Massage Therapy Insurance provider
Directory Audit

The WSMTA Clinical Practices Committee member, Julie Johnson, conducted an all-volunteer audit of the Regence Provider Directory from all over Washington. We wanted to have a focused effort to confirm what we’ve been hearing for years from our members and clients/patients – the medical insurance directories are inaccurate. With seventeen LMT volunteers (THANK YOU!), we could only confirm 176 individual licensed massage therapists out of 1078 directory listings were actively taking Regence in November of 2022.

Julie sent a letter “WSMTA – November 2022 Insurance Audit” detailing our findings for the Office of the Insurance Commissioner, the House Health Care and Wellness Committee and the Senate Health and Long-Term Care Committee, along with our concerns regarding network adequacy. We are excited to report our project and outreach yielded results. 

In late March of 2023, Julie was invited to a meeting with John Haworth, our OIC Deputy Insurance Commissioner in charge of Company Supervision, because his department felt the statistical information presented within the letter and the volunteer effort we embarked on was significant. He agrees that the Consolidated Appropriations Act (CAA) that went into effect this year is not going to be enough to fix most of the issues we had with the Regence Provider directory and his suspicion is that the problems we reported within the directories are not confined to just massage therapy. We talked about several other healthcare professions, but the similarities to what is happening in massage therapy is also being reported by other healthcare professionals in Washington. 

In addition to reviewing the results of what was reported in the letter, we discussed at greater length the barrier of usability when trying to update directory listings and other processes necessary to work with insurance companies. He asked what the process was and the frequency the insurers reach out to request updates, the process to get the directories updated or changed, the issues with credentialing/re-credentialing, the lack of feedback from insurance companies when submitting changes and requests, the difficulty of having multiple third parties with different systems handling different branches of information that do not communicate and synchronize data, and the lack of knowledgeable or available insurance employees in provider relations to contact with issues with all of these processes for help and assistance. 

On the topic of network adequacy, we discussed the issue of billable time. LMTs are not working 40 hours of hands-on/treatment time in a week like other healthcare professionals. We are also concerned about the duplicate listings and how many hands-on hours those practitioners are really available for treatment at each location listed. I continued to frame all my points around the availability of massage therapists in each region for patients trying to access massage treatment. He can see a need to verify the number of “treatment” hours each practitioner has at each location every week when considering network adequacy.

The OIC’s next steps are:

1. Reaching out to other healthcare professionals to see if their experiences with the provider directories are similar to what we uncovered. His suspicion is this is systemic for all healthcare providers.
2. Create a new process for the OIC to measure directory accuracy.
3. As part of that process, make recommendations to insurance companies of changes they need to make regarding usability concerns, feedback, treatment hours and provider relations access.

Julie ended the conversation with a willingness to be available for any assistance WSMTA can provide, our hope that the OIC can compel more provider relations availability from the insurance companies for our professional organization and in-network providers and our availability to educate and communicate with massage therapists in Washington State. 

Letter to the OIC and State Representatives on our November 2022 Audit of LMTs in the Regence Provider Directory

What can you do? Write your own letter to our healthcare committee state representatives about your experiences as an LMT with medical insurance providers.

Representatives on the House Health Care and Wellness Committee are Marcus Riccelli, Chair; Jessica Bateman, Vice Chair; Joe Schmick; Spencer Hutchins;  Stephanie Barnard; Dan Bronoske; Lauren Davis; Jenny Graham; Paul Harris; Nicole Macri; Jacquelin Maycumber; Gina Mosbrucker; Tina Orwall; Tarra Simmons; Monica Jurado Stonier; My-Linh Thai and Steve Tharinger.

Representatives on the Senate Health and Long Term Care Committee are Annette Cleveland, Chair; June Robinson, Vice Chair; Ann Rivers; Ron Muzzall; Steve Conway; Manka Dhingra; Jeff Holy; Mike Padden; Emily Randall and Kevin Van De Wege.