Notice for Providence Health Plan of Oregon Consumers

Providence Health Plan of Oregon

Out-of-State Insurance, Corporate Autonomy & Documentation Policy

Documentation Through Cigna Nevada Is Non-Negotiable

Due to the overwhelming volume of Providence Health Plan of Oregon consumers seeking massage therapy without proof of medical necessity, Massage Healthcare of America, Inc. (MHA Inc.) has an obligation to state clearly that proper clinical documentation routed through our Cigna Nevada provider network—originating from a licensed Nevada physician—is non-negotiable.

As reference, Cigna's own published standards require that participating physicians document referrals in the patient's medical record, and that specialty-care providers note the referral in the patient's record as well. MHA Inc. holds itself to that same standard for every patient we accept.

Corporate Independence & System Structure

Massage Healthcare of America Inc. (MHA Inc.) is a fully independent corporate enterprise operating strictly under the regulatory, legal, and medical billing compliance guidelines of the State of Nevada. MHA Inc. is completely independent and is not owned by, connected to, or affiliated with any large integrated health systems, corporate physician conglomerates, or vertically integrated healthcare networks.

As an autonomous corporate entity providing highly specialized, standalone medical massage healthcare, our services are not an ancillary department under external medical supervision. Accordingly, MHA Inc. retains absolute corporate authority over all aspects of our business operations, including:

  • Patient & Case Selection: The unilateral right to determine where we conduct business and which clinical cases meet our strict intake thresholds.
  • Data Sovereignty & Security: Total in-house control over our proprietary Practice Management (PM), Electronic Health Records (EHR), and database infrastructure. All clinical and operational data is secured within private, standalone systems and is never shared, pooled, or integrated with external health networks.
  • Claims & Revenue Integrity: Complete independence in defining our internal billing procedures, compliance crosswalks, and claims submission protocols to guarantee total regulatory adherence.

Out-of-State Insurance & Transfer Exclusions (State of Oregon)

Out-of-state healthcare frameworks—specifically insurance providers operating within the State of Oregon, such as Providence Health Plan—frequently utilize localized insurance benefits that allow consumers to access massage services without formal physician clearance, active diagnostic evaluation, or a verified determination of medical necessity.

MHA Inc. does not participate in or accept these non-medicalized frameworks. Operating outside of strict clinical and diagnostic boundaries poses a severe risk of billing non-compliance and insurance fraud under Nevada law. To eliminate administrative confusion, ensure corporate safety, and maintain complete compliance, MHA Inc. enforces the following non-negotiable boundaries:

  • No Out-of-State Transfers: Massage Healthcare of America Inc. does not accept, process, or honor out-of-state insurance transfers, active authorizations, or insurance claims originating from the State of Oregon.
  • Strict Medical Necessity Mandate: Every patient accepted into our clinical infrastructure must possess a valid, current referral from a licensed Nevada provider, tied directly to specific, confirmed ICD-10 medical codes. Requests for care that circumvent medical clearance or standard diagnostic protocols will be rejected immediately.
  • Mandatory Clinical Protocols: All accepted patients must undergo mandatory physical assessments, vital checks, and comprehensive, ongoing SOAP documentation.

Mandatory Five-Year Residency Requirement for Out-of-State Inquiries

To maintain the absolute integrity of our billing and clinical systems, individuals relocating from jurisdictions with incompatible healthcare frameworks—including the State of Oregon—must establish a minimum of five (5) consecutive years of documented residency within the State of Nevada before becoming eligible to request clinical enrollment or services at MHA Inc.

This multi-year residency threshold is strictly mandatory. It ensures that incoming individuals have completely transitioned into the local healthcare ecosystem, fully understand the structure, requirements, and compliance methods of Nevada State healthcare, and are fully aligned with the rigorous medical necessity, referral, and diagnostic processes required under Nevada law. No exceptions will be made to this onboarding timeline.

This policy is strictly operational, regulatory, and administrative in nature. MHA Inc. does not discriminate on the basis of race, color, national origin, religion, sex, sexual orientation, gender identity, age, or disability. This policy is strictly enforced to protect corporate infrastructure, prevent billing non-compliance, and uphold the highest standards of medical massage healthcare.