions/).

Important dates to c onsider

If your company was created or registered prior to January 1, 2024, you will have until January 1, 2025, to file your initial BOI report. However, if your company was created or registered anytime in 2024, you will have just 90 days to file your initial report after receiving notice that your business entity is legally recognized. This is important as you may be liable for significant penalties (and possibly even jail time) when failing to comply with the registration requirements. This can include filing false information or filing incomplete information. If you have missed a deadline for filing you may be able to explain your reasons and get a reduced penalty.

Additional links:

For more information: https://www.fincen.gov/

To file your report online: https://boiefiling.fincen.gov/

Filing dates graphic: https://www.fincen.gov/sites/default/files/shared/BOI_Reporting_Filing_Dates-Published03.24.23_508C.pdf

A YouTube walkthrough for online reporting: https://www.youtube.com/watch?v=5xOsSiQI-C8

Elizabeth Jane Brooks, LMT, BCTMB

WSMTA Board Director

Clinical Practices Committee

Washington State Massage Therapy Association

Visit us at: mywsmta.org

Upcoming Call to Action

WSMTA — Tue, 24 Oct 2023 20:29:12 GMT

We wanted to give you a heads up as the 2024 Legislative session grows closer (session begins 1/8/2024) that we will likely be reaching out to you to answer A Call to Action about one bill for sure.

The “for sure bill" is, HB1655 (and its Senate companion) An act relating to provider contract compensation. Informally this bill has been referred to as the COLA bill. If passed it would require health carriers to adjust reimbursements for those providers not affiliated with hospitals or their affiliates (think LMTs and Chiropractors as well as others) at the same level as the cost of living. To see more about the 2023 history of this bill click here. https://www.mywsmta.org/CPP-News/13245226

WSMTA works for YOU, licensed massage therapists in Washington state, Advocating for Massage Therapy as a Recognized and Respected Health Care Profession. Stay tuned!

Massage Therapy Insurance Provider Directory Audit

WSMTA — Sat, 16 Sep 2023 17:42:46 GMT

A WSMTA Clinical Practices Committee member, Julie Johnson, conducted an all-volunteer audit of the Regence Provider Directory from all over Washington. We wanted to have a focused effort to confirm what we’ve been hearing for years from our members and clients/patients – the medical insurance directories are inaccurate. With seventeen LMT volunteers (THANK YOU!), we could only confirm 176 individual licensed massage therapists out of 1078 directory listings were actively taking Regence in November of 2022. To read about the audit, our findings and what the OIC said, check out our article Massage Therapy Insurance Provider Directory Audit (link to https://www.mywsmta.org/page-1075480)

Julie Johnson, LMT, ACOM
Clinical Practices Committee
jjohnson@mywsmta.org

Washington State Massage Therapy Association
Visit us at: mywsmta.org

*****************************************************************

New LMT Support Group starting in November:

Many of us are working in isolation. Even in clinics with multiple practitioners, schedules usually leave little opportunity to connect with other therapists. WSMTA’s Clinical Practices Program will start offering monthly meetings to inform, discuss, vent, problem solve, and support each other. Meetings will happen on Zoom on the 1st Monday of each month, starting November 6th 2023, from 7 to 8:30pm.

Meetings are open to members, and non-members. Depending on topics, CE credits will be available for free to WSMTA members. Non-members may join WSMTA to receive free credit as well.

Please email Dagmar Growe at dgrowe@mywsmta.org to receive the zoom link before the meeting. Due to a prolonged absence, expect to receive the zoom link the day before the meeting.

WSMTA Clinical Practices Program also offers “Best Practices”, a support group for therapists and clinic owners which takes place every other month Wednesday 8 - 9am. Please email srosen@mywsmta.org if you would like to be included on the invitation list. These meetings are held on Zoom.

Success: Insurance Reimbursement is Finally Increasing!

WSMTA — Thu, 24 Aug 2023 18:56:26 GMT

By Dagmar Growe, LMT

When WSMTA was founded in 2015, two of our goals were to work with insurance companies toward making processes less cumbersome for LMTs and patients, and to work toward a badly needed increase in reimbursement rates. Most of our founding members had been around since the late 1990s when insurance companies sought out their advice on how to implement the new requirements to cover massage therapy and we were hoping to build on those relationships.

Almost immediately after our founding, we had to face some difficult facts, WSMTA learned that advocating for a rate increase as an organization would be a violation of antitrust law. We also learned that insurance companies were not at all interested in communicating with anyone to help solve problems with procedures. Provider reps changed frequently so we were not able to build consistent relationships. Supervisors made themselves unavailable. In fact, with some health insurance companies, it seemed that not resolving problems was part of a strategy to discourage enrollees from using benefits, and to encourage massage therapists to withdraw from networks.

WSMTA had to change strategies, so we started to focus on alternative payment options and the issue of provider network adequacy - or the lack thereof. We focused on the following:

Educating massage therapists about accessing patient benefits and payment through their flexible health savings accounts.
Encouraging massage therapists to do a cost analysis so that individual businesses could assess if being a provider for a health insurance company was economically viable for their business.
Educating massage therapists about contract violations. For contracted providers, it will generally be a contract violation to deny appointments to insured patients while offering them to non-insured clients. We encouraged massage therapists to choose between either honoring their contracts or canceling them in order to avoid violations.
Encouraging massage therapists to have their patients complain to their HR Departments and the Office of the Insurance Commissioner (OIC) if they were unable to obtain treatment in a reasonable timeframe.
Conducting an audit last fall, with a handful of dedicated volunteers, of one insurance company’s massage therapy provider directory. WSMTA found that the directory was inflated due to duplicate provider listings, listings of providers no longer contracted or not taking insurance any more, and retired LMT’s. We shared our findings with that insurance company, the OIC, and all legislative representatives on healthcare committees. And, we informed a number of other companies that we were planning on conducting similar audits of their directories.

And finally, this summer, everyone’s efforts have started bearing some fruit. After years of mainly decreasing rates, Kaiser announced a rate increase. Regence has also announced a rate increase, (although they moved all 3 CPT codes that LMTs were using to the same reimbursement level so therapists who were eligible to use and have been using 97112 will not see much of an increase).

We are proud of this achievement which is shared by WSMTA and all massage therapists who did their own homework, said no to unsustainable rates and decided for themselves what worked best for their business. For many, this meant taking what could feel like a risky step by canceling their contracts rather than continuing to hold out in hopes that things might somehow get better on their own. Thank you also to massage therapy patients who lobbied their insurance carriers to increase treatment access. It is our hope that the remaining health insurance companies will realize that they cannot find providers unless they are willing to reimburse us at an acceptable rate.

These changes did not happen because insurance companies saw the light and wanted us to receive fair pay. It happened because LMT’s educated themselves and took action. Thank you to all of you who have worked behind the scenes for these changes. And, if you are not yet a member of WSMTA, I do encourage you to join today both as a member and a volunteer. Improvements happen, but they do not happen unless we are willing to fight for them!

HB1655--the Cost of Living Allowance (COLA) Bill

Robbin Blake — Wed, 23 Aug 2023 17:19:26 GMT

In the 2023 legislative session, the Washington State Chiropractor’s Association (WSCA) helped to initiate and heavily pursued HB1655, the Cost of Living Allowance (COLA) bill, which would require health insurers to include a COLA increase in provider fee schedules for those not attached to hospitals or hospital affiliates.
When WSCA put out the call to action to its membership to get involved, WSMTA picked up on the information and passed it forward to massage therapists in our state, but it was too late in the process to provide any substantial support.
Although the bill was well-received; there just was not enough grassroots support for it to move out of committee.
In the 2024 legislative session, WSCA will be seeking a companion bill in the Senate to increase the chances of success for COLA as well as pursuing it again in the House.
Currently, massage therapists are in a different place than chiropractors. Recently, health insurance companies have made substantial improvements to reimbursement rates for massage therapy services. However, chiropractors have not had any substantial change for about 20 years.
Over the next several months we will keep massage therapists updated about COLA as well as to provide recommendations on what massage therapists can do to promote COLA with legislators.
For information about the 2023 COLA bill, just click on this link: https://app.leg.wa.gov/billsummary?BillNumber=1655&Year=2023

Election

WSMTA — Wed, 24 May 2023 15:00:39 GMT

By Dagmar Growe, LMT

I have been honored to serve my profession and my fellow massage therapists for the past 7 years as a board member of WSMTA. I love the connection to the amazing people who are leading this organization, and our members. When I started I didn’t know what a WAC was (the rules that govern our profession), or how to find them. My insurance billing was based on a mixture of rumor and guessing. And I felt a sense of isolation, as I was practicing mostly on my own. Stepping up and volunteering for WSMTA has been a huge benefit for me.

I am now in what I hope will be a drawn out final stage of a 30+ year career. As I am shifting my focus to things other than work and family, I have decreased my work time and canceled my health insurance contracts. I am traveling a lot and keep missing WSMTA meetings. I am losing my enthusiasm for taking on insurance companies.

Many of the folks who guide and protect our profession through their volunteer service for WSMTA, AMTA-WA, or the Board of Massage, have done this for 30+ years. They have brought us from being an obscure profession with a dubious reputation into the 21^st century: We are accepted as healthcare providers, our patients seek our expertise for their health issues, doctors refer to us, and yes, well, insurance companies reimburse for our services – kind of. None of this has come easy, every step was fought for, and there is a constant pressure all around us to reverse this progress. Municipalities write codes that discriminate and aim to limit our scope of practice in the name of fighting human trafficking. Insurance companies try to limit coverage for massage therapy, or to make processes so cumbersome that we would give up and go away. I believe massage therapy as a healthcare modality does not have a future unless we keep fighting for it. There is an urgent need for younger therapists to be trained to step in to take our place as this current generation of therapists transitions out.

