MET 101 Tip 17 - What Can a MES Bill to an Insurance Carrier?


In "MET 101 eBook Tip 17," Dr. Mike looks at the complex world of insurance billing for medical exercise training professionals, a topic that has gained significant attention over the years. Dr. Mike debunks some of the myths and lays out the realities of navigating insurance reimbursement using a MET Insurance Reimbursement criterion. This video is part of the "MET 101 eBook" series, where Dr. Mike shares his extensive experience and insights, drawing from his background of owning PT clinics, to help medical exercise professionals understand how to secure and retain insurance payments for their services.

Key points from the video include:

Evolution of Insurance Billing: Dr. Mike discusses the shift in insurance billing practices since 1994, highlighting the growing interest among medical exercise professionals in understanding how to bill insurance carriers.

The Reality of Insurance Billing: Emphasizes the critical importance of accurate billing and the potential for audits by insurance companies, stressing the need for medical exercise professionals to be well-informed and cautious.

Insurance Reimbursement for Exercise Programming: Notes that some insurance carriers in North America are beginning to recognize and reimburse for medical exercise services post-physical therapy, reflecting a slow but positive change in the acceptance of medical exercise training.

Criteria for Insurance Reimbursement: Outlines the specific criteria set by insurance companies for medical exercise training reimbursement, including the necessity of a written referral from a physician.

Challenges with Medicaid and Medicare: Discusses the limitations and challenges of billing government-funded health insurance programs, which typically do not cover services not provided by a licensed medical professional.

Pre-Authorization and Documentation: Highlights the importance of obtaining pre-authorization from insurance companies and providing thorough documentation to increase the chances of reimbursement.

"MET 101 Ebook Tip 17" is an invaluable resource for medical exercise training professionals seeking to navigate the complexities of insurance billing. Dr. Mike's expertise and practical advice offer a roadmap for understanding the intricacies of insurance reimbursement, the importance of compliance with an MET criteria, and the strategies for maximizing reimbursement opportunities.

In conclusion, this video is a must-watch for any medical exercise professional looking to expand their knowledge on insurance billing and reimbursement practices. Dr. Mike's insights provide a solid foundation for understanding some of the basic criteria the client and their condition must meet before you begin seeking reimbursement for MET services.

For those interested in further exploring the principles of medical exercise training and gaining more understanding of the MET insurance reimbursement criteria, join us Friday, March 22nd at 2 pm ET/11 am PT for a look at “6 Criteria for Insurance Reimbursement for MET Services”. Use the link below to register and pay. The webinar is sponsored by the Medical Exercise Specialist Network. Join here:

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