Freed Bodywork
Integrative Therapy

MVA/Insurance

MVA | Workers Compensation| Health Coverage

Specializing in motor vehicle accidents, I can help unwind the injuries sustained from the smallest rear end to the biggest of accidents. Regardless of whether you have liability or full coverage, or who caused the accident we are allowed up to $15,000 for hospital bills, lost wages, and alternative care with car insurance Personal Injury Protection.

Accepting some health insurance as an out-of-network provider. Billing as an out-of-network provider for all insurance plans means I have more freedom to customize my treatment for you. Verification of massage therapy as a benefit is needed first, then a referral from a doctor, primary care physician, or chiropractor and we can begin. You may have a deductible to meet and a small co-insurance/co-pay which will require you to pay some out-of-pocket expenses for your treatments. I will take care of all billing, keep a record of your chart notes, and out-of-pocket and insurance payments.

Feel free to give me a call and I can walk you through the process, offer support, and answer questions or concerns you may have about your MVA, health insurance coverage, and massage therapy.


MVA Insurance Form

Name *
Name
Address *
Address
Phone Number *
Phone Number
Date of Birth *
Date of Birth
Emergency Contact Phone *
Emergency Contact Phone
Insurance Information
Was injury a result of an accident?
if yes, related to:
Date of Injury Onset
Date of Injury Onset
Insurance Company
Billing Address *
Billing Address
Phone Number *
Phone Number
Contact person/Adjuster
Contact person/Adjuster
Attorney (if applicable)
Name of Attorney
Name of Attorney
Address
Address
Phone Number
Phone Number
Authorization *
I hereby authorize the release of medical information necessary to process my insurance claim. This may include intake forms, chart notes, reports, correspondences, billing statements and any other information to my attorneys, health care providers and insurance case managers. I am responsible for all charges for all services provided. In the event that the insurance company denies benefits or makes a partial payment, I am responsible for any balance due. This may not apply to insurance companies that I am under contract with. I understand the benefits and risks of massage and give my consent for massage. I will consult my practitioner with any questions or concerns imediately. I have stated all medical conditions that I am aware of and will keep my practitioner informed of any changes.
Date *
Date

I understand the process of an MVA professionally and personally. Call, email or schedule a session now for pain relief and guidance after a car accident.