I have therefore decided to step down from my position as a WSMTA Board member and make room for someone who has a longer professional life ahead of them, and more energy and investment. Please notice that I did not mention “more time”, as just about nobody I know has extra time on their hands. However, a wise friend of mine once told me: “I don’t have time, I make time. For what’s important to me.” And my profession has always been important to me. I am planning to continue to be involved actively, mentoring younger therapists, giving more of my attention to South Sound LMTs, a local networking group that I have been part of since I first got licensed, and you might see the one or other article I feel compelled to write for WSMTA. As a lifetime member I will continue to be part of it, giving my time to the occasional project.

What does this position entail? Board members are also part of one of our programs (in my case Clinical Practice, there are also Membership and Government Relations). That’s 2 phone or zoom meetings a month, a total of about 4 hours, which count towards your continuing education hours. Whatever board members contribute beyond those meetings is mostly based on their interests and the time they are able to make available. My contribution has mostly consisted of writing articles, researching information, answering member questions, and taking minutes at meetings.

If you do care about our profession, and want to see it thrive in the future I very much encourage you to start volunteering now. Bylaws require that members serve actively for 6 months on one of the programs before being eligible to serve as a director. Please do not hesitate to nominate yourself or contact us to let us know in what function or area you would like to volunteer. Your service is needed to ensure the viability of our profession in the future.

Understanding Healthcare Provider Contracts Webinar

Julie Johnson — Sun, 23 Apr 2023 22:51:26 GMT

REGISTER HERE

This is an affordable opportunity for a group legal consult with John Conniff, a highly knowledgeable and experienced healthcare attorney. John provided a comprehensive review & analysis of the Regence Provider Agreement in 2022.

This webinar is interactive, focusing on our shared concerns as well as your specific questions regarding the Regence Provider Agreement.

Our goal is to understand the provisions and requirements stated in a provider agreement before we sign it and gain knowledge to question provisions that are not in our best interests or even legal.

An example is Regence declares the contract itself is "confidential and proprietary", it is not. In addition, there is contract language that conflicts with Washington State law. Washington State law supersedes the contract language.

Please join us for an interesting and useful workshop on a topic that affects all insurance providers.

This webinar satisfies the Washington State 4-hour ethics requirement.

Dates: Monday, September 18th, 2023 from 7 - 9pm for Session 1 and TBD for Session 2. Registration closes on September 11th.

Location: Live Webinar via Zoom

Cost: $120 for those who have already purchased the Regence Provider Agreement review done by John Conniff. $220 for those who have not previously purchased the review document – the price includes the $100 review document.

CE Hours: 4

Terminating an Insurance Contract

WSMTA — Wed, 22 Mar 2023 14:46:30 GMT

by Elizabeth Jane Brooks, LMT, BCTMB

If you have contracted with an insurance carrier there may come a time when you wish to terminate that contract. Following are some suggested steps for getting this accomplished.

1. Obtain access to your contract

When the decision has been made, you need to look at the requirements in your specific contract. If you have a copy of your contract, this is easy. For many, you will need to obtain a link from the insurance carrier with an access code to open the contract file online. Contacting your insurer’s representative, or your Provider Relations Representative (if they have one), is an effective way to do this.

2. Locate termination requirements

Once you have your contract, locate the section on terminations to find the exact requirements. Some things you need to know are:

Do you need to send a certified letter?

What needs to be stated in your letter?

Where to send your letter?

To whom should this letter be addressed?

How much notice must be given?

Keep in mind, termination must be done in writing. For this, sending it by Certified Mail is a great way to prove the writing was both sent and received. In addition to notifying the insurance carrier, if there is an administrator for the insurance, such as Tivity/WholeHealth or Community Health Plan, they will also need to be notified.

Below is a sample letter that you can tailor to your situation and use for termination. It has not been reviewed by an attorney, however, it is what a current member used to successfully terminate their own contract. Remember, your contract will tell you exactly what needs to be included in your letter of termination.

——————————

Attn: [Department, representative, etc.]

BY CERTIFIED MAIL, RETURN RECEIPT REQUESTED

To Whom It May Concern:

This letter constitutes notice that I am voluntarily terminating my contract with your company and all its affiliates at the earliest date allowed by the contract. [Reason for terminating.] Thank you for the many years of partnership. My NPI number is [XXXXXXXXXX].

Immediately upon the effective date of this termination, I will then be out of network with your company, and all patients in your plans will be expected to pay my out-of-network fees.

Please let me know promptly if you have any additional requirements concerning my contract termination.

Sincerely,

[Full name], LMT

——————————

WSMTA hopes you find this information useful, and we acknowledge that understanding contracts can be challenging. If you still have questions or concerns regarding terminating properly, it would be wise to consult your attorney.

We at WSMTA do our best to stay on top of the latest news in massage, especially as it relates to laws, insurance, and business. We hope you find the articles on the website helpful (mywsmta.org). We also hope that you will consider joining us as a volunteer—you will make strong connections, gain support, and be at the forefront of the massage industry!

___________________

SAVE THE DATE

Understanding Healthcare Contracts

New May TBD via Zoom

2 CE's

Excellent opportunity to consult directly with John Conniff, healthcare attorney, who provided a comprehensive review of the Regence Provider Agreement. Get your questions answered, understand provisions and requirements included, some of which are not enforceable. More information to follow. The Regence contract review can be purchased on our website.

Healthcare and Capitalism: Why does our Healthcare System Work for (almost) No One?

WSMTA — Mon, 20 Feb 2023 05:50:04 GMT

By Dagmar Growe, LMT

Here in the US our economic system is unapologetically based on the tenets of capitalism: The maximization of profit and a free market to manage the distribution of resources. In many ways this works really well. Cousins of mine who lived under the planned economy of former Eastern Germany will assure you as much.

Massage therapy, the self pay kind, is a good example. Prices are based on a variety of things: The quality of massage and marketing skills of the therapist, and the economic makeup of the clientele. Are you working at an upscale spa in an affluent area, or in a small town with low wage jobs? Are you trying to fill your schedule, or trying to work less? Lower or raise your prices, and things will sort themselves out accordingly, at least in theory.

But there are some conditions under which this system is bound to fail. First, if a person's life depends on a product, like food, housing, or medical care, then they are forced to pay whatever the asking price is. This situation is more akin to blackmail than a free exchange of goods. We are seeing some of this with housing and pharmaceuticals.

Secondly, a functioning free market depends on multiple participants to allow for competition. Many areas have 1 or 2 insurance companies that dominate the local market. This lack of competition allows them to take an attitude of "Take it or Leave it" with providers. And as we have repeatedly pointed out, in the name of free market competition, individual providers are banned from uniting for the purpose of negotiating better pay. This puts big health care organizations at an advantage as they too have regional monopolies and can use those to negotiate individual contracts for their organizations. Unfortunately, non-allopathic care is not generally of interest to those organizations.

And finally, the insurance system puts multiple middle agents between the provider and the patient (aka the "consumer"). If I provide massages to self paying patients those patients are my customers. They get to decide if my treatments are worth the price. Interestingly, if I provide a treatment under an insurance contract, that patient is no longer my customer, the insurance company is. And even more complex, the insurance company's customer is not my patient but the HR Department of my patient's employer. And in some way, the employee could be seen as the customer of their employer. This is where profit, or savings, maximization come in. The HR Department wants to buy a health plan for the lowest price they can get that still satisfies their employees needs to some extent. The insurance company calculates their prices to be competitive, while at the same time profiting as much as possible, meaning paying out as little as possible. Patient and provider actually have no relationship at all in an economic sense. The patient has to take whatever provider is contracted with the plan, and the provider has to accept whatever rates the insurance company offers or cancel their contract..

Where does that leave us? Any change needs to follow the convoluted path of market place relations. Once employees (who are allowed to organize) complain to their HR departments about the lack of an adequate network, then it could be hoped that HR departments would put pressure on insurance companies to improve their network. And if insurance companies cannot find sufficient providers at the rate they offer, then and only then would there be an incentive to raise reimbursement rates. Massage therapists keep asking the question: When will insurance companies increase their rates? And here is the answer: Why should they? They are for profit businesses, maximizing profits, which is exactly what their shareholders want them to do.

So what can we as providers do: First, we can refuse contracts that do not offer us a living wage. As long as a sufficient number (by whatever standards) of massage therapists are willing to accept current rates there is no need to change, from the perspective of the insurance companies. Being a contracted provider but limiting the number of patients one is willing to treat under a certain plan is both a contract violation under most contracts, and inflates the number of therapists available in a network. Secondly, we need to educate our patients why we are not accepting their insurance, both for financial and administrative hassle reasons. We need to encourage them to document their difficulty finding a provider, and complain to their HR departments and the Office of the Insurance Commissioner (OIC) if they cannot get the care their health plan offers. Third, LMTs need to increase their level of political involvement. Most healthcare provider associations spend tens or hundreds of thousands of dollars on lobbyists. They get that money from their members who recognize the importance of having their interests protected. If you have been around long enough you may remember Insurance Commissioner Deborah Senn who brought complementary care into the mainstream. She was elected with a lot of support from professional organizations.

It is important to keep in mind that everything will be a slow uphill battle every step of the way because the system is not meant to provide healthcare but to provide profit. But to do nothing means giving up on massage therapy as a healthcare modality being offered on par with other modalities. We have gained so much in the last 30 years - let’s make sure we don’t lose it.

And lastly, here is one piece of good news: As of the publication of this article - House Bill 1655 is being considered by the legislature. The bill recognizes that small groups and individual providers have no power within the system to negotiate reimbursement rates, and requires automatic cost-of-living increases. Please follow the bill’s progress and contact your legislator if the bill makes it to the voting stage. Watch your WSMTA mails for updates.

