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Massage Therapy And Direction To Pay Contracts

Massage Therapy And Direction To Pay Contracts

When I met the lawyer and he found out I did massage therapy, he immediately asked: “do you do direction to pay”?

“No”, and then I gave him a list of the reasons why I wouldn’t do it.

Mostly it was just things other friends had told me about why to avoid it.

He just stared at me blankly, then proceeded to give me shit.

As our conversation developed over a hockey game and we got to know each other a little bit we continued to discuss the topic. I was intrigued by his reasoning. He was pretty persuasive, (he is a lawyer after all) and assured me that most of my doubts were unfounded. I sat there and listed several reasons I have heard about why this was a bad idea.

He listed the reasons why I should do it, but the main one: “you’re leaving money on the table”!

We set up a time to sit down and chat and I figured I might as well hear him out.

That day forever changed my massage therapy practice.

Generating Massage Therapy Referrals From Lawyers

Direction to pay is where a lawyer sends patients to your office for treatment after they have been in a car accident, workplace injury or are on some sort of an insurance claim and need help from a therapist.

But you don’t get paid until the claim is settled with the insurance company.

I have heard horror stories about this and was advised by several RMT’s over the years never to do direction to pay.

And I’ll be honest, my opinion of lawyers was pretty jaded.

As I sat in the lawyer’s office and spoke with him and his associate, they wanted to know every reason why there is such a bad reputation with this type of thing among Massage Therapists.

I listed off most of the reasons that had been told to me in the past:

  • The lawyer calls back and tries to negotiate less money
  • You NEVER get paid
  • Sometimes it takes YEARS to get paid
  • You’re constantly chasing around the people in order to get paid.
  • If the insurance company doesn’t settle, you won’t get paid.

The lawyer sat there in disbelief.

He was shocked to hear that anything like this had ever happened. As much as I believed it was a bit of a slight on Massage Therapists when these things happen, he considered it just as much a slight on his profession.

As the meeting went on he addressed each of these issues and pointed out why some of those things could happen and then why they wouldn’t happen in our dealings.

He gave what was probably the biggest piece of advice that convinced me to get involved with him:

“just look at it like a forced savings account, honestly the first year is going to suck but then you’ll all of a sudden start getting cheques rolling in every month”

His associate (who is a former car insurance company adjuster) looked at me and said “you’re leaving a huge marketing opportunity on the table by not doing this”

Now granted, they’re also trying to get me to help them with their business, so they’re going to be persuasive. Since they were taking the time to actually have an appointment with me in their office and take time out of their day, I figured maybe there was something to this. What did I have to lose?

It was at least worth a try.

I reluctantly agreed.

Direction To Pay Contracts For Massage Therapists

Together we developed a contract that would be an agreement between the two of us.

The patient is only part of this contract in that they agree to the stipulations provided within it. The contract itself is between me and the lawyer.

It took a little time to develop and I used some information from our local association as they provide things like that for us. Eventually we came up with a contract that I would go on to use with every patient he sent me.

Here is a pdf copy of the agreement for you to download in case you’re interested in doing this kind of work (just make sure to use your name and clinic name etc). The patient fills out the first part when they fill out their intake form. They put their name in the first part, then they lawyers name and the date of their accident.

The form is sent to the lawyer to sign the bottom half of the form. I keep this on file with any other document regarding the patient.

The nice part about this arrangement is the patient cannot take off without paying their bill at the end of the settlement.

The lawyer negotiates a settlement with the car insurance company only after getting the invoice from you and adding the total to the claim. Your invoice amount is added to the claim and the money is deducted by the lawyer before the patient sees any money from the settlement.

With so many therapists that I talked to over the years, one of their biggest complaints was that once the settlement was done, they would never see the patient again and the money was gone.

However in most of these cases, the therapist entered into the agreement with the patient, not the lawyer.

The patient would come in and make claims like “yeah my lawyer said to get you to just do direction to pay and we’ll pay you at the end”.

In many cases, the therapist didn’t even know who the lawyer was and also went on a verbal agreement with the patient without a signed contract.

Do not let this happen. If this is something one of your current patients wants to do, make sure to get the name of the lawyer and enter into an agreement with them, not the patient.

Unfortunately even though you may have built a relationship with a patient over the years, it doesn’t mean they are always going to be honest.

Make sure you protect yourself first.

Massage Therapists On A Team Of Experts

As I mentioned before, the lawyer was trying to get me to help him with his business.

This brings up a very valuable point.

Entering into an agreement like this is helping the lawyer with their business, so they want to do things right. If at any point something goes wrong in this agreement it looks bad for them and their business.

