Maya provides direct courtesy billing to all auto insurance providers and to the state and employers for personal injury and L&I claims. All of our providers are fully licensed, insured, and credentialed. Nearly all Personal Injury Protection (PIP) policies for auto accident cover massage, acupuncture/east asian medicine, naturopathic medicine to provide relief and recovery from traumatic or repetitive injury. Labor & Industries (LNI) for workplace accidents typically covers massage, but not acupuncture or east asian medicine services.
Medical Massage (both Billed and Prepaid Network) requires a prescription or referral from a health care professional legally qualified to issue a ICD-10 diagnosis code and a treatment plan that provides diagnosis code, number and frequency of treatments, and duration of treatment plan.
Acupuncture and Naturopathic Services
Maya Whole Health Studio is a preferred provider, offering in-network acupuncture and naturopathic services under most major medical plans. Our studio provides billing services and accepts direct payment from most health insurance companies for acupuncture and naturopathic treatments.
Massage, Tui Na, and Cupping
Medical Massage, Tui Na and Cupping are not eligible for direct billing to major medical insurance plans. If you have a benefit on your medical plan for massage and you have a current treatment plan on a prescription or referral, you may request Prepaid Network Medical Rate for massage services and receive an an itemized invoice (aka: SuperBill) to submit to your insurance company for reimbursement. (Reimbursement is dependent on terms of your plan benefit and cannot be checked or guaranteed by Maya Whole Health staff.) Use the following links to go to the reimbursement form for your insurance provider:
Medical Massage services are customized to meet client needs, based on treatment plan provided by medical practitioner and information provided by client during intake and during the treatment. One Hour Medical Massage provides for 10 minutes of intake assessment, charting, and follow up; 50 minutes of direct treatment; billing services (if L&I or PIP) or an itemized invoice "SuperBill" that provides treatment codes and proof of payment.
Maya Whole Health Studio massage practitioners are currently credentialed in several networks. We cannot guarantee continued inclusion in these health insurance networks.
*Maya Whole Health Studio has Naturopath Doctors (NDs) on staff who can provide evaluation and treatment plan for medically warranted massage services. Click Here more information on Naturopath Health Care services.
In all cases in which our studio bills services to a 3rd party payer (health insurance, L&I, PIP), the client is responsible to verify benefits for those services PRIOR TO receiving treatment. If you receive services at Maya Whole Health Studio, and a 3rd party fails to make payment on your behalf, you will be held responsible for those charges. In the state of Washington, no 3rd party (ie. health insurance plan, L&I, PIP) can absolve you of financial charges to a healthcare provider for services you have already received, other than by making payment.
In all cases in which a client is submitting to their insurance provider for reimbursement, the client is responsible to verify benefits and recover payment. Maya Whole Health Studio cannot provide information regarding your health plan benefits. If you are planning to submit your superbill for reimbursement, we strongly recommend that you contact your insurance provider to determine whether your services are covered under your plan and at what level. Reimbursement is dependent on terms of your plan benefit and cannot be checked or guaranteed by Maya Whole Health staff. The following links will take you to the reimbursement claim form for the indicated insurance provider:
Premera Claim Form
Regence Claim Form
Regence Uniform Claim Form
United Health Care Claim Form
Cigna Claim Form
If you are having a difficult time receiving reimbursement from your insurance company, you can contact the Insurance Commissioner's Office. You can contact them by calling 800-562-6900 or by going to their website at https://www.insurance.wa.gov/connect-with-us/.
To determine whether your plan provides coverage for services you have received at Maya Whole Health Studio or for services you are seeking reimbursement for, contact your insurance provider at the number on your insurance card or contact your plan administrator. Health plan coverage of charges may include variables, such as exclusive deductibles, pre-authorization requirements, diagnosis exclusions, or employer exemptions that can create patient responsibilities. Please be aware and prepared to cover those costs, in the case of insurance denial. Maya Whole Health Studio cannot provide any guarantee of coverage under your plan or of reimbursement for services received, and our studio cannot be held responsible for failure of an insurance company to pay your charges. A few key questions to ask when determining your coverage:
1) Does my plan provide coverage for the specific service (ie. massage, acupuncture, naturopath, etc.)?
2) Regarding acupuncture services, does my plan cover the consult/office visit, in addition to the insertion of needles and other services provided as part of a typical East Asian Medicine treatment? (Some plans refuse to cover the consult/office visit portion of the visit, but our practitioners cannot provide acupuncture services without first consulting with you to determine your current condition and your goals for treatment, etc.)
3) Do I need to meet a deductible before your services are covered?
4) Are any services (or specific "CPT codes") only allowable with a particular diagnosis (DX code)?
5) Do I have a co-pay or co-insurance amount?
6) Does my plan require a prior authorization for the services I'm going to be receiving?
Acupuncture –Naturopath - Massage – Private Lessons
You may cancel an appointment 24 hours prior to service with no financial penalty, up to 3x/month. Cancellation of services with less than 24 hours notice may result in a charge of 50% of the missed treatment. In the event of a no-show, you will be charged the full amount of the scheduled service. Be aware that insurance plans will not cover no-show or late cancel fees, so the no-show fee is the total cost of the appointment (not the typical co-pay amount). No further appointments can be scheduled until late cancel/no-show fees are paid in full. This policy is necessary for our studio to continue to employee the best possible healthcare practitioners to serve your needs. In order to assist you in keeping your appointments as scheduled, we provide multiple reminder options, including e-mail, text, and phone calls. To determine whether your insurance plan qualifies for direct billing for the services you're planning to receive at Maya, please first check with your insurance company to get details regarding what you plan will cover.
On your first visit, we request that you provide a credit card for any patient responsibility charged back by health insurance, L&I and PIP. If you prefer to be billed for those charges, you will receive a monthly statement of charges, only when there is a balance owing. In the event that a 3rd party payor does not make payment or services within 60 days, all amounts will revert to patient responsibility. Any amount that 3rd party payor indicates is patient responsibility will immediately revert to patient responsibility, even if an appeal is being filed. All balances are due within 14 days of first notification. Any statement with overdue balances will include a $5 late fee/statement charge. Appointments will not be scheduled for clients with balance over $240, without management approval. For clients experiencing financial hardship, payment plans and financial assistance are available on a limited basis via our Karma Love Fund.
We thank you for choosing Maya Whole Health Studio for your health and fitness needs and for honoring these policies that we have developed to serve the needs of all of our clients and practitioners. If you have any questions or concerns about our billing policies, please call 425-336-1421 or email email@example.com.