United Healthcare to Increase Market Share

WSMTA — Mon, 09 Jan 2023 23:00:43 GMT

By Dagmar Growe, LMT

LMTs will likely see an increase in Uniform Medical insured patients looking for a United Healthcare provider. Premiums for Regence Uniform plans for retired members for 2023 have increased significantly so people are looking for cheaper options, one of which is United Healthcare. Please note that

United Healthcare is separate from Regence. This means you have to apply to them to be a provider. It also means you should not expect that their reimbursement rate is the same.
Some United Healthcare Uniform plans do not cover massage therapy. Uniform Medical is a self-insured plan. It is a trust fund for health care expenses financed by the State of Washington for its employees, rather than coverage bought from an insurance company. However, Uniform hires insurance companies to administer the trust fund. These plans are regulated by ERISA (Employee Retirement Income Security Act of 1974, a federal law that sets minimum standards for most voluntarily established retirement and health plans in private industry to provide protection for individuals in these plans). Because federal law supersedes state law, Washington’s every-category-of-provider provision does not apply to these plans. They may opt to provide massage therapy benefits or not, and they can apply additional rules which are not always clear. We know of at least one plan that offers benefits for acupuncture and chiropractic care but not for massage therapy.
Some plans may offer the option of out-of-network benefits, allowing you to bill even if you are not a provider. This usually offers better pay because you have not agreed to the company’s rates. You can also offer to provide the client with a billing statement or receipt so they can apply for reimbursement if the plan allows.
Remember HSAs (Healthcare Savings Accounts) and FSAs (Flexible Spending Accounts) . You can offer to accept payment through those if you are set up to accept credit cards. Make sure you are registered as a healthcare provider with your payment processor.

As always, if you choose not to be a provider, educate the client about your reasons. I have found that most patients are appalled when I tell them what the insurance companies would pay me and how much work would be involved.

What constitutes our Intake paperwork?

WSMTA — Mon, 21 Nov 2022 21:22:35 GMT

By Joshua Elan & Susan Rosen

Of course we have basic personal information and health history, and these days we have Covid policies. We've always had a bit about our office policies, but it was time to rethink what might have once been either too brief or overly convoluted.

In that spirit, we have been developing a document to clarify our framework of care goals. One primary concern is clarity of communication. One key element of communication is an explanation of what constitutes care, the LMT’s responsibilities and the patient’s responsibilities therein. Another vital piece is to make more clear the facts and expectations of insurance billing for those that are utilizing insurance.

Combining and clarifying our office policies into one more vital - and easy to read document has been a long time coming, and we hope you like the result. We are about to begin 'road testing' this new part of intake with patients, but it is not set in stone: we welcome your thoughts on how to make our intake paperwork process even better.

SRA Philosophy of Care Draft 5a - Google Docs.pdf

Two Financial Paths for the Massage Therapist

WSMTA — Fri, 21 Oct 2022 15:07:52 GMT

By Elizabeth Jane Brooks, LMT, BCTMB and Dagmar Growe, LMT

We at WSMTA hear many complaints from massage therapists regarding how difficult it is to make enough money to support themselves and their families through massage. As seasoned massage therapists, we would like to pass along some advice which we hope you will find helpful.

With massage there are basically two paths to earning money, working for someone else or working for yourself. Another way to look at it is, there’s the easier way and the harder way. Let’s examine the two paths.

The Two Paths

When we first graduate from massage school we have some knowledge but we are inexperienced. A great way to gain experience is to work for someone else, such as a clinic or a spa. They can send you a steady stream of patients, helping you to gain experience. This usually comes at the cost of low pay (anywhere from $15 to $40 per massage). Therapists that stay working in this type of arrangement tend to overwork trying to make ends meet. Many therapists become burned out or injured, and end up leaving the profession.

If the newly graduated massage therapist decides to work for themself, the struggle is in getting a steady stream of patients. However, if they are able to gain a few good sources for referrals to their practice, the income will be much higher than what is received if working for someone else. This, too, comes with the cost of having to learn all the behind-the-scenes work like setting up a business, advertising, purchasing, billing, taxes, etc., all at once and often in isolation.

For most therapists, working for someone else is easier at first, but in the long run it is more strenuous and less financially rewarding. While working for yourself requires an investment of time and energy that is not necessarily immediately rewarded, it eventually offers more freedom, flexibility, and income.

A good suggestion for someone just starting out would be to work for a clinic for 1 to 2 years and then branch out on your own after gaining some experience, because the best way to make a lot of money with massage is by working for yourself. It is not hard to learn how to manage your business but it does take time and steady devotion. Therapists who are willing to do their own scheduling and billing can operate a business at very low cost which means a high profit margin per massage. It does require a certain amount of entrepreneurial spirit and the willingness to manage fluctuating income. Paying for the training you need from those that have successfully created a busy practice, and investing in building one's skills to set oneself apart from the competition, are well worth the money. You will save steps and time, and make even more money than those trying to reinvent the wheel by learning everything on their own.

However, therapists who do not want to work for themselves do have options for increasing their income. Here are some examples:

Branch out and start your own practice part time.
Remain working for your employer and negotiate a raise for your work.
Get a job working at a high end spa, which normally pays better, plus, the tips are usually quite generous.
Charge for extras, like hot stones, arnica application, aromatherapy, herbal packs, etc., and negotiate with your employer that the income generated goes to you not the employer.

Where it All Leads

It is interesting to note that the entire field of massage therapy over the last 20 or so years has shifted from predominantly self-employment or independent contractors to employment. Some of this has been driven by legal changes, specifically enforcement of labor laws regarding independent contractor status. The medical field in general has seen a move towards larger clinics with employed providers - there are hardly any independent doctors or other providers left. What sets us apart from most of the medical field is the fact that our patients are more likely willing to pay out of pocket for our services. In addition, we do not need lots of staff and office space.

However, if less of us are willing to take the risk of independence, if less of us are willing to fight for our profession, to engage and be involved with making the rules that determine our scope of practice and our rights to practice, if more and more of us are happy to let someone else handle these things for us - we may find one day that we will no longer have the opportunity to work on our own. Earning a good living with massage therapy may have become a thing of the past.

We hope this sparks a few ideas to explore and ends with you making the money needed to more than survive, but to actually thrive.

Call for Volunteers

WSMTA — Mon, 19 Sep 2022 15:34:41 GMT

The Washington State Massage Therapy Association (WSMTA) is conducting a Medical Insurance Survey to determine if they are maintaining an accurate provider directory of contracted, active licensed massage therapists in our state. This directory must be updated monthly and certified with the OIC that it is current and accurate in accordance with WA state law. This directory is also the foundation to know if there are enough credentialed massage therapists with current, signed contracts in each region of our state with each medical insurer.

With the input of the Office of the Insurance Commissioner (OIC), the WSMTA is going to conduct a survey in November to check the accuracy of these directories. We need volunteers to help. There will be a brief training the first week of November via Zoom, volunteers will be given the entire month of November and part of December to call as many practitioners listed in the directories as they are able and they will document the accuracy of the information. The more volunteers we have, the more practitioners we can call, the more regions we can cover and a more accurate accounting will be gained. You will not need to travel to volunteer. Training will be done via Zoom. You will need a phone, computer and internet connection to participate in the project. Calls can be made in your free time. The project has a hard deadline in mid-December when your time will no longer be needed. You do not need to be a massage therapist to volunteer. If you know of anyone that may be interested in helping – clients, friends of massage therapy, retired parents, they are welcome as well.

To volunteer or for more information, please contact Julie Johnson at jjohnson@myWSMTA.org with the subject “Volunteer for WSMTA Insurance Audit”.

If you are unable to volunteer for this project, you can still be an active participant in our efforts with medical insurance companies.

- Make sure your information in the Provider Directories is accurate and get it updated if necessary.

- Canceling your contract? This must be in writing and tell them WHY. If you do not cancel in writing, you are still considered a contracted provider.

- Unhappy with your agreement, communicate and negotiate. Assume they need YOU. Don’t give up!

- Unhappy Clients/Patients, tell them why you’ve stopped accepting the insurance or are no longer accepting new patients. Encourage them to contact their insurer. If they are experiencing a delay in their care or are unable to find a practitioner in their area, they should contact the OIC. The OIC is there to advocate for the insurance consumer - not the practitioner - not us. Until patients complain about their inability to get access to massage services, nothing will change. YOU need to explain this to them and ask them to act. They can also volunteer for our insurance survey. Have them contact Julie Johnson at jjohnson@myWSMTA.org. .

- Go forth and share this with all WA Massage Therapists!

Jane Brooks wrote an excellent article on Insurance Network Adequacy which inspired this insurance survey effort.

For more information, visit WSMTA and our Clinical Practices Committee page.

Monkey Pox Protocol

WSMTA — Wed, 24 Aug 2022 20:23:09 GMT

By Robbin Blake

Currently, Monkey Pox (MPV) is in the news and WSMTA has received quite a few questions about it. The Washington State Department of Health (DOH) has a website page that provides very thorough information about the virus – you can see pictures of what it looks like, read about how and where it is spread and what to do if you are exposed. Fortunately, the virus has very defining characteristics and is mostly transmitted with direct contact. From the information on the DOH website you can create intake questions if you feel that you have the possibility to be exposed. If you feel that the person on your massage table may have MPV then do exercise your pathogen protocols that you have in place for handling linens the person came into contact with, disinfecting equipment in the room and washing your hands and forearms. As we are required to wear masks during massage still at this point, this protects against the smaller possibility of airborne transmission.

For details about the monkey pox virus, please see the following websites:

DOH: https://doh.wa.gov/you-and-your-family/illness-and-disease-z/monkeypox

CDC: https://www.cdc.gov/poxvirus/monkeypox/index.html

WA Retirees protest when PEBB tried to take away health benefits.

WSMTA — Fri, 22 Jul 2022 23:11:31 GMT

By: The Olympian

We highly recommend this article summarizing the Public Employees Benefits Board meeting and their decision not to terminate Uniform Medical Retiree plan, (which is currently administered by Regence BlueShield).

It's an excellent illustration and inspiration of how collaboration and forging alliances between advocacy groups, patients, providers and other stakeholders can work.

Stay tuned as CPP plans to consult with Laurie Weidner, executive director for the Retired Public Employees Council (RPEC) on strategies to forge such alliances.

