Advocating Through Insurance Billing

Editorial Note: Today's blog post comes from our FANTASTIC office manager, Christy Deneau!

Being constantly surrounded by amazingly talented music therapists, I get a first hand peep into the world of music therapy. I see the incredible progress they make with their patients each week, as well as the grueling schedules that they keep. I ask myself, what can a person like me do for music therapy? I don’t have a musical bone in my body.

Luckily, I am fortunate enough to have the ears and eyes of insurance companies each day. A big part of my job is working with our families and their insurance companies to receive 3rd party reimbursement for our services. Although music therapy is becoming more main stream, insurance companies are still learning about music therapy, its benefits for each population, and its place as an allied health profession.

It is not always an easy process. In the event that I need to appeal a decision, I take advantage of knowing that a Medical Director will be thoroughly reviewing my file. I am always sure to send loads of fact sheets, supporting research, and information on music therapy to educate them appropriately. I am happy to report that we have appealed many times successfully and continue to see an increase in medical plans that cover music therapy, an often necessary therapy for our patients. Helping to educate the insurance companies and help our families out on the financial end of things is what I can do (since you never want to hear me sing or play an instrument!)

Did you know The George Center is one of the leading music therapy private practices when it comes to billing insurance? It's true! We successfully bill insurance for about 80% of our clients!  Contact us today and we'd be happy to see if YOUR insurance company will cover music therapy services!

 

Photo credit: Keith Allison (http://www.flickr.com/photos/keithallison/5992627966/)

Does Medical Insurance Cover Music Therapy?

Today's post comes to us from our office manager Christy Deneau.  Christy began working for The George Center after gaining years of valuable experience in the healthcare industry as a physician recruiter.  Christy is an insurance guru who works diligently to ensure that clients of The George Center get affordable access to high quality music therapy services.

Many times when an individual calls our office inquiring about music therapy services, one of the first questions they ask is "Does medical insurance cover music therapy?"  In many cases, YES! As with all rehabilitative services, the answer lies with the patient’s individual and/or family insurance plan. All insurance companies are not the same just as all medical and mental health plans are not the same. While there are some plans that specifically exclude music therapy as a covered service, we at The George Center successfully bill 3rd party insurance providers for over 80% of our patients!

There are many effective CPT codes that music therapists successfully use that describe a variety of music therapy interventions. However, these codes are not discipline specific and are often used by other related healthcare professionals (i.e. physical therapy, occupational therapy, speech therapy, mental health professionals, etc.). Therefore, we always communicate your benefits and plan details so that you may choose how and if you want to use your therapeutic benefits for music therapy. This also helps to avoid a duplication of services with your other therapy providers.  In addition, the code(s) we use must fit our therapeutic goals for the patient.

Please keep in mind, at this time music therapists are considered out of network providers with ALL insurance companies. It is our mission as we increase national and state recognition of our credentials that music therapists will be able to apply to be in network providers very soon!  Until then, music therapy is typically subject to an out of network deductible that has to be met before your insurance company will pay any claims.

There continues to be a great deal of progress in the world of music therapy regarding advocacy, recognition, and reimbursement. Just this past March, Georgia Senate Bill 414 for music therapy licensure passed!  Licensure increases awareness and access to quality music therapy services for Georgia residents. Our own Jamie George served on the task force that worked to pass this bill and continues to work to educate and advocate for music therapy across the state and the nation. Make sure you sign up for our newsletter to stay informed about news and happenings regarding music therapy recognition and reimbursement options in our state and across the country.

We are always happy to call on your benefits to see what options might be available for music therapy services. Please keep in mind that insurance companies make it very clear that a verification of benefits does not guarantee payment. However, The George Center prides itself on working diligently to obtain claim approvals for all of our patients who have therapy benefits that include music therapy as a related service. We look forward to hearing from you soon!