Self-Billing Medical Insurance

If you would like to get reimbursed for your out of network medical massage we can help you.

Since each insurance company has different rules regarding reimbursement for massage therapy, you should call them first to confirm the following:

  1. What forms do you need?
  2. Do you need a referral or prescription from your healthcare provider?

Typically you will need items below to request reimbursement for your out-of-network medical services:

  1. Reimbursement form
  2. Invoice
  3. Receipt

At time of payment, please let us know that you are billing out-of-network, and we will provide you with the following:

  • Proof of payment
  • Procedure code
  • Itemized charges
  • Our Tax ID
  • Diagnosis code from Dr.’s Prescription

Once you complete the forms, mail them along with your documentation to your insurance, and you will received the reimbursement payments.

Insurance Forms

Popular insurance company reimbursement forms

Aetna (PDF)

First Choice Health (Link)

Kaiser Permanente (PDF)

Premera (PDF)


United Healthcare (PDF)