Please click on the link below to read or to listen to an audio version.

https://www.theolympian.com/news/politics-government/the-state-worker/article263196203.html

WA retirees protest when PEBB tried to take away health benefits | The Olympian

Weidner explained that the process required a lot of public engagement with the issue before the board committed to the resolution last week to postpone a decision on UMP until Jan. 1, 2024.

www.theolympian.com

Network Adequacy

WSMTA — Sun, 22 May 2022 15:12:31 GMT

by Elizabeth Jane Brooks, LMT, BCTMB

Last month, WSMTA asked our members if they were turning away insurance patients. In response, 20% said no (with some saying they would like more) while 73% said yes. Of those who said yes, 33% said they terminated some or all of their insurance contracts. These results lead to a recent board discussion on network adequacy and how some therapists have unfounded concerns over not taking new patients.

To begin, what exactly is network adequacy?

In order for an insurer to deliver their members medical benefits, they are required by law to supply a geographic area with an adequate number of in-network providers capable of providing those services in a timely manner. To do this, they create provider panels: listed as directories of contracted providers. If an insurer can show that it has an adequate supply of providers, it will close their provider panel and no longer issue new provider contracts. Because of this, it is important to let the insurer know when you are not accepting new patients. If medical providers inaccurately report that they are accepting new patients, the insurer cannot accurately determine if there is a need for additional providers.

When there is network inadequacy, it’s common to hear patients complain about how long it takes to get an appointment with their healthcare providers—and we’re hearing this more and more. With the proliferation of narrowing health insurance networks, it is vitally important for us to be part of the solution.

Some participating providers are concerned that if they report being closed to new patients it will negatively affect them and their contracts. To be sure, this is not just an issue for massage therapists, but for all healthcare providers. However, this concern is unfounded. Reporting that you are not currently accepting new patients will not harm your contract or reflect poorly on you. Instead, it will have the opposite effect: it will show that you and your services are in demand.

Faulty information impairs the entire system. In order for insurers to provide their members with the required number of providers, it is imperative that they have accurate information so that they can properly determine their adequacy. Accurate reporting and frequent status verification, therefore, is a best practice that helps insurers both credential a sufficient number of providers for their members and allows newer practitioners to become contracted. It helps everyone.

With all the issues facing insurance in our industry, accurately reporting our status is one critical way we can both encourage and reward good insurance practice.

Upcoming Event: Register Today

WSMTA Annual Meeting. June 26 2022 -Empowering LMT's and Clinic Owners in an Insurance Dominated Environment.

EVENT DETAILS:

Please join us for the 2022 WSMTA Annual Meeting, including continuing education!

This year we have chosen to meet once again via Zoom. We have realized that this format has allowed us to reach LMTs well beyond the greater Seattle/I-5 corridor areas, so we are continuing in an online format.

This year's theme is:

Empowering LMT's and Clinic Owners in an Insurance Dominated Environment.

We have a lineup of three very knowledgeable presenters. Here are the logistics of the Annual Meeting:

Day: Sunday, June 26, 2022

Time: 9:30 am - 2:30pm PDT

Where: Zoom

CE Hours: 4 hours

John Conniff, Attorney:

John Conniff combines his broad background and practical knowledge to help clients find workable solutions to difficult problems. For over 25 years, he has counseled individuals, businesses, professionals, legislators, and government officials. In addition to running a law firm, John is a serial entrepreneur. He has owned or co-owned small businesses including Healthy Patients | Healthy Lives, providing business services to small health care practices and a multi-media company – JJP Media.

His wide range of experience provides him with insight into the complicated connections between business and law. He has worked extensively on employer issues, business contracting, insurance regulation, information privacy and security, health care regulatory

compliance, ERISA, and business transactions. John is a local attorney who has a decades long history with healthcare law and massage. He will be presenting on the topics of:

Competition law and healthcare networks
Antitrust and related business practices law
Supply and demand (with regards to massage)
Network adequacy and directory accuracy

B.J. Erkan, LMT:

While serving in the US military in 1990, B.J. hurt his back and experienced a musculoskeletal injury from the patient’s point of view. He was referred to a naturopath that had been previously trained in bodywork. Extremely skeptical at first, B.J. had a life changing, perspective shifting experience. Realizing he was meant for different things, he and his family moved to the Seattle area in 1991.

B.J. graduated from the Brian Utting School of Massage in 1994. Soon after being licensed, He had the opportunity to treat an MD with severe low back pain, and became known in the Kirkland area as a therapist who could effectively treat musculo-skeletal pain. In 1997 He began teaching massage anatomy and physiology at Bastyr University. In 1998 B.J. moved from Kirkland to Bothell and opened Bothell Integrated Health (BIH), LLC. Since then he and the BIH staff have given over 200,000 massages to people from Bothell and the surrounding areas. He also enjoys teaching CE classes to the BIH staff, and other therapists, and has taught, by request, at other medical massage clinics. BJ will be discussing:

History and economics of the massage business and how this relates to the formula of price setting and the importance of the collection of data of actual overhead costs in a variety of settings.
The downside of signing contracts for low pay and how that affects the entire profession.
The power of “collaboration and solidarity” amongst massage therapists, massage clinics, massage profession associations and other allied professional associations.
How to empower providers and our patients to create positive change in reimbursement rates.

Jane Brooks LMT:

Jane runs a private therapeutic massage practice dedicated to injury treatment and chronic pain relief. She is a board director with WSMTA, educator, writer, business consultant and the inventor of a patented seamless face cradle cover. As a seasoned therapist who has successfully navigated poor economic times, decreasing insurance rates, excessive demand for service, and Covid-19, she has a keen interest in helping others create their own sustainable and lucrative practice. Jane has been strategic in growing her practice to include multiple streams of income and moving from an insurance to a cash-based practice—all while charging premium prices, working fewer hours, and teaching others how to do the same. Jane will talk about:

How to increase revenue and stability with your insurance based practice.
How to transition from an insurance-based practice to a cash-based practice.
Ideas for potential additional financial streams and strategies.

ADDITIONAL INFORMATION:
Zoom attendance is 100 participants. We plan to record the meeting for later access and viewing.

WSMTA Raffle Prizes for June 2022 Anual Meeting.pdf

Regence Legal Review: The Power of Collaboration

WSMTA — Sat, 16 Apr 2022 02:17:26 GMT

by Dagmar Growe LMT

There is an ice axe on the wall above the row of cash registers at my local REI store. A sign next to it explains the significance: A bunch of decades ago, some NW mountaineers decided to band together so they could negotiate better prices for their equipment – like ice axes. I wonder if any of the folks involved imagined their little co-op becoming the retail giant it is today!

It is stories like this that I want to keep in mind when dealing with situations as frustrating and overwhelming as massage therapists’ struggles in dealing with insurance companies. We have written in the past about the problem with “negotiating” collectively: US antitrust law which was created with the goal of protecting consumers against large and powerful companies, in a perverse twist of circumstance, is now protecting large and powerful companies against consumers (who can’t find a massage therapist to work with them) and small business owners.

And yet, just like those ice axe purchasers we can still marshal the power of the collective in a legal way. A great example is the collective purchase of legal services. Some Regence contracted LMTs had concerns about the latest contract that was sent out a few months ago by Regence. A respected and highly experienced healthcare attorney, John Conniff, provided the Washington State Massage Therapy Association (WSMTA) a legal review of the new Regence agreement We all know that legal services are expensive, and this lengthy contract and regulatory filings (228 pages) required many hours of work and resulted in a 13 page legal review that details the commitments that therapists enter into, the inconsistencies, and the conflicts with Washington statutes that exist in the contract. If WSMTA was charging hundreds of dollars in membership fees per year like other professional organizations (Chiropractors, PTs) we would gladly make the review available as a membership benefit. Given our current membership price, we have to handle legal reviews like the ice axe guys: Everyone pitches in and we all win. The review will be available to members for $100 – the cost of 1 massage (well, not an insurance massage) If you are not currently a WSMTA member you can go to our website, become a member for $40 and then be eligible to purchase the review for $100.. Your payment helps us to continue to provide services like this in the future.

Now, of course, you wonder: why would you want to know everything that is wrong with this contract, as you don’t have the power to negotiate a different contract with Regence’s non-existing provider service. We will share one bit we learned from the review upfront: The contract states that it is a confidential document. Not true, according to Mr. Conniff, healthcare contracts like this have to be filed with and approved by the Office of the Insurance Commissioner, and then are placed on their website, which makes them public information. This means we can legally talk about the contract. You also might want to know which parts of the contract are legally enforceable, and which are not! And then, depending on your circumstances, you can make an educated decision on whether to sign or not, or if you already signed, if you want to cancel or not.

This is but one example of how LMTs can exercise some power in a healthcare system that favors large companies. BJ Erkan, LMT and clinic owner will share more ideas at the upcoming WSMTA Annual Meeting on June 26. And the next time you go to your local REI store, look around:This is Power of Collaboration! Let’s make it our own power.

WSMTA Member Store Link

Navigate to the Store from the navigation bar. Store is only visible and accessible to members. Be sure to login to access the Store

Insurance Protection for Your Business

WSMTA — Wed, 23 Mar 2022 20:58:55 GMT

by Elizabeth Jane Brooks, LMT, BCTMB

Here at WSMTA, our goal is to promote and ensure the accessibility and financial viability of massage therapy as a reimbursed healthcare service and to provide resources to support practitioners. We have a strong desire to protect your interests and assist where we can.

Whenever we work with health insurance companies, use our computers for patients, work from our homes, or are injured on the job, there are some vulnerabilities that we’d like to bring to your attention—and their possible solutions.

Working with Health Insurance

In Washington State we are quite fortunate in being able to contract with health insurance companies. This is especially beneficial for our patients, as it can significantly reduce their out-of-pocket costs—and it is also great for massage therapists, as it may expand their practice and provide a steadier paycheck. For those early in their career, it can be of particular benefit: being in-network with an insurance company can bring many referrals, providing ample experience and filling your practice with new patients. Even experienced practitioners might use insurance as a stepping-stone, switching over to cash once they no longer need the referrals and demand allows for better pay.

However, working with insurance does have costs: lower rates, overworking, and post-payment audit risk.

