| Visitor
Resources |
 |
| |
| |
|
We
can save time if you print and complete these forms
BEFORE you come for your 1st visit, if you plan to see
me for a massage therapy or personal
training session. |
|
| |
|
Help finding
a therapist and ensuring that the therapist you choose
meets legal requirements and
tests of competency. |
|
| |
|
Forms
to be used for Medical Massage Insurance Billing. |
|
|
| |
The
remainder of this section offers links to a variety of
additional Online Resources related
to Massage Therapy.
|
| |
|
|
|
| |
| SESSION
INTAKE FORMS |
| During
your first visit, you will need to complete the following
paperwork. You may wish to print and complete the following
4 forms prior to your visit: |
|
|
| |
| Click here for Insurance Billing forms. |
| |
| |
| GIFT
CERTIFICATES |
| Please
call 703-989-6025 or contact us via email to
purchase a gift certificate. |
| • Online
purchasing currently disabled |
|
|
|
| |
| INSURANCE
BILLING FORMS |
Digital
Rose, Inc. will submit insurance claims when requested by
clients/patients.
At
a minimum, we will require a prescription from a licensed
medical healthcare provider, such as a physician or chiropractor,
since a Massage Therapist cannot legally diagnose conditions
or prescribe treatment plans. We work under the specific
direction of your doctor. We treat you as your doctor's
patient, following
the instructions provided within the prescription.
Digital
Rose, Inc. will help you determine whether you might be
reimbursed and provides several forms and documentation
to assist you.
Please contact us if you would like to receive a copy these
forms and documentation.
|
| |
| Insurance
Verification Script |
| The
Insurance Verification script contains questions for your
provider to determine whether you may be reimbursed for your
sessions. |
| |
| Physician's
Prescription / Referral / Letter of Medical Necessity |
| This form
may be used by your doctor to specify medical massage. It
contains the information required
by most insurance companies. We also offer a sample cover
letter that you may provide to your doctor that explains
the services provided by Digital Rose, Inc. |
| |
| Payment
Policies Supplement |
| The
Payment Policies document contains additional pricing and
payment information for Medical Massage Insurance Billing.
|
| |
| Assignment
of Benefits |
| The
Assignment of Benefits form allows payment to be rendered
directly to Digital Rose, Inc. Both forms must be completed
by patients for insurance billing. |
| |
| The
following prescription form may be used by your doctor to
specify medical massage. It specifies the information required
by most insurance companies. A sample cover letter has also
been provided. |
| |
| Release
of Responsibility (when submitting your own claims) |
| If
you wish to submit insurance claims yourself for financial
reimbursement, then we require that you complete
our Release of Responsibility form. |
| |
|
|
| |
| FINDING
A MASSAGE THERAPIST |
| [ CLICK
HERE — READ THIS FIRST ] |
| Here
is a list of resources to help you find a licensed Certified
Massage Therapist in the Commonwealth of Virginia: |
|
|
| • NeuroFascial.com |
|
|
| |
| MEMBER
ORGANIZATIONS |
| I
currently belong to the following membership organizations: |
|
|
|
|
| |
| MASSAGE
THERAPY RESEARCH |
| Here
are just a few sources for research into massage, manual
therapies, and bodywork: |
|
|
|
|
|
| |
| MASSAGE
TECHNIQUES |
| A
little more information about some of the techniques I frequently
use in my practice: |
|
|
| |
|
|
Copyright Digital
Rose® Inc. All rights reserved.