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Medical Insurance

​Please verify with your insurer that you have massage benefits before adding your insurance information to your intake form. We lack the administrative staff to verify benefits for all clients. You can ask about both massage (97124) and manual therapy (97140) as we can bill for either service as massage therapists, but some plans exclude these services being performed by LMTs.

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Please keep in mind that out-of-state policies are less likely to recognize LMTs as medical providers and are more difficult for us to communicate with. If this applies to your plan, please note that we may need to bill you directly for services rendered.

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Billing insurance is something we do to improve accessibility and affordability for our clients and we do so at our expense. We do our very best to be thorough and transparent. Different plans have different requirements and cover different things, and we are not always able to get correct answers from representatives. In the case that insurance refuses to pay for your treatment, you will be expected to pay for the services. We appreciate your patience, kindness, and understanding as we navigate this process.

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Insurance Verification Policy

At RituaLuna, we are committed to ensuring that your insurance billing is handled smoothly and efficiently. To facilitate this, we require a minimum of 7 days to verify insurance benefits prior to your first appointment. If we do not receive the necessary 7 days to confirm your coverage, or if we are unable to obtain the required information from your insurance provider, the following will apply:

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  • Clients will need to pay the cash rate for their session at the time of their appointment.

  • Reimbursement will be issued to your card on file once your insurance benefits have been verified or in some cases the claim has been processed and paid by your insurance company.


Thank you for your understanding and cooperation in allowing us to manage your healthcare benefits effectively.

What medical insurance does RituaLuna Wellness accept?

Provider
Regence, Asuris, Bridgespan, HMA
Providence
Moda
Wilder
x
Sierra
x
x
x
Magidah
x
x
x
Sarah
x
x
x
Courtney
x
x
x
Morgan
x
x
Momo
x
x
Roxanne
x
x

Note: Our therapists have transitioned to not accepting PacificSource due to a significant decrease in reimbursement rates. Please contact PacificSource to let them know that this is making it difficult to find LMTs. Your advocacy makes a difference.

 

What restrictions should I expect?

  • Most plans prefer your provider to be in-network. Some plans will not cover out-of-network providers. Many plans will cover out-of-network providers, but may charge a higher coinsurance. Many plans will waive deductible for in-network providers, and apply deductible to out-of-network.

  • Most Blue Cross/Blue Shield plans require a doctor's referral.

  • A few plans require prior authorization. Our office handles these. The authorization will require you to have treatment with the same one therapist when visiting our practice. (This does not affect your freedom to see providers at other clinics.)

  • Despite showing us as in-network, a few plans exclude (will not cover) massage therapy, services provided by massage therapists, or acupuncture.

Which RituaLuna Wellness providers are in-network with my plan?

Use your insurance provider directory. Enter your member number or network, and search for the provider's name. If the search brings up a provider's profile, they are in-network.

Do I need a referral for massage or acupuncture?

Insurance companies that do not require referrals:

  • Providence Health Plan PPO plans do not require referrals for in-network care.

  • BlueCross BlueShield Federal Employee Program (FEP) plans do not require referrals for specialists.

  • Moda commercial plans rarely require a referral.

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Insurance companies that require referrals for massage therapist services and acupuncture include (but are not limited to):

  • Regence BlueCross BlueShield of Oregon

  • Regence BlueShield (Washington)

  • Regence Group Administrators

  • Regence BlueShield of Idaho

  • Regence BlueCross BlueShield of Utah

  • Premera Blue Cross of Washington

  • Premera Blue Cross Blue Shield of Alaska

  • Anthem Blue Cross (California) HSAs

  • Asuris Northwest Health

  • Bridgespan

  • Healthcare Management Administrators (HMA)
     

We require referrals for out-of-state Blue Cross Blue Shield plans such as Anthem, Blue Shield of California, Empire, Highmark, Horizon, Independence, and Wellmark.

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If you have a plan not listed above, please contact your insurer before your appointment to confirm benefits (see below).

What is a referral?

A referral is a document similar to a prescription that providers proof of a condition that we can treat.    The referral must contain:

  • a diagnosis that massage therapists are authorized to treat, typically as a musculoskeletal condition identified with a ICD-10 diagnosis code beginning with M (e.g., "M25.551 - pain in right hip").  

  • the prescribed number of treatment sessions and/or a designated time frame for the referral's validity. For example, it might specify "6 sessions of 60-90 minutes, valid for 6 months" or "twice weekly for 8 weeks."

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Who has the authority to write a referral?

  • Oregon: Physician (MD), Doctor of Osteopathy (DO), Physician Assistant (PA, PA-C), Nurse Practitioner (NP, ANP, PNP, FNP, GNP), Naturopath (ND), Chiropractor (DC), Podiatrist (DP) for lower extremity problems only, or Dentist (DDS, DMD) for craniomandibular disorders only.

  • Washington: Physician (MD), Doctor of Osteopathy (DO), Physician Assistant (PA, PA-C), Nurse Practitioner (NP, CRNP, ARNP), Naturopath (ND), or Osteopathic Physician Assistant (OA).

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My insurance does not cover massage or manual therapy performed by LMTs. Will getting a referral change that?

No, a referral cannot override policy exclusions, nor does it guarantee benefits.

Referral Form

Out-of-state BlueCross BlueShield plans:

Our Regence-credentialed providers can accept Blue Cross Blue Shield insurance from outside the Pacific Northwest, such as Anthem, Highmark, Empire, Wellmark, etc. Unfortunately, these plans do not provide us with a way to confirm your benefit information. Therefore, we require all patients with these plans to call and confirm coverage and benefits before their appointment. Please ask the following questions:

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For massage:

  • Does my plan cover massage (97124) and/or manual therapy (97140)? (Pro tip: ask about both)

  • Are LMTs excluded from providing this service under my plan?

  • Does my plan require a referral for these services?

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For Acupuncture:

  • Does my plan cover acupuncture?

  • Does my plan require a referral for these services?

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Additionally, please inquire about the following details:

  • What is my copay/coinsurance

  • What is my deductible?

  • Are these services excluded from my deductible?

  • How many sessions/what is the dollar amount limit of these services?

  • What is my out-of-pocket maximum?

  • Are these benefits shared with other types of services?

  • How much of this benefit have I used this year?

  • When does my plan reset (what is my coverage period?)

 

I found a RituaLuna Wellness provider listed on an insurance network not listed above. What does that mean?

Sorry! Some of our therapists are incorrectly listed in some plan directories which have not been updated recently. If it's not one of the medical insurers listed above, we have opted out of it due to low reimbursement rates.

I have out-of-network benefits; how do I use them? 

If you have Regence, Moda, Providence, Asuris, Bridgespan, HMA, or out-of-state Blue Cross/Blue Shield medical insurance, we will bill them directly.

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If you have another insurance company, you will pay us for the session, then request a superbill from your therapist at the time of checkout, then you will send the superbill to your insurance for reimbursement.

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Does RituaLuna Wellness take Oregon Health Plan, Medicaid, or Medicare?

We have been unable to successfully bill for services under any OHP or Medicaid policy including those managed by companies we are in-network with. We cannot bill Medicare except for Medicare Advantage (Part C) plans.

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How do I verify my medical insurance coverage/benefits?

When you book a session, you will fill out an intake form that will send your insurance information to our office. If you aren't ready to book, email a picture of the front and back of your insurance card to office@ritualunawellness.com

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