To work with insurance, we must sign contracts accepting a reduced rate for our services in exchange for the many referrals that come from being one of their listed providers. These referrals are a definite benefit, but we are not able to enjoy this benefit to the same degree as a physician, nurse practitioner, or physical therapist who can see numerous patients in any given hour. In contrast, our work is physically taxing and takes at least one hour with the patient on the table—with additional time for the patient to get dressed, take payment, and rebook; extensive cleaning and disinfecting; resetting the room for the next patient; charting/report writing and billing. Several of our WSMTA members estimate that for every hour of work on the table there is often roughly one hour off the table.

Consequently, for many practitioners the major advantage of contracting with health insurance is how the referrals give us greater job security. As we gain experience we build up long waiting lists, and often end up unsustainably working nonstop for these lower reimbursement rates in an attempt to keep up with the demand. Fortunately, some of these patients will turn into cash clients when they have exhausted their benefits, or when coming in for a non-covered service (such as relaxation or maintenance massage).

When we contract with health insurance carriers, we agree to post-payment audits where the carrier can request chart notes and supporting documentation going back, on average, 1–2 years, and occasionally up to 10 years. During an audit, insurance auditors review your chart notes to see if everything charted matches with the referral and all necessary information is on it. Should the audit show any discrepancies or missing information, you are asked to retroactively repay the monies for the particular charts in error. If a massage therapist has been charting incorrectly in some way for years, the repayment for the incorrect charts can be so costly that the therapist’s practice may not survive.

Post-Payment Audit Insurance

This potential is the reason behind the search for post-payment audit insurance, also known as medical defense insurance. While common coverage for a physician, it has been difficult to find for massage therapists because we are relatively new to billing health insurance. Washington is one of the few states that allow us to bill health insurance companies, but as massage is increasingly recognized as effective healthcare, more states are positioned to join us, and more insurance companies are hopefully coming on board soon.

With so few companies providing this coverage, the quest has not been easy. The author of this article, for example, spent over a year communicating back and forth with different insurance companies trying to convince them to cover massage therapists. These included ABMP, AMTA, MMIP, Hands on Trade, and many more companies less known to massage therapists. She eventually found an excellent insurance agent, Christina Haranda at American West Insurance Agency (listed in the resources below). Christina went above and beyond in finding the coverage we need. She found MEDEFENSE coverage through Tokio Marine HCC, which is protection for healthcare professionals covering exposures—such as billing error proceedings through both government and private payers, as well as HIPAA and other regulatory proceedings.

MEDEFENSE coverage includes reimbursement of defense costs, fines, penalties, shadow audit expenses, including qui tam actions (filing false claims for funds from the government programs), HIPAA proceedings, EMTALA (Emergency Medical Treatment and Advanced Labor Act) proceedings, and STARK (self-referral and anti-kickback law) proceedings. Coverage limits go up to $1,000,000 each claim and a policy general aggregate up to $5,000,000. The minimum deductible is $1,000 and there is a minimum premium of $1,200 for a one year policy. Full prior acts coverage is also available.

In short, MEDEFENSE covers the defense of an audit, but not any monies due to be repaid to the insurance company due to fraud, errors, and/or omissions. This coverage includes a shadow audit—an audit where you hire an independent auditor to go over your charts, which can reduce the amount needed to repay an insurance company. It will also reimburse legal fees, fines, penalties and the previously mentioned proceedings. It is expensive for the average massage therapist; however, in the event you are wrongly accused of fraud, errors, or omissions and the insurance carrier is asking for $25,000–$100,000, it would be money well spent.

Another suggestion is to hire an independent auditor to review your charts before you are audited—it can be especially helpful if you can find an auditor experienced with massage coding and charting. To find an auditor, many have found it helpful to search local hospitals or large clinics.

Cyber Liability Insurance

Tokio Marine also offers cyber liability insurance coverage which can be bundled with MEDEFENSE or purchased separately. Cyber insurance covers your business liability in case of a data breach of sensitive patient information—this can be a breach of any files containing personal identity information, health and/or financial records. Additional items covered are legal expenses, negotiation and payment of ransomware demands, plus restoration of data. It should cover both your business and third parties (i.e. your patients). Some questions to ask yourself to determine your vulnerability are:

Do you email medical information?
Do you keep any patient medical information on your computer, tablet, or cell phone?
Do you keep any patient financial records on your computer, tablet, or cell phone?

If you answered yes to any of the above questions, cyber liability insurance is worth considering.

Homeowners & Renters Insurance

There are quite a few LMTs that work in their homes rather than in a business office space. Some insurance companies have a problem with this, as the lines between what is business and what is personal can become blurred, potentially increasing claims. In these situations, the insurance company is concerned with patients injured on the premises pursuing both our business liability insurance and our homeowners/renters insurance, and because of this it can be difficult to find coverage for these circumstances. Thankfully, the following insurance companies are favorable to those of us that work from home (sometimes through an additive “umbrella” policy): MetLife, Travelers, Country Financial, and in some cases Allstate.

Disability Insurance

Disability insurance can be difficult to find as a massage therapist because the injury rate is significant in our field. However, Crump Disability Solution Center has stated they have carriers that will cover massage therapists, including Assurity and Mutual of Omaha.

Should you be unable to work for a period of time due to illness or injury, most disability insurances pay between 50–70% of your pre-disability gross salary. For therapists with S-corporations, it will be important to check if their passthrough income can be included.

To be covered, most plans require a minimum of a 30-hour work week to qualify, which for massage therapists can be made up of such things as massage, cleanup, setup, billing, education, and purchasing supplies. With this minimum met, costs will depend on a variety of factors such as age, health, and income.

Some questions to ask yourself:

How long can I manage my monthly expenses without my paycheck?
Do I have personal savings or a retirement plan I can dip into if needed?

In Conclusion

WSMTA is providing this information for you to consider for your protection and that of your business and patients, along with some possible resources. If you are aware of other resources, please send them to us at info@mywsmta.org.

Resources

Medical defense, cyber liability, homeowners/renters, and auto insurance:

Christina Haranda

206.218.8980

christina@americanwestins.net

American West Insurance Agency, Inc.

Medical Defense:

Tokio Marine MEDEFENSE Plus

Cyber liability insurance:

Travelers Cyber Insurance

RPS (Risk Placement Services)

Tokio Marine Group

Umbrella insurance:

Travelers

Liberty Mutual

Homeowners/renters insurance:

MetLife/Farmers

Travelers (homeowners)

Travelers (renters)

Country Financial (homeowners)

Country Financial (renters)

Allstate

Regence/DocuSign Recontracting Emails

WSMTA — Thu, 24 Feb 2022 20:49:14 GMT

Have you been receiving unsolicited emails from what looks like it could be a Regence email address? Is it real? Or, is this part of a cyber attack? Could it be both?

The answer to this question seems to depend on who you talk to at Regence and how far the representative is willing to dig into the question. Some providers who have called Regence Providers Relations and spoke with a representative have been told “Yes it’s real. The website says Regence is switching all individual provider agreements with a new, standardized Professional Services Agreement and must be in electronic format.” Other providers who have called Regence have spoken with representatives who have dug-in a little deeper, (beyond the first page of their website), and have been told they can not find anyone at Regence who will take responsibility for sending these emails out to providers.

So what do we do?

Cyber Security 101 tells us to never click on any links contained in unsolicited emails we may receive.

At the very least, here are some of the precautions a provider should take if receiving such emails:

Be cautious of any emails that use exclamations like “URGENT”, “MUST RESPOND”, or mention some sort of penalty if you don’t respond immediately. Typically, these emails are not from any legitimate source.
Be suspicious of any emails that have spelling or grammatical errors and dates that haven’t been updated to the current year.
Double check email addresses and make sure they match previous legitimate email correspondence. Look for slight misspellings and differences.
It is easy for malicious operators to download logos, contact information and text to look like the real thing.
If you are unsure, consider looking on your secure Availity portal to see if you have any alerts or messages.
Always go directly to the providers' website, contact information or secure portal to look for updates and current information.
Double check to see if your Regence provider contract is still current or due to expire.
Consider calling Regence Provider Relations before filling out any information online.

Regence is in the process of updating their contracts and moving renewals online. After ensuring any email communication from Regence is legitimate, here are a few things to consider with a new contract.

Read and compare your new contract to any previous contracts.
Is this the same contract or does it have changes other than moving to an electronic format?
Am I willing to take on the responsibility that this new contract requires of me and my business?
Have I checked with the OIC to see if this contract has been approved?
If I sign this new contract, could it still be binding even if the OIC has not approved it?
Should I have an attorney review the contract BEFORE I sign?
What are the ramifications if I don’t sign this new contract?

Do you have questions regarding this new contract? Please send your questions to us as soon as possible.

We have reached out to an attorney who specializes in reviewing provider contracts. Our goal is to have him thoroughly review & clarify the contract(PSA) language including any additions/changes from prior contracts and research approval by the OIC. (Office of the Insurance Commissioner)

Are you interested in helping share the costs and the results of this legal review/consultation. Please let us know along with any questions you may have.

Doing the Math: Putting It All Together

Amy Thomason — Thu, 30 Dec 2021 20:42:54 GMT

By Dagmar Growe, LMT

In our quest to determine the rate we need to charge for our services versus simply charging what everyone else does, we have looked at the actual cost per massage, and our needed and desired income. The method we used to determine cost per massage can of course be applied to all other services we offer.

In this last segment we will put the numbers together and see how close we are to having a financially stable and successful business. We will also look at some additional considerations.

Your real hourly income:

Maybe you work in a setting where a 1 hour massage consists of 50 minutes, and you walk out of the office after your last massage with no further worry. Otherwise, it’s important to look at how much extra time you put in. Client calls, insurance billing, promotion, bookkeeping, business management all need to be compensated by your massage income. If you make house calls, this includes your driving time. If you have employees there is all the time you spend managing them. Keep track for a week or two of how much time you spend outside of actual massage time. Maybe you find that for every massage you provide you spend 1 ½ hours work-time, meaning you have to divide the net income per 1 hour massage by 1 ½ to determine your hourly income.

Self-employed vs. Employed:

Generally, employed therapists have less extra duties than self-employed therapists. However, requirements can vary greatly from one place of employment to the next. If you interview for a job be sure to ask about all the additional work you are expected to perform. Will you be paid per hour of shift time? Per massage? What happens when a client does not show up, or an appointment does not get filled? What benefits are offered? What are the rules when you decide to leave - will you be allowed to take your clients with you? What restrictions are placed on you by your employer?

