Bevin Keely, LMP

Pre-Authorization

Regence Blue Shield has recently begun to require pre-authorization for physical medicine services, including massage therapy. If your plan is administered by Regence, but independent of them (ex. King Care, UMP) this does not affect you.

I am still learning how this works, but it is supposed to go like this:

  • You come in for an initial assessment and treatment.
  • I submit for a pre-authorization online.
  • If you have not yet received any physical medicine treatments for the year, you get four sessions automatically, to be used within three months. This includes the initial treatment and assessment.
  • After four sessions, if you still feel that you need treatment, I then submit an updated treatment request showing changes you have made since the start of care, and outlining how we are going to quickly and efficiently get you healed within, say, another four sessions.
  • If you have already received some physical medicine treatments, including Physical Therapy, other Massage Therapy, and possibly Chiropractic care, I’m not even sure what we have to do. I haven’t jumped that hurdle yet, and as you may know, getting answers from insurance companies can be tricky.

Here is a chart showing their progress expectations:

I will update this post as I learn more about how this works in practice.

In the meantime, if you are a Regence client (not a King Care or UMP subscriber) and have had some physical medicine treatment already this calendar year, I will need you to contact me before you make your appointment so we can try to set the gears in motion.

Thanks.