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Insurance Verification Policy

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• Insurance Benefits Verification

• Clients are responsible for checking their own insurance benefits prior to your appointment. We are no longer able to verify benefits for all clients. 

• We ask that you complete the insurance benefits questionnaire in your intake form using information provided by your insurer either via phone or portal (phone may be easier to understand).​​​

• The buttons below link to documents you can use during your call. Please fill this information into 

• your intake form or (less preferred) email them to office@ritualunawellness.com

• If you are unable to obtain this information on your own, you may contact our office at office@ritualunawellness.com for assistance.

• Requests handled by the office require at least three business days to process. 

 

 

 

 

 

 

 

• Insurance Not Submitted: If your insurance is not submitted before your appointment or request for assistance is not submitted with 3 days of processing time, you will need to pay the cash rate for your session at the time of your appointment.

• Refunds: Any overpayments or payments made before we obtained confirmation of benefits will be automatically refunded to your card. This occurs at regular intervals throughout the month. If you have questions about refunds email office@ritualunawellness.com​

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Stuff You Need to Know

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• Out of state plans: are less likely to recognize LMTs as medical providers and are more difficult for us to communicate with, check benefits, etc. If this applies to you, please note that we may need to bill you directly for services rendered, even if you have massage or manual therapy benefits.

• Out of network benefits: While you may have out of network benefits, we must currently decline to bill out of network due to the increased administrative burden of communication when we don't have access to their portals. We are happy to provide you with a super-bill itemized receipt for medical care that will allow you to be reimbursed through your insurance. Please ask your provider for a Super-Bill after each appointment or email office@ritualunawellness.com to have them sent to you. (you will be asked if you want to use massage or manual therapy benefits)

• Referrals: Regence, BCBS, Asuris, Bridgespan require a referral from a physician. This is written into our provider contracts and may not be listed in the language of your plan. Whatever your insurance customer service might say, if RituaLuna Wellness doesn't have a referral on file, payments can be retroactively pulled back from us even years after treatment. We have decided on a strict policy to protect us from this risk. We have a specific form that we provide to Dr's offices so that we get a correct referral to cover services. It is linked below. Please share this with your provider when requesting a referral for the first time, future referrals will be requested by our office

• Federal employee plans seem to be an exception to this rule and do not require a referral

• Referral Writers: MD, DO, ND, NP, or PA. Physical therapists, optometrists, acupuncturists, don't qualify. Chiropractors seem to qualify for MVA claims but not private insurance. 

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• Preauthorizations: Many plans require pre-authorization for manual therapy benefits. We are unable to guarantee that insurance will authorize appointments and you may be liable for the first appointment if they decline. After the first appointment and we have the pre-authorization in hand we are pretty confident that they will pay for your visits. Additional "treatment plans" may or may not be approved and are usually approved for fewer visits than the initial one. These plans also require additional record keeping and you may be sent clinical questionnaires based on the requirements from your insurance. 

• Patience and Kindness: Dealing with insurance can, at times, be a large burden for a small clinic. We take insurance because is helps us provide care to more people with more consistency as well as helping our business maintain a more regular schedule throughout the year. Often, insurance companies use unclear language, change the rules without telling us, and sometimes they just don't pay the bills and we don't know why. If payment for treatment is declined, we will check for errors on our side and then ask for you to contact your insurance company for an explanation next steps. If we are unable to get paid within a reasonable amount of time, we will ask for you to pay for the services. Please be kind to us. We have sensitive nervous systems and we really do our best. 

• Tracking Benefits: We do our best with the information we have, but it is your responsibility to track your benefits. Knowing when you've met your deductible, your out of pocket maximum, and when you might be toward the end of a fixed number of visits for the year is all information that should be available to you on your portal or from customer service. If you've exhausted your benefits and continue to get care, you will need to pay for those visits

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Stuff you might want to know

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• Insurance not listed?: We may be mis-represented on provider directories for a number of reasons. Maybe it was an error when being contracted with other/related insurance companies, maybe that provider is in network at a different practice location, or maybe we opted out but they failed to remove us. In any event. We only take the insurances listed above and if your insurance isn't on that list, you can contact your insurance company to see if you're able to be reimbursed for out of network benefits. (see out of network benefits above)

• What about OHP for acupunture?: We are working on getting our acupuncturist on OHP Open Card and will update once that's complete but it's likely to take many months. Other OHP plans are not currently accepting acupuncture applications from acupuncturists.

• What about OHP for massage?: Our understanding is that OHP doesn't cover LMT's who work independently of physicians, chiropractors, etc. 

• What about medicare?:  We're sorry but our understanding is that medicare doesn't cover massage at all and only covers acupuncture if it's provided by an MD, NP, PA, etc. who is dual trained and licensed in both western and eastern medicine. Our acupuncturist does not qualify. 

• If Massage or LMT's are excluded: There's no real way around that. A referral won't help. You may be able to get services at another clinic with a broader team of providers such as ND's and Chiropractors as they can sometimes bill for massage under their medical license.

• LMT: Massage vs Manual Therapy: In the state of Oregon, LMT's are allowed to provide manual therapy under the physical therapy benefit and/or massage therapy under another alternative care bundled benefit. Some plans will specifically exclude LMT's from providing manual therapy in the language of the plan. Out of state plans also may not recognize LMT's scope of practice being able to provide these services. It is important for you to understand any exemptions in your plan. 

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