Self-employed therapists generally have more freedom to set their own schedule. With that comes the extra work of managing one's own business. Think about which jobs are worth the expense of hiring out. Bookkeeping? Laundry? Insurance billing? This is not just a money question, but also one of skill, time constraints, and personal preference. If you really hate bookkeeping it might be worth the cost of a bookkeeping service - I prefer to do my own so I can stay on top of my business finances month-to-month. Also keep in mind that you will owe quarterly self-employment taxes, which are double the social security tax that an employee pays - the employer is responsible for the other ½. On the up side, for most self-employed therapists the biggest expense is office rent. As this is often a fixed cost, the cost per massage will decrease with more massages given. This makes it easier to increase one’s income if needed.

Insurance or Not:

Insurances claim that their lower reimbursement rates are made up for by the larger number of clients they provide to your business. This makes sense only if you cannot generate enough business without those referrals. You may be willing to fit insurance clients into your busy schedule to make massage therapy available to patients who could otherwise not afford it. But you also will need to look at your cost per massage, and in fact your hourly income per insurance massage as insurance work often requires significant extra time. You may find that the reimbursement rate does not cover your cost or leaves you with a ridiculously low hourly income.

My Story:

All of these considerations play out differently in different phases of our lives. I started massage therapy when employment was rare. Initially I tried to build my own business, but found it difficult to generate enough clients. I switched as an independent contractor to a local massage business which provided me with lots of clients - great for a new LMT to “practice”. I then found a place of employment which provided me with health insurance for my growing family, and allowed me to take extended maternity leave without having to worry about my practice. Eventually, my relatively low hourly pay created financial hardship for my family, and when my employer discontinued offering massage I jumped at the opportunity to be self-employed. My income immediately increased significantly. I worked from home, which meant very low cost per massage (and allowed my kids to appreciate how hard their mom was working - not a bad lesson for children). After a few years of working on my own, I joined a local clinic part-time. I had not even realized how isolated I had become in my home office. Now that my children are on their own, I appreciate the opportunity to take off as much time as I want. I still work part-time at home because of the low cost, and part-time at a clinic because the interaction with peers is important for my quality of life. I am constantly decreasing my insurance availability because the reimbursement rates do not afford me the life choices I am making.

Your story:

I hope these articles have been of help in looking at the facts of your business and considering the options you have. Like with my story, different options may be better than others at different times of your life. With the current shortage of LMTs this is an excellent time to carefully consider all the facts, and make continuous choices in the direction of your dreams.

Good Luck!

Uniform Medical increases limit to 24 Massages

Amy Thomason — Mon, 22 Nov 2021 16:10:34 GMT

By Dagmar Growe, LMT

There has been a lot of buzz around the increase of the maximum number of massage therapy treatments allowed through Uniform Medical Plan. Uniform Medical members are calling massage clinics and asking to schedule “their” bi-monthly massage. However, as is generally true, things aren’t as simple as they seem, especially when you read Uniform Medical’s fine print.

First of all, it’s important to note that this change only affects Uniform Medical, not any other plans administered by Regence. Uniform is a self-insured plan which means it can make up its own rules, including offering higher limits on allowed visits.

Second, according to the Uniform Medical Plan(UMP) Certificate of Coverage a prescription is still required. This means a physician’s order for a service (or a procedure) that is needed to treat a specific condition, specified by a diagnostic code. In other words, Uniform continues to require medical necessity in order to pay for treatments. If a future audit finds that massage services were not provided as treatment for the condition indicated by the prescription, the massage therapist might be faced with a demand to repay insurance payments received for those massage treatments.

Unfortunately, the benefits summary is not specific about any of this, physicians frequently provide very general prescriptions at patient’s requests, and massage therapists are left in the uncomfortable position of explaining to patients the unexpected limit of their benefit. Be sure to carefully and correctly document the treatment nature and medical rationale for any massage services you provide, especially for treatments that are reimbursed by health plans. Your treatment records are your best, and likely only defense if you are facing an audit.

Effective 9/30/21--M54.5 Is No Longer Billable

Amy Thomason — Sat, 23 Oct 2021 23:52:25 GMT

by Robbin Blake

September 30, 2021 was the last day M54.5, lumbago (low back pain), was a valid and billable ICD-10 diagnosis code. Beginning October 1, 2021, all healthcare providers should have changed this code to one of the newly created back pain codes which are:

• S39.012, Low back strain
• M51.2-, Lumbago due to intervertebral disc displacement
• M54.4-, Lumbago with sciatica
• M54.50, Low back pain, unspecified
• M54.51: Vertebrogenic low back pain
• M54.59: Other low back pain

There is also a warning that S39.012 “Strain of muscle, fascia and tendon of lower back” should not be used with any other diagnosis beginning with M51.2-, M54.4-, or M54.5- as it will likely result in claim denial.

You can find more detail about M54.5 and S39.012 at:

Webpt.com (major physical therapy biller, scheduler, charting company https://www.webpt.com/blog/m54-5-is-no-more-the-scoop-on-icd-10s-low-back-pain-code-change/
Icd10data.com (primary ICD-10 code website) https://www.icd10data.com/ICD10CM/Codes/M00-M99/M50-M54/M54-/M54.5

Choosing a Healthcare Plan

Amy Thomason — Fri, 22 Oct 2021 02:38:53 GMT

by Elizabeth Jane Brooks, LMT, BCTMB

With open enrollment just around the corner, some helpful information for your consideration is below. This information will help self-employed individuals choose a healthcare plan that is best for their needs in the upcoming year. Open enrollment begins on November 1, 2021 and ends on January 15, 2022. A few things to consider:

The 4 categories: Bronze, Silver, Gold, and Platinum
Type of plan you like: HMO, PPO, EPO, or POS
If you want a Health Savings Account (HSA)
Your total out-of-pocket cost

The 4 Categories

	Bronze	Silver	Gold	Platinum
Insurance pays	60%	70%	80%	90%
You pay	40%	30%	20%	10%
Premium	Lowest	Moderate	Higher	Highest

Bronze plans are a good choice if you want to pay a low premium and only want to be covered for major illness/accidents. Since these plans are eligible for a Health Savings Account, your routine care (which is not covered by the Bronze plan) could be paid from the HSA.
Silver plans are a good choice if you don’t mind a slightly higher premium and have more routine care coverage. They are also eligible for a Health Savings Account.
Gold plans are a good choice if you use a lot of medical care and are willing to pay a higher premium than the Silver plans, and are wanting more costs covered. These plans are not eligible for an HSA.
Platinum plans are a good choice if you need a lot of medical care and are willing to pay a high monthly premium. These plans are not eligible for an HSA.

Types of Plans

Health Maintenance Organization (HMO)
With this type of plan you must stay within their network. A primary care physician manages your care and will give you the necessary referral to see a specialist if needed. If you see a provider that is out of network, you will have to pay the full bill yourself (e.g. a cancer specialist, a favorite cardiologist, etc.).
Preferred Provider Organization (PPO)
You have the freedom to see any healthcare provider with this plan but you will pay a higher percentage for out-of-network providers. In addition, there is usually a higher deductible for out-of-network providers.
Exclusive Provider Organization (EPO)
This plan only covers in-network providers, and there is no need for a referral for specialists from your primary care physician. It’s important to know beforehand whether all of your providers (e.g. your anesthesiologist during a surgery) are in-network so you are not surprised by a high bill.
Point-of-Service Plan (POS)
You can see both in- and out-of-network providers with this plan; however, you will pay a higher portion for out-of-network. Your primary care physician coordinates your care and provides the referral if you need to see a specialist.
Catastrophic Plan
This is for those under 30 or those who qualify for a “hardship exemption.” This plan offers a lower premium, free preventative care, and 3 primary care visits, even if your deductible has not been met. This plan’s deductible is $8,550 for an individual and $17,100 for a family in 2021. After you reach the deductible the plan pays 100% of covered medical benefits.
High-Deductible Health Plan (with or without a Health Savings Account)
This is similar to the Catastrophic Plan in that it has a lower premium. The deductible begins at $1,400 for an individual or $2,800 for a family, but not more than $7,000 for an individual and $14,000 for a family in 2021. Preventive care is free even if you haven't met your deductible.

Health Savings Account (HSA)

This is a savings account used for medical expenses when you have a healthcare plan that has a deductible of $1400 for an individual and $2800 for a family. Money left in your HSA account at the end of the year is not lost and will carry over to the next year. If you rarely go to the doctor, an HSA account can be used to build up savings as you are able to keep all monies invested until you decide to use it for medical expenses, tax free. With deciding plans, note also that out-of-pocket costs include deductibles, copayments, and other amounts (but not premiums).

	Single Plan	Family Plan
Max contribution	$3,650	$7,300
Catch up contribution	$1,000	$1,000
Minimum deductible	$1,400	$2,800
Maximum out-of-pocket	$7,050	$14,100

Deciding Factors in Choosing a Plan

Health: How healthy are you? If you are very healthy, a bronze or silver plan may be sufficient for you. If you have a major illness you would most likely be better off with a gold or platinum plan which would give you more coverage.
Medications: If you have expensive medications necessary for maintaining your health, you want to make sure those particular medications are covered by your plan.
Networks: Do you think you may need any out-of-network providers for the upcoming year? Is your primary physician in- or out-of-network for a particular plan? You will want to make sure that your favored providers are in-network to reduce your out-of-pocket costs.
Area of Coverage: People who enjoy backcountry sports, such as mountain climbing or backpacking, and people with significant health issues that may require transport to a city hospital in an emergency, need to make sure their plan covers them should they need airlifting. You don’t want to be surprised by a $20,000+ bill, so consider where you live, work, and play, and the ramifications of needing care in those situations.
Total Costs: After considering your circumstances and individual needs, determine which category you would like (Bronze, Silver, etc.) and the type of plan you prefer (PPO, EPO, etc.). Then, take your maximum out-of-pocket expenses and add your annual premium expense. This number gives you the total possible cost for any plan.

