FIRST-TIME BOOKING HOW-TO

When booking online, to help your first session go smoothly and timely please follow the prompts given.

When booking an appointment by phone, email, or other platform you can choose to fill out the form(s) ahead of the appointment, in my office, or request forms to be emailed to you.

If billing insurance for the appointment you must provide your insurance billing information at least 72 hours BEFORE your first appointmentto confirm coverage and/or copay amount.

Without pre-authorization of your insurance, you will be required to pay in full for your first appointment. Depending on your insurance, you may be required to pay for your appointments and be provided a form to submit to your insurance company directly for your reimbursement.

Patients are responsible for the full appointment fee, copay, or any balance due that was not covered by the insurance company


					

Opioid Crisis and Massage Therapy

I normally don’t watch C-SPAN and especially not 2 hour-long Senate hearings, but I came across an article on the AMTA website for massage therapists. It was stating that massage therapy is recommended in the help with the Opioid Crisis/ Epidemic. I wanted to see the transcript of these claims and couldn’t for the life of me find one! I tried googling for videos that were made mentioning massage and came up with nothing. That’s how I ended up watching 2 hours of “Testimony for the Senate Health, Education, Labor and Pensions Committee Hearing on managing Pain During the Opioid Crisis (February 12, 2019.)”

In February, The U.S. Senate Health, Education, Labor & Pension Committee (H.E.L.P) held a hearing on the opioid crisis in the US focusing on alternatives to opioids for pain relief. Emphasizing on non-pharmacological solutions to pain, it was loud and clear to the senators and witnesses that there is a huge demand for health insurance companies to cover alternative and complementary therapies.

The opioid crisis has been a long time coming. In the late 1990s, drug companies and the healthcare community did not believe opioid pain medication would cause addiction. Patients did become addicted however and doctors were prescribing them at an alarming rate not knowing it would become harmful to the patient. When it came on the White House’s radar, more than 72,000 Americans died of drug overdose in 2017 alone (many opioids), President Trump declared it a public health emergency. 

Two years later, there have been some new guidelines on the prescribing of opioids. Many states have limits on the duration/amount of opioid prescriptions with professionals now being in agreement that though opioids are powerful  and effective, they are extremely addicting.

With electronic monitoring of opioids through prescription drug monitoring programs (PDMPs) doctors can see clinical and pharmacy data to prevent doctor shopping and fraud. In addition, prescriptions were limited to 3 days and rarely more than 7 days. Exceptions being for active cancer, palliative, or end-of-life care. This left out chronic pain sufferers who rely on those medications for pain management.

Sue Glod, MD, palliative medicine specialist, “Drugs are being denied by insurance companies…(and) pharmacies aren’t stocking sufficient quantities of opioids, leaving our staff to go through a lot of paperwork, so there are wait times.”

These wait times can be devastating. While the doctor is waiting for an authorization policy for a prescription, the patient waits sometimes up to several days. During that time, if the patient has been using the opioid prescription regularly then they begin to go through withdrawal almost immediately. Many chronic pain sufferers have accompanying illnesses or diseases that are being overlooked and instead scrutinized by the public and even some doctors dismissed as medication-seeking. 

At the Senate hearing, two doctors, a pharmacist, and an addiction advocate gave testimony. They agreed that there was no one size fits all approach to pain management or to the epidemic at hand. In January, the US Department of Health and Human Services published a report on best practices for pain management that calls for individualized, patient-centered pain management which includes recommendations related to massage therapy.   At the same time, the Centers for Medicare and Medicaid Services (CMS) wrote to Medicare Advantage programs urging them to cover massage therapy in 2020. 

“CMS encourages MA (Medicare Advantage) organizations to consider Part C benefit designs for supplemental benefits that address medically-approved non-opioid pain management and complementary and integrative treatments… In addition, non-Medicare covered chiropractic services, acupuncture, and therapeutic massage furnished by a state licensed massage therapist, may also be incorporated into plan designs. “Massage” should not be singled out as a particular aspect of other coverage (e.g., chiropractic care or occupational therapy) and must be ordered by a physician or medical professional in order to be considered primarily health related and not primarily for the comfort or relaxation of the enrollee. The non-opioid pain management item or service must treat or ameliorate the impact of an injury or illness (e.g., pain, stiffness, loss of range of motion).”

I am hoping that after the Testimony for the Senate Health, Education, Labor and Pensions Committee Hearing (February 12, 2019), additional statements from organizations, and more funded research, Medicare, Medicaid, and more private insurance companies will consider including massage therapy in their coverage. All things considered,  I was really only left with the Big Question. Where as a country do we go from here? 

