Thank you for seeking out medical massage (Mx) and bodywork with Blissful Being Wellness, LLC

Our mission to serve our community with therapeutic and holistic care extends to providing services covered by insurance as much as we are able. All LMTs working at Blissful Being Wellness can provide care for Auto Accidents (MVAs), but not all health insurance companies.

Please complete the following information so we can begin the process of billing ASAP and best serving YOU :)

VERY IMPORTANT*:

For MVA/WC, you WILL need a referral from a healthcare provider for Massage/Manual Therapy WITH Dx codes.

For Health Insurance Mx, you MAY need a referral from a healthcare provider and must find out from your insurance provider if your plan qualifies.

**ALL referrals MUST be submitted to us ASAP as it delays billing/reimbursement. You may be required to pay your 1st appt.

With ALL insurance covered massage, we require you to complete our Financial Agreement. Please print and complete to bring to your first appointment. All information is stored in a secure and locked location, never to be shared. https://drive.google.com/file/d/1HMBAiQXd9B5GtgCLwTajbl6Rc6PMrYY6/view?usp=sharing

SECTION 2: MVA/WC

The following questions are specific to Auto Accidents and Worker's Compensation.

ALL questions are required and if unanswered will delay our progress. 

Please leave blank if this section does not apply to you and move on to SECTION 3: Health insurance Medical Massage & SECTION 4: Scheduling

SECTION 3: Medical Massage as part of a health insurance plan (skip for MVA/WC)

The following questions are specific to Health insurance covered Massage Therapy (Please note, we cannot bill OHP/Medicare/Medicaid insurance plans).

ALL questions are required and if unanswered will delay our progress. We urge you to contact your insurance member benefits representative to help answer unknown questions. Thank you!

SECTION 4: Scheduling

THANK YOU so much for all of this information, your time and your confidence in our services. We look forward to working with you soon & now you can get scheduled! FIRST, we require prepayment of first-time services, that which is covered by insurance will be reimbursed OR applied to future co-pays. *Most insurance only covers 60minutes, you may opt to pay out of pocket for longer treatment.

Please follow the link to schedule your appointment with us. www.massagebook.com/biz/blissfulbeing

If your insurance covers the first appointment and other costs are already met, this amount will be refunded to you within 30 days of first insurance reimbursement received.

New Client Intake Form (required):

https://www.blissfulbeingwellness.com/_files/ugd/ca1e2f_3d98d280f0ff4c56a2c877141c475ff1.pdf

By choosing to work with us, you are agreeing to Blissful Being Wellness Policies & Agreements, please read them here:  https://www.blissfulbeingwellness.com/policies-agreements