WSMTA hopes this article makes your choice for a health care plan a little bit easier for you.

Resources:

Health Plans

Brokers

HSA allowable expenses

Doing the Math, Part 2: How much income do you need?

Amy Thomason — Thu, 16 Sep 2021 22:13:26 GMT

By Dagmar Growe, LMT

Today we are continuing to pursue the question of how much we need to charge for our services. In Part 1 of this series, we looked at how much you earned per massage, and the structure of different rates in your business. Today we will take a step back from your business, and look at your personal financial picture. Today’s questions are: How much do you need to earn, and how much would you like to earn? And we will ask how much you want to work, and how you would like to structure your work.

How much income do you need? How much would you like to earn?

Unless you can answer these questions with a fact based dollar amount, I challenge you to sit down and do some math. Again, let’s first look at fixed expenses - those that are roughly the same every month. Make sure to include expenses paid less frequently, like property taxes, and quarterly taxes. Sort them into 2 categories: Needs (like utilities) and wants (like a gym membership or a Netflix account). Figuring your flexible spending is a little more tricky: If you generally pay cashless, you can go over your statements. You may want to log your cash expenditures over a period of time to average your needs and wants per month.

Because our income can fluctuate wildly from month to month it is important to have some reserves. Getting a realistic idea of your minimum expenses will help you with establishing an appropriate reserve for times of illness or vacation. Knowing how much it takes to cover your wants can give you guidance and peace of mind if you consider cutting back work hours.

How Much Do You Want to Work?

In a culture where more is better, determining what is simply enough can be a task of spiritual dimensions. Most of my friends never ask themselves this question as their jobs are all or nothing situations. One of the advantages of our profession is that most employers offer part time schedules. But there is a constant temptation to be lured into more hours - because our clients or our employer really wants us to or because we like the idea of earning more.

Massage therapy is strenuous work - how many massages per day can you do without injuring your body? How many days per week do you want to work? What are your family’s needs, and how can you best balance them with work? Do you like evening or weekend work?

Right now our profession faces a serious shortage of therapists. Clinics are looking for employees or contract LMTs, patients are looking for a new therapist because their previous one retired or left the profession. This is a great time to make the changes you would like to make for your own benefit. Do you want to change your working hours? If you are willing to work weekends and evenings you may decide to charge extra for those times as those appointments are difficult to find. Should you re-evaluate how much you are being paid per hour?

Part 3 of this series will look at putting the numbers together! Have fun playing with the numbers. I promise you some surprises, and some peace of mind if you follow through on this. You will be able to make decisions based on fact - or, as they call it in our field: Evidence based planning and decision making.

Vaccinations Considerations, Part 2

Amy Thomason — Wed, 18 Aug 2021 04:15:59 GMT

By Dagmar Growe, LMT

Thanks to the many LMTs who responded to our recent informal survey. We appreciate the time you took to write.

First off, I want to clarify a point that some respondents seem to have misunderstood: WSMTA has no position as to whether therapists should be requiring patients to be vaccinated or not. This is a decision individual business owners need to make for their business.

Not surprisingly, there is a shared sense regarding one’s autonomy about healthcare issues. On the one end of the spectrum are those who for a variety of reasons are choosing not to be vaccinated, on the other are those who fear for their own safety, and the safety of vulnerable family members or patients when exposed to unvaccinated patients. I heard from a therapist who works at a spa where a sizable number of patients ask to be seen by vaccinated therapists only. Most therapists are ok working with unvaccinated patients, as long as masks are worn (see article regarding mask requirements).

A number of respondents asked if refusing to work with unvaccinated patients is legal. A business owner has the choice to refuse service, unless the service is rendered under a health insurance contract. That contract will contain a non-discrimination clause, and insurances will look at the refusal as discrimination.

Some responses seemed to indicate a certain lack of tolerance for those making a different choice regarding vaccination. I would like to remind all of us that the right to make a choice regarding our own health goes in all directions: To receive the vaccine, or to not receive it, both for therapists and for clients, to expose oneself to unvaccinated patients or to unvaccinated therapists.The patient who chooses to not see an unvaccinated therapist deserves as much respect as the therapist who chooses (again for whatever reason) to not receive the vaccine. We can accommodate our patient’s choice by developing referral relationships: Those who are not willing to work with unvaccinated patients can provide names of therapists who will, therapists who are not vaccinated can refer to vaccinated therapists. Our strength lies in being a diverse community of massage therapists - by working together we can accommodate many different choices and needs.

Doing the Math: Keeping your Business Safe

Amy Thomason — Fri, 23 Jul 2021 14:38:00 GMT

By Dagmar Growe, LMT

Nicole Chryst, business consultant, owner of Ballaura Wellness Spa in Olympia, and presenter at WSMTA’s recent annual meeting, made an interesting comment during her presentation. Massage therapists, she suggested, generally base their pricing on what others charge, rather than figuring out how much they need to charge in order to have a viable business which provides the income they need or desire. Not knowing the full financial picture of one’s own business can keep us from taking early action to remedy problems, and to intentionally move our business in a direction that we desire.

Many of us are great healers, but not everyone has a past in business or accounting. Here are some easy steps you can take to assess the health of your business.If you have a pretty clear idea of the numbers below for your business: Congratulations! If not, I challenge you to spend a little extra time to find out how well you really are doing.

Expenses per Massage: The easy way:Take the total expenses from last year’s taxes, adjust for any changes (like having been closed, or a rent increase), and divide by 12 month. Then figure out the average number of massages your business provides in a month, and divide your expenses by that number. This is what it costs you to provide a massage.

However, it may be worth the extra time to break your expenses down into fixed and flexible expenses. Fixed expenses are those you have to pay regardless of how many massages your business provides. Rent and utilities, a receptionist hired for a set amount of hours, marketing expenses. Make sure to include expenses that are due annually, like your license, your insurance, and if you own your business location, property taxes. Flexible expenses are those that change depending on how many massages your business provides. Expenses for employees who get paid per massage (include payroll taxes), laundry and PPE expenses are examples. The interesting part is that the portion of fixed expenses per massage will decrease as the number of massages in a month increases, and vice versa. This information is important when you are trying to figure out solutions to potential problems

Income per Massage: Total your massage income over a period, and divide it by the number of massages your business provided during that time. This is your average income per massage. However, you may want to look at it a little more detailed. How many of your clients pay the full price? Maybe you offer discounted rates for packages or membership or friends. Do you offer a sliding scale? Do you bill health insurances, and receive various reimbursement rates depending on which insurance? Tally your various payment levels so you know exactly how many massages you provide for each payment level.

Now you know exactly what it costs you to provide a massage. Are any of your rates below the combined fixed and flexible costs per massage? YOU are paying for those clients to receive a massage from you or your staff. How many just barely cover their cost? Where do you make money? You may find that you need to limit the number you offer of certain payment levels. Knowing the numbers allows you to identify the weaknesses and strengths of your business, and guides you to where changes will be most effective.

A few years ago I did the math for my own business. When I added into my calculation the time spent on scheduling, room changes and billing, I realized that certain health insurance reimbursement rates would amount to an hourly wage close to minimum wage. I decided to cancel those contracts. I now track these numbers monthly. It does not add much work as I have set up an efficient system for it, but it gives me the confidence to know that I am on track.

To be continued….

Vaccinations Considerations for LMT's

Amy Thomason — Thu, 24 Jun 2021 19:27:07 GMT

By Dagmar Growe, LMT

We want to hear from you:

Over the course of the last year, massage therapists and clinic owners have figured out how to practice while keeping ourselves and our clients safe. Mostly this involved a combination of sanitizing protocols, PPE, assessment of health status and lifestyle choices. However, as vaccines have become widely available, we are faced with a new set of questions. Do we require vaccination, for our patients, for our staff? Do we change our protocols for vaccinated patients? Do we require masks when both patients and therapists have been fully vaccinated? Do we feel safer with vaccines, or do we feel less safe as social distancing practices decrease? These are some of the questions massage therapists face during this next phase of Covid-19. And likely there are others that you have been considering or dealing with.

We would like to hear from you! What are your thoughts, concerns and policies? We want to share your questions and solutions with our members so that we can continue to practice safely. Please email me at info@mywsmta.org

PPE Reimbursement

Amy Thomason — Sat, 24 Apr 2021 00:02:21 GMT

By Elizabeth Jane Brooks

Substitute Senate Bill 5169 -- PPE Reimbursement

SSB5169 enables all healthcare providers to seek reimbursement for personal protective equipment during the state of emergency related to COVID-19. This bill adds a new section to chapter 48.43 RCW and provides a contingent expiration date and declares an emergency.

The Washington State’s legislature finds that since the delivery of healthcare services is essential and maintaining patient safety during this pandemic is paramount, healthcare providers are incurring substantially increased costs in following state and federal regulations to minimize the risk of viral transmission. These costs are associated with obtaining personal protective equipment. Since these substantial costs have not been factored into our contracts with health carriers, the State Legislature found this bill necessary to alleviate the burden on healthcare providers.

Many healthcare providers do not have a way to recoup the costs of personal protective equipment since many contracts with health carriers prevent the billing of supplies to patients and their health insurance providers. Therefore, the legislature finds that to help ensure patient safety and continued access to personal protective equipment, it is necessary that health carriers reimburse healthcare providers for costs associated with personal protective equipment.

A new section is added to chapter 48.43 RCW to read as follows:

For the duration of the federal public health emergency related to COVID-19, a health benefit plan shall reimburse a health care provider who bills for incurred personal protective equipment expenses as a separate expense, using the American Medical Association's current procedural terminology code 99072 or as subsequently amended, $6.57 for each individual patient encounter. For purposes of this section, cost sharing is limited to the covered service according to the terms and conditions of the health benefit plan and does not apply to an expense for personal protective equipment. This section is not intended to apply to health care services that are not provided in person.

This act took effect on April 16, 2021 and will be in effect for the duration of the federal state of emergency related to COVID-19 and will expire when this state of emergency is over.