When they have a new claimant come in for their advice and are able to lay out how they are going help them deal with the insurance company and can say they have a team of practitioners who will help them through all of this, how do you think that looks to the new claimant?

It instantly puts the persons trust in the lawyer, knowing their best interests are being taken care of.

However you also need to make sure your best interests are being taken care of as well.

Make sure if you are going to enter into this type of arrangement with a lawyer, that it is a reputable lawyer.

There are lawyers out there who will take on any case in the hopes that they’ll make a buck off of it. Seek out a lawyer who focuses in this area and maintains a good reputation. If they are sending people to other practitioners in town (i.e.: chiro, physio, other massage therapists) ask if you can contact them to see what the experience is like.

In fact some lawyers actually consider having you and other practitioners as a “team of experts” on their side in representing their clients.

One of my friends asked me “what if the claim doesn’t ever settle?”

In asking the lawyer the same question, his response: “we don’t take on claims where this is a possibility of no settlement”.

Remember, the reputable lawyers are looking out for the best interests of their client but are also looking to build a successful business. They don’t want false claims or bad dealings with their network to harm that reputation.

Here are a few resources to use if a lawyer approaches you, or you’re looking for a lawyer to work with.

Photo by: unsplash

Photo by: unsplash

Getting Paid

It is true that sometimes it can take a while to get paid for your work, depending on how long a settlement takes.

One of the things that got me hooked when starting this, was when he said “look at it as a forced savings account”.

The first year was tough as he predicted. A few times a month I would get an email telling me that a new person would be coming in for treatment.

That has consistently built up over the past year or so and now various claims are starting to settle.

Cheques are coming in and I’ve had the opportunity to help some people that I may not have never met otherwise.

Now as the settlements come in, I’m able to take that money and apply it to my tax account or designate some of it for holidays or any other savings/purchases that I need to cover.

One of the great things about this is, at the beginning when you start with a new patient you can take the time to explain how the whole process works to them. Explain that if they no-show an appointment it will still be billed with their settlement. They are much more likely to show up for appointments if they know they are going to be billed and paying for the appointment.

Remember, the contract is with the lawyer and part of the contract is that no-show appointments are still paid.

I do have some accounts that will take well over a year to settle and some that may go longer.

But so far, for every claim that has settled, I’ve been paid in a very reasonable amount of time.

As I’ve mentioned so many times before, a big part of being a Massage Therapist is building relationships.

The same applies here.

I’ve taken the time to build this relationship with the lawyer and there has been very regular communication between us throughout this whole process. He’s even given me free legal advice on some other questions I’ve had.

He considers me to be an important part of his business, but more importantly, an important part of helping his clients get better after an accident.

While this type of work may not be for every therapist out there, it’s definitely worth taking a look at. I honestly wish I had started doing this right out of college, it would have gotten me busy a lot quicker. When you look at different avenues to market your business and how much it costs, this is a very lucrative form of marketing. It doesn’t cost anything, just some patience and money management while waiting for payment. However when I think of the first couple of years while I built my practice, there was typically several spots a week that were empty (especially at the start) which could have easily been filled by the lawyer. I wasn’t making any money in those spots anyway, so I could easily have used a “forced savings account”. If you do decide to get into this type of work, take the steps to make sure you’re dealing with a reputable lawyer. Ask friends and patients, consult legal websites, cross examine the lawyer and get your questions answered by them. Don’t be like me, don’t listen to every massage therapy rumour out there, do the homework and research for yourself, it can make a significant difference in your practice. 

As the creator of the site, I hope you like what you’re reading. I’m a Registered Massage Therapist in Victoria BC, former Massage college clinical supervisor, First Responder instructor, hockey fan and volunteer firefighter. Come hang out on the facebook page, where we can share some ideas about how to improve the perception of the Massage Therapy industry.

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Jamie Johnston

Founder at The MTDC
As the creator of the site, I hope you like what you’re reading. I’m a Registered Massage Therapist in Victoria BC, former Massage college clinical supervisor, First Responder instructor, hockey fan and volunteer firefighter. Come hang out on the facebook page, where we can share some ideas about how to improve the perception of the Massage Therapy industry.
Jamie Johnston
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  1. Melissa May 17, 2016

    Thankyou for posting! This was excellent advice and tips! I’m sure it will be valuable to some people. I personally wouldn’t do it. I waited on one claim over 5 years! Finally the case was dropped and I lost big time! 🙁

    • Jamie Johnston May 18, 2016

      I hate hearing when things like that happen to therapists. Did you have a contract with the lawyer?


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