Legal Question in Credit and Debt Law in Pennsylvania

I had been going to a massage therapist for spine pain for a few years and she mentioned if I was ever in an accident, that she accepts auto insurance. She charges 65 for a 1 hr massage. A year later I was in a car accident and I mentioned about my accident and had a claim filed with my auto insurance company. So she said I didn't have to pay up front, that she could file with the insurance company directly to get paid. I went to 10 massages. Once a week. The insurance company paid 5 of the claims and after a peer review they denied the last 5 massages. ( it has now been 2 months since I had the last massage, but just got notified now) so the massage therapist sent me a bill saying I owe what the insurance company would have paid her for 5 massages. She is charging double per massage of what I normally pay her (65 per hr) this seems wrong of her to me. Is this allowed or should I try to fight this?


Asked on 6/12/16, 10:10 pm

1 Answer from Attorneys
Rachel Hunter

I don't know about professional masseuses, but healthcare providers have negotiated rates with insurers. Those who are uninsured pay different rates. Why did your insurer pay for some treatment and deny others? Seems like you can appeal the determination by your insurer. If you appeal and your claim is still denied, then you can always negotiate with the masseuse to pay something but not as much as she is claiming. I don't know why the masseuse would be different from any other provider - if you can pay in a lump sum, see if she will knock off some money. I wouldn't be going back to her though. You might also want to contact the state board of massage therapy in PA and see if they can answer your question: http://www.dos.pa.gov/ProfessionalLicensing/BoardsCommissions/MassageTherapy/Pages/default.aspx#.V2Dmv7srLIU

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Answered on 6/14/16, 10:26 pm


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