 

None of Your Beeswax

Time to spring forward the clocks and think ahead for the upcoming season! I’ve been busy this winter making some natural lotion, butters, lip balm, and soap for selling at the markets in the summer. Oh, and new clients get a free massage lotion bar with their first massage at my studio!

I like to keep things simple. My massage lotion bars are the perfect thing for cracked or dry heels and sore feet. I use mine on my elbows and hands before bed and wake up to softer skin. It’s completely made of oil so a little goes a long way! By not adding water the bars are able to stay more solid and last longer without preservatives.

Ingredients: Local beeswax, organic coconut oil, sweet almond oil, raw mango butter

Now Accepting FSA and HSA Cards!

At Country Massage, we are now accepting medical FSA and HSA debit cards as methods of payment. Do you have a flexible spending account (FSA) or health savings account (HSA) as a part of your health insurance plan? Did you know it can be used for massage therapy? For those that don’t know what these are I’ll break it down!

A flexible spending account is an account that can be set up through an employer’s benefit plan. The card allows the employee to save a portion of their income to pay for medical/ non-medical expenses that are listed under the plan. This money cannot be taxed and is taken from the employee’s income, however, if the money is not used by the end of the year then it is gone. To qualify, you must be an employee for a company that has adopted the “Federal Flexible Benefits Plan or FedFlex.”

A health savings account is slightly different in that it is available to taxpayers who have an “HSA-qualified high deductible health plan.” This card is similar to an FSA card with the exception that funds are not lost at the end of the plan’s year. The money in the account is rolled over from year to year! Also, some tax advantages are that the employee isn’t taxed at the time of the deposited funds. To qualify, you must have a high-deductible health plan, no other form of health insurance, and cannot be listed as a dependent on someone’s tax return.

With FSA cards, the employee can use all of the available funds at any point in the year. If the employee is no longer working for the company the funds in the account do not have to be paid back. In a high deductible health plan the employee pays a lower premium. In a HSA, the plan will usually cover up to 100% of the medical costs without coinsurance. Since there’s no deadline to use the funds, the employee has the benefit of using tax-free health care and tax-deferred retirement.

Country Massage accepts FSA and HSA cards as payment but if you’re uncertain of your available funds and benefits please inquire before the appointment with your plan’s representatives. Having a prescription for massage therapy is always the first thing I like to recommend to ensure you are not paying any unnecessary out of pocket costs. I look forward to working with you and as always feel free to ask any questions via phone call or email.

January Health Insurance Update

My credentialing process with Regence is over and I’ve been approved! This means I’m on my way to becoming a part of the Regence network and a preferred provider.

I am going to estimate that I’m one month away from being official so until then I can bill clients for appointments but only as an “out of network provider.” I recently sent a network participation application to Moda Health and have no other updates for the other companies.

If you want massage therapy to be covered by your insurance you must check out your plan first by speaking with a representative for your health insurance and whether or not massage is a medically necessary treatment. If you have a prescription from your doctor then using me as an out of network provider is more likely to be covered but not guaranteed.

Alternatively, I can run your Health Savings Account card and email, text, or print you an invoice/receipt for your records. If you have any questions don’t hesitate to call!

Auto Injury Massage and Personal Injury Protection (PIP)

Were you injured in a car accident in Oregon? Did you know your auto insurance must pay for “medically necessary” massage therapy treatments? All auto insurance policies in the State of Oregon include Personal Injury Protection (PIP.) This will pay for massage therapy regardless of who was determined to be “at fault.” This coverage allows you to be treated for your auto accident related injuries with a referral/prescription that has the necessary codes for billing. This can be done by your chiropractor, naturopath, osteopath or doctor.

Oftentimes it’s the body’s soft tissues injured in an accident. Auto injury massage can help with recovery from whiplash, neck/back injuries, muscle spasms, myofascial pain, headaches, stress and insomnia.

Just ask your doctor for a prescription! I will be documenting your progress after every treatment. PIP coverage will pay for massage treatments relevant only to your injuries caused by the accident for up to 2 years from the time of the claim or until the benefits are exhausted at $15,000. You will need to keep track of the balance of your benefits.

The most current rate set for massage therapy and manual therapy by the State of Oregon Worker’s Compensation Fee Schedule is $51.90 per 15 minute unit for “massage therapy” and $47.13 per unit for “manual therapy.” Additional codes would be applied for treatments that include heat/cold therapies (hot stone therapy, hot towels, heat packs, ice packs) and add-ons like topical analgesics.

