Methow Massage Therapy

Injury Treatment, Deep Tissue and Sports Massage in the Beautiful Methow Valley

Insurance Information

Information for massage clients for Insurance Billing.

Insurance Information

Washington law requires insurance companies to offer alternative medicine in their plans, which means massage therapy may be a covered benefit. Alison takes personal injury, L&I and OWCP claims, and am a preferred provider for Regence, Premera, and LifeWise. Call your company to find out if massage is covered. If so, simply bring a (legible) prescription from a doctor or chiropractor with the following information:

Massage therapy
Diagnosis with a diagnosis (ICD-9) code
Frequency, and duration (ex. 6 visits in 6 weeks)

Having complete scripts makes my billing agent happy, which makes me happy and able to see more clients. Thank you in advance for doing your part!

If you plan on billing insurance, please fill this out prior to your visit:

Insurance Information

Name

First Name

Last Name

Email Address

Phone

(###)

###

####

Mailing Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Date of Birth

YYYY

Did this injury occur on the job?

If yes, please enter date of injury, your claims manager's name, and phone number. If not, please skip next two fields.

Yes

Date of Injury

YYYY

Claims Manager Name and Phone Number

Was this injury a result of a motor vehicle accident?

Yes

If yes, please provide date of injury

YYYY

Please read below and sign:

I understand that I have requested Alison Naney to bill my insurance company as a service to me. I am responsible for meeting the criteria for payment dictated by my particular plan. I am aware that my plan may have a limited number of visits or a cap on the amount that may be reimbursed for services. I hereby assign my insurance benefits to be paid directly to Alison Naney. I also authorize Alison Naney to release any information required to process this claim. I understand that I am fully financially responsible for non-covered services.

Date of Service

YYYY