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Directory Audit

The 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.

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Julie sent a letter “WSMTA – November 2022 Insurance Audit” detailing our findings for the Office of the Insurance Commissioner, the House Health Care and Wellness Committee and the Senate Health and Long-Term Care Committee, along with our concerns regarding network adequacy. We are excited to report our project and outreach yielded results. In late March of 2023, Julie was invited to a meeting with John Haworth, our OIC Deputy Insurance Commissioner in charge of Company Supervision, because his department felt the statistical information presented within the letter and the volunteer effort we embarked on was significant. He agrees that the Consolidated Appropriations Act (CAA) that went into effect this year is not going to be enough to fix most of the issues we had with the Regence Provider directory and his suspicion is that the problems we reported within the directories are not confined to just massage therapy. We talked about several other healthcare professions, but the similarities to what is happening in massage therapy is also being reported by other healthcare professionals in Washington. In addition to reviewing the results of what was reported in the letter, we discussed at greater length the barrier of usability when trying to update directory listings and other processes necessary to work with insurance companies. He asked what the process was and the frequency the insurers reach out to request updates, the process to get the directories updated or changed, the issues with credentialing/re-credentialing, the lack of feedback from insurance companies when submitting changes and requests, the difficulty of having multiple third parties with different systems handling different branches of information that do not communicate and synchronize data, and the lack of knowledgeable or available insurance employees in provider relations to contact with issues with all of these processes for help and assistance. On the topic of network adequacy, we discussed the issue of billable time. LMTs are not working 40 hours of hands-on/treatment time in a week like other healthcare professionals. We are also concerned about the duplicate listings and how many hands-on hours those practitioners are really available for treatment at each location listed. I continued to frame all my points around the availability of massage therapists in each region for patients trying to access massage treatment. He can see a need to verify the number of “treatment” hours each practitioner has at each location every week when considering network adequacy. The OIC’s next steps are: Reaching out to other healthcare professionals to see if their experiences with the provider directories are similar to what we uncovered. His suspicion is this is systemic for all healthcare providers. Create a new process for the OIC to measure directory accuracy. As part of that process, make recommendations to insurance companies of changes they need to make regarding usability concerns, feedback, treatment hours and provider relations access. Julie ended the conversation with a willingness to be available for any assistance WSMTA can provide, our hope that the OIC can compel more provider relations availability from the insurance companies for our professional organization and in-network providers and our availability to educate and communicate with massage therapists in Washington State.

Letter to the OIC and State Representatives on our November 2022 Audit of LMTs in the Regence Provider Directory

What can you do? Write your own letter to our healthcare committee state representatives about your experiences as an LMT with medical insurance providers.

Representatives on the House Health Care and Wellness Committee are Marcus Riccelli, Chair; Jessica Bateman, Vice Chair; Joe Schmick; Spencer Hutchins;  Stephanie Barnard; Dan Bronoske; Lauren Davis; Jenny Graham; Paul Harris; Nicole Macri; Jacquelin Maycumber; Gina Mosbrucker; Tina Orwall; Tarra Simmons; Monica Jurado Stonier; My-Linh Thai and Steve Tharinger.

Representatives on the Senate Health and Long Term Care Committee are Annette Cleveland, Chair; June Robinson, Vice Chair; Ann Rivers; Ron Muzzall; Steve Conway; Manka Dhingra; Jeff Holy; Mike Padden; Emily Randall and Kevin Van De Wege.


The Clinical Practices Committee has a plea and request of every Massage Therapist in Washington State who works with Medical Insurance Companies or who have patients/clients seeking Massage treatment covered by medical insurance. 

  1. Check your contact information on insurer's websites. Make sure it is current. If you do not have availability to accept new patients/clients or have a long wait to get in, make sure that information is also updated on the insurer's website. 
  2. If you are canceling your Insurance agreement, tell the insurance company why in writing.
  3. If you have problems with your agreement, communicate and try to negotiate with the insurance company. Call or write regularly through channels presented to you.
  4. If your patients are unhappy that you no longer accept insurance, tell them why you’ve stopped.
  5. If your patients are unable to find "In Network" practitioners, encourage them to contact their insurer for solutions. If none are given, have them file a formal complaint with the OIC if there is a significant delay to prescribed care. The OIC is there to advocate for the insurance consumer – not businesses who accept insurance. Until our patients start formally complaining about their inability to get access to massage services guaranteed by their contracts, nothing will change. We need to ask them to act.  
  6. Go forth and share this information to all WA Massage Therapists and have them do their part as well.

Stop assuming making a complaint won’t matter. Stop assuming your patients won’t make the effort to file a grievance. Stop assuming your voice doesn’t make a difference. We can’t make change happen unless every WA Massage Therapist who wants to be available to patients with insurance explains and communicates to the insurance companies and patients why medical insurance is a barrier. Please help the Clinical Practices Committee get to the table with medical insurance companies. If we can do this, we can open the communication channels for all massage practitioners.


Every month the Department of Health audits 2% of the license renewals which have continuing education due. A shocking 50% of therapists fail the audit. This is not always due to a lack of education hours, but can also be due to not having hours in the required categories. The Board of Massage has developed a handy tracking form which lists the requirements and space to enter your continued education classes.

Print out the form, write in any classes when you take them, attach your certificate, and you are ready for a successful audit.

There will likely be some changes to CE requirements in the near future. We will let you know when the regulations become effective and supply you with the link to the updated form.


In Washington State, massage therapists are in a unique position, licensed by the state and credentialed by insurance as health care providers.  LMTs are included in insurance provider networks.  The Clinical Practices Program (CPP) mission is to be a communication portal (conduit) to address issues that impact clinical practices at the state level, while bringing best practice information to individual massage therapists and clinics.  We bring our voices, our knowledge, our experience and collaborative approach to Washington State's regulatory, legislative and insurance arenas.  We also prioritize effective communication with our members as well as other professional organizations in the healthcare field, particularly rehabilitation therapy.

Our current and ongoing focus is to provide the most up-to-date and accurate information for Best Clinical Practices and for compliance with our massage laws as well as other regulations that apply to healthcare providers.  We seek and participate in opportunities to work with networks and insurers on behalf of Washington LMTs to address issues including but not limited to credentialing, improving access to provider networks, network adequacy, prior authorization requirements, payers compliance with reimbursement regulations.


Our Board and Committee members are all unpaid volunteers working for you. Our little group could use individuals willing to take on jobs big and small. It allows you to connect with other LMT professionals, receive mentorship, find out the latest discoveries in our profession, receive CE hours for certain activities and support other up and coming LMTs. We are looking for volunteers interested in helping with, but not limited to:

  • Making contacts with medical insurance companies, provider networks/provider services including those with open panels, 3rd party payers and other professional healthcare organizations.
  • Research
  • Content development for the website like forms, articles and imagery.
  • Suggestions and organization of educational opportunities
  • Attendance and reporting on professional meetings and conventions

Our Board and Committee members are all unpaid volunteers working for you. If you have a story idea, an educational experience or ideas to share, please contact us. Please specify your interest in the Clinical Practices Group, our coding subcommittee or if you are looking for volunteer opportunities.


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 thirteen page legal review that details the commitments that therapists enter into, the inconsistencies, and the conflicts with Washington statutes that exist in the contract. The review is available to members for $100 – the cost of one 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.

Link to Regence Legal Review Document in the WSMTA Store

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