So, What Does This Mean?

Healthcare providers treating patients in state-regulated commercial health plans who have incurred costs for PPE will be able to bill the newly created CPT code 99072 and be reimbursed $6.57 per patient encounter as recommended by one of the American Medical Association's committee.

The law operates prospectively, meaning that carriers are not required to reimburse this code for dates of service prior to the law’s effective date; but moving forward and continuing for the duration of the federally declared state of emergency relating specifically to COVID-19, they must reimburse for it.

Given that it can be difficult to know whether a health plan is subject to state regulation, or is exempt from state laws, the Washington State Medical Association recommends billing the code liberally in appropriate circumstances as those health plans which are not subject to the law may opt to reimburse the code.

In contrast, the Washington State Chiropractic Association (WSCA) recommends just billing state regulated plans (which do not include self-insured plans or those subject to ERISA) as this is a state law and ONLY applies to state regulated plans. They have produced a very helpful video Q&A that can be found here: https://www.youtube.com/watch?v=LTAwY3Pa4N0

You can read, (and you should read), the bill in its entirety here: http://lawfilesext.leg.wa.gov/biennium/2021-22/Pdf/Bills/Session%20Laws/Senate/5169-S.SL.pdf?q=20210423145331

Billing Codes

Amy Thomason — Sat, 17 Apr 2021 16:52:24 GMT

By Dagmar Growe, LMT

I have recently come across a number of questions regarding billing codes. In my early days of insurance billing, I remember being told by more experienced therapists about a few numbers to be entered into certain fields of the HCFA form, with no understanding on my part, and possibly theirs, about the meaning of any of them. Some things have gotten easier with electronic billing as pull-down menus offer explanations, for example for “Place of Service” (POS). However, there are 2 codes that are essential to understand:

ICD-10 (International Classification of Diseases, Edition 10): This is a numeric expression of a diagnosis - what we treat. Since it is outside of the scope of practice of massage therapists to diagnose, we will need to have this code supplied to us by a healthcare professional who is licensed to diagnose. Even if insurance policies do not require a referral, we still need an ICD-10 code to fill out the HCFA form and get paid. It is also important to note that some insurances will not pay for certain codes, for example fibromyalgia, myalgia, or certain headache codes. If you get a referral with one of those codes you’ll need to call the doctor’s office and request a different code to be assigned.

CPT (Current Procedural Terminology): This is an expression of the “procedure” we are performing--how we treat-- and it determines the amount of reimbursement. In theory, LMTs should be able to bill for any CPT code that covers techniques or procedures which are part of our scope of practice. However, many insurances will only pay for 97124, which stands for “massage, including effleurage, petrissage, and/or tapotement”. Other possible codes include 97140 (manual therapy) and 97112 (neuromuscular reeducation). However, if using these codes, it is of utmost importance to understand what these codes describe, and to document your treatment accordingly. Also, be sure that you can show you have been trained to perform these techniques. If you get audited and your documentation is deemed insufficient you may be required to return insurance payments. More information on codes can be found here.

Correction-Low Cost Continuing Education

Amy Thomason — Sun, 28 Mar 2021 18:30:15 GMT

By Dagmar Growe, LMT

(Updated CE requirements Link)

While hands-on continuing education (CE) requirements are suspended for now, LMTs need to continue to report 24 hrs. of CE every 2 years with their license renewal. With the loss of income due to the COVID19 pandemic, many LMTs are struggling to come up with funds to pay for continuing education. Here are some low cost and free options

Professional Associations: ABMP and AMTA offer free and lower cost CEs for members.
Service on massage related boards or committees: Volunteer with WSMTA and receive CEs for your service.
Self-study: Up to 2 hrs. per reporting period. A 2 page synopsis of the studied material is required.
Teaching: Consider offering a class – the first time you teach it it will count toward your own CE.
Local networks such as North Cascades Massage Connection or South Sound LMPs offer low cost CE. If there is no network in your area consider starting one. We will be happy to support you.
Subscription Services: These often offer a large amount of online CE for a low flat rate. This is a buyer beware category, so do your research.
As a member of WSMTA you may earn up to 3 free continuing education credits by attending WSMTA’s Annual meeting.

Find the regulations regarding CE here, and the Board of Massage’s proclamation temporarily suspending hands-on CE can be found here: CE requirements. Plan ahead - don’t wait until the month before your CE is due: Spread your CE over the 2 year period, and take advantage of affordable and interesting opportunities.

Low Cost Continuing Education

Amy Thomason — Wed, 17 Mar 2021 15:16:43 GMT

By Dagmar Growe, LMT

Professional Associations: ABMP and AMTA offer free and lower cost CEs for members.
Service on massage related boards or committees: Volunteer with WSMTA and receive CEs for your service.
Self-study: Up to 2 hrs. per reporting period. A 2 page synopsis of the studied material is required.
Teaching: Consider offering a class – the first time you teach it it will count toward your own CE.
Local networks such as North Cascades Massage Connection or South Sound LMPs offer low cost CE. If there is no network in your area consider starting one. We will be happy to support you.
Subscription Services: These often offer a large amount of online CE for a low flat rate. This is a buyer beware category, so do your research.
As a member of WSMTA you may earn up to 3 free continuing education credits by attending WSMTA’s Annual meeting.

Federally Regulated Health Plans & Massage Therapy Coverage

Carl Wilson — Sun, 15 Nov 2020 19:54:54 GMT

Federally Regulated Health Plans and Massage Therapy

by Dagmar Growe, LMT

There is a lot of confusion surrounding federally regulated health plans. The Every-Category-of-Provider statute requires that insurers must not exclude any category of providers licensed by the state of Washington who provide health care services or care within the scope of their practice for services covered as essential health benefits (WAC 284-170-270). Since this is a state statute it does not apply to anything which is regulated by federal law. This means that massage therapy benefits can either be excluded by any of those plans, or be limited by any number of arbitrary rules the plan chooses. Because the customer service representatives are generally not very forthcoming with information, it is easy to end up with unpaid claims.

This article aims to shed some light on the different types of federally regulated plans and what to be aware of.

Federal Employee Health Plans (i.e. US Postal Workers Health Plan): These never cover massage therapy. However, I have been told otherwise by a customer representative, just to be told later “only if performed by a PT”.
Self-Insured Plans: Large employers or associations like trade unions may opt to create a trust fund for health care expenses, rather than to buy coverage from an insurance company. However, they may then hire an insurance company to administer the trust fund. The best known example of this is Uniform Medical, which is a self-insured plan for WA State employees that is administered by Regence Blue Cross. These plans are regulated by ERISA (Employee Retirement Income Security Act of 1974, a federal law that sets minimum standards for most voluntarily established retirement and health plans in private industry to provide protection for individuals in these plans). These plans may opt to provide massage therapy benefits, likely because of customer demand, but then apply additional rules which are generally not volunteered by customer service representatives. Here are some examples: “Yes, we cover massage therapy, but only if performed by a PT; but only if billed through a chiropractor, PT or MD office; but only if part of a PT treatment plan and the PT has to bill first”. Additionally, these plans may offer ridiculously low reimbursement rates, and in one case I saw only cover “up to 2 units”.
Federal Health care plans like Medicare, VA healthcare, and Tricare: These plans never cover massage therapy. However, many Medicare insured people have supplemental plans that will cover massage. It is standard practice for supplemental plans to require a medicare denial before covering remaining expenses. The large insurance companies generally know that massage therapy is never covered, and that massage therapists are unable to obtain a denial, and do not ask for this. Some insurances (or some of their staff) do not understand this, and insist on the denial. In this case filing a complaint with the Office of the Insurance Commissioner will be helpful.

Delegating the research regarding plans to patients will not work, as it is important to ask the right questions. It may be helpful to ask if patients have had massage covered by insurance before, but it will not be a guarantee that a claim will be paid.

COVID 19 Interim Guidance Documents

Carl Wilson — Wed, 23 Sep 2020 02:29:24 GMT

Interim Guidance on Personal Protection Equipment Rev 9/18/20

This document is an interim guide for massage therapists in making selections on Personal Protective Equipment (PPE) to use while in the treatment room or office. WSMTA makes minimum PPE recommendations for massage therapists and their clients, highlights the options available and how to choose the best option for your practice and your clients/patients.

What’s New: Updated information on facemasks and respirators as well as new information on how to obtain PPE from the WA State PPE Stockpile.

Click Here or on the title above to open the document link.

Interim Guidance on Sanitation Rev 9/17/20

The Sanitation document builds on the Interim Guidance on Personal Protective Equipment by providing more information on cleaning and disinfecting PPE, extending the life of it and storing it. This document also provides information on cleaning and disinfecting (the how, why and strategies for reducing the amount of time doing it) as well as many other important things related to the setup of a massage room or clinic while COVID-19 is an issue.

What’s New: Updated section on air quality in the treatment room and new information about aerosol, droplets, infectious dosage and viral load.

Click Here or on the title above to open the document link.

Interim Guidance on Practice Guidelines Rev 9/19/20

The Practice Guidelines document provides information on how to check for symptoms and signs of health in yourself and your patient/client. It takes all of the prior information the PPE and Sanitation guidance documents provided helps the massage therapist to put it into an infection prevention and control plan as well as provides strategies for before the massage session, during the massage session and after the massage session.

What’s New: The section on “Blood Clotting and Best Practice Considerations” has been significantly updated to “Effects of COVID-19 on the Body and Best Practice Considerations” as well as other smaller updates throughout the document.

Click Here or on the title above to open the document link.

Regence Contract Changes

Carl Wilson — Fri, 24 Jan 2020 02:25:36 GMT

Breaking: Regence Providers

It has come to our attention that some Regence providers have received a contract amendment titled, "Regence BlueShield Data Access, Use & Transfer Addendum", sometime in December or early January. We advise you to take note of this amendment and read it carefully. WSMTA is working on clarifying some of the provisions with Regence, but we encourage you to do your own research.

WSMTA is committed to continuing this vital function and representation for Washington LMT’s.

We need your continued support with your membership and/or donations to support our operations at www.mywsmta.org.

Thank you!