*Insurance policies and laws vary from state to state and from one policy to another. These are general statements and may or may not reflect your own policy. Please inform yourself about your own coverage.

Please call ahead before booking an appointment online if you’re wanting covered by auto insurance. After confirming with you and the company, that your claim is approved and massage is covered, please bring in the following;

— Name of insurance company
— Name and phone number of your insurance representative
— Claim number
— A prescription for massage therapy from your doctor (M.D., Chiropractor, Osteopath or Naturopath)

What is Mango Butter?

With DIY skin care I’ve been noticing that natural butters like cocoa and shea can alter the scent you’re going for. I read about mango butter being a great substitute for this and for those who have bad skin reactions to shea butter. I used it in a three-ingredient lotion bar and am happy with the results. It was unscented, hard but soft enough to break up for melting, and gives the bar a creaminess that I normally don’t see with solid lotion.

Mango butter has a higher level of vitamins and antioxidants from the other butters and different fatty acid profile. Containing vitamins A, B, C, D, E. Vitamin A helps with cellular turn over and collagen production. Vitamins C, D, E, B, palmitic and stearic fatty acids assist with cell regeneration.

None of the actual meat of the mango is used. It’s actually made from the kernel inside the mango fruit. Expeller pressed then machine refined to remove its odor. Raw mango butter can’t be sold for cosmetic use as its natural odor is pungent and not desirable.

With its many nutrients mango butter is naturally able to help heal cracked and severely dry skin. I used it as a base for lotion but I plan to use it in the future for body butter and much more!

 

Homemade massage lotion bar I made

Last minute Christmas shopping!

At Cross Rifle BBQ restaurant in Fossil, I’ll be offering chair massage, selling gift certificates, and giving away 10% off COUPONS for any 1 hour massage modality! There will also be Fossil Threads and LulaRoe shopping! It’s not too late to get last minute stocking stuffers and gifts.

When: 5-7pm Thursday December 20th (TODAY!!)
Where: Cross Rifle BBQ restaurant

Massage after breast cancer

Women who’ve had breast cancer often are recovering from breast surgery. After surgery, common issues are pain and restricted or limited range of motion compared to pre-surgery activity.

For most, recovery consists of rest, medication, and physical therapy but recent research has proved that massage therapy helps manage pain levels and with range of motion, in addition to the mental benefits for depression and anxiety.

With any invasive surgery you will develop scar tissue from the incision site but did you know that scar tissue affects range of motion beyond the incision site? Massaging scar tissue (once healed) keeps the tissue from hardening so much that it affects your movements and the muscles surrounding it.

After surgery, the swelling and bruising of tissues causing discomfort and pain are the same reasons to not want to get a massage. The idea of lying on a table on your chest or being pressed against the padding of a massage chair likely sounds awful. To that I can say there are other ways to comfortably have a massage. Having a breast cancer patient on the massage table just means they are in a side-lying position for easier access to the back and being on the back is also possible.

For those still using drainage tubes I can help assist them onto the table if needed and I am a certified nurse aide so have quite a bit of experience with post-surgery patients. I supply towels, blankets, and pillows, to make your session as comfortable as possible. For post-surgery patients I offer complimentary essential oils if desired.

Medical evidence suggests massage may speed up healing and lessen the recovery period.

In the International Journal of Therapeutic Massage and Bodywork, it showed that myofascial massage, was able to “significantly reduce the pain and disability associated with breast cancer surgery.”

For the study, 21 women recovering from breast surgery, randomly selected, received either myofascial massage or Swedish massage.

Each woman had 16 massage treatments over eight weeks. They were questioned about pain, disability and quality of life at the start and end of the study.

The evaluator and data collector did not know which massage they were given.

The participants with myofascial massage had a significant reduction in pain and a significant increase in mobility, a feeling of better general health, AND overall quality of life when compared to the other group.

“Myofascial massage is a technique that focuses on applying fascial holds, stretching, stroking, and varied pressure to tissue at modified depths.”

With breast surgery, the fascia which covers muscle is cut through and when fascia heals it becomes tight, uncomfortable and inflamed. “Fascia is a thin layer of connective tissue that encases your body under your skin like a wetsuit and wraps itself around every muscle, joint, and organ.”

Because of this it needs to retain its flexibility to keep everything running smoothly. For pain relief and better mobility massage can help and complement traditional medicine and treatments.