Harvest of Peace

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Massage Policy Highlights

  • All massage must be scheduled online through Jane App. It is a safe, HIPAA compliant site to manage your health information and make communication easier. All consent and health history forms must be completed online (some injury cases may have additional paper requirements). If you are unable to complete your online forms, please reach out to me for assistance prior to your appointment. Health forms are a vital part of your treatment and are required for all massage treatments.
  • A credit card on file is required for all appointments. You may choose to pay with card on file, HSA card or cash. Cash is greatly appreciated however, we don’t keep change in the office.
  • If your insurance company or HSA card requires a physicians referral, you must submit it before your appointment. HSA cards behave just like any other card so we will not know to ask. It is your responsibility to follow the agreement of your plan.
  • Appointments may be rescheduled or cancelled online up to 24 hours in advance of your appointment with out penalty by logging in to your Jane account.
  • No shows will be charged for the entire scheduled visit.
  • Your appointment will begin and end on time. Please come prepared.
  • Please do not come to your appointment if you have fever, chills, nausea, active contagious skin conditions or have been exposed to someone who exhibits these symptoms. Massage will very likely make your condition worse, not better.
  • We are currently not requiring masks but are happy to wear one upon request.

Massage Policy in Detail

Privacy Policy

Confidential Records:

  • We are committed to protecting the privacy and confidentiality of your personal and health information. All records, including treatment notes and personal information, are kept confidential and are only accessible to authorized personnel.
  • Your records will not be disclosed to anyone without your written consent, except as required by law or outlined below.

Use of Information:

  • Personal information collected from you, such as your name, contact information, and health history, is used solely for the purpose of providing you with quality massage therapy services.
  • Information about you may be used by the personnel affiliated with Harvest of Peace for diagnosis, treatment, continuity of care, and billing. We may disclose it to practitioners at Harvest of Peace or employees and business associates affiliated with this clinic such as billing, quality enhancement, training, audits, and accreditation.
  • We may use your information to communicate with you about your appointments, treatment plans, and other relevant information related to your care.
  • We do not sell, rent, or share your personal information with third parties for marketing purposes.
  • If you elect to have us bill your insurance company, we are required to submit your chart notes and physicians order along with our invoice.
  • If you issue a charge back or legal claim against us, we may release your chart notes or other information in order to defend ourselves. 
  • In pursuit of payment for services rendered and when payment has not been remedied, we will share your information with collection agencies.

Patient Rights:

  • You have the right to review and request a copy of your records at any time. If you believe that any information in your records is inaccurate or incomplete, you may request that it be corrected.  We may assess reasonable fees for copies and our research time.
  • You have the right to request restrictions on how your information is used and disclosed. However, we may not be able to accommodate all requests, especially if they affect our ability to provide you with quality care or violate other laws we may be subject to.
  • You have the right to request confidential communication of your information, such as contacting you only at a specific phone number or address.
  • All requests must be in writing. 

Compliance with Laws:

  • We comply with all applicable federal and state privacy laws, including the Health Insurance Portability and Accountability Act (HIPAA) and the Washington State laws regarding patient privacy and confidentiality.
  • We reserve the right to update or modify this Privacy Policy at any time. Any changes will be posted on our website and will be effective immediately upon posting.

If you have any questions or concerns about our Privacy Policy, please email therese@harvestofpeace.com with your request. 

Office Policy Regarding Fees and Payments

I understand that all billing and accrued balances are ultimately my responsibility. I agree that I will pay these amounts at the time of service (except PIP insurance billing cases). All balances unpaid by your auto insurance company must be paid within 30 days of receipt. Appointment cancellations require 24 hours advanced notice. Voicemail and email are available 24 hours a day, 7 days a week. I will be charged the full cost of a visit for any missed appointment without 24-hour notice. If I arrive late, I may receive a shortened treatment and will be billed for the entire visit. If we have to go to extra lengths to collect for services rendered, administrative/late fees will be added to your bill. We reserve the right to send uncollected debts and credit card charge backs to collection services for payment.
Office Policy Regarding Fees and Payments 1. Private Pay – Full payment is expected at time of each visit. We accept cash or MC/Visa/AMEX. If payment is not received at the time of your visit, you will not be eligible for a Time-of-Service discount. 2. Health Insurance – For patients who have private health plans covering our services: We do not bill your insurance company. However, as a courtesy, we will submit bills on your behalf. Your insurance company may reimburse you or apply balance paid toward your deductible. Insurance coverage is NOT a guarantee of payment and you are fully responsible for any fee your insurance does not cover. You are responsible for checking your benefits and confirming coverage for all services. Please be aware, we will need to submit your health information to complete this process. 3. Personal Injury/Car Accidents –As a courtesy, we will bill and collect from your car insurance company if you have an active PIP claim, however if your insurance company does not pay your balance in full, you are responsible for any unpaid portion within 90 days of treatment. If we are submitting your claim for billing, you do not qualify for a Time-of-Service discount. 4. Worker’s Compensation – If you have been injured on the job, you are required by law to report to your employer first and open a claim. The first provider you see following your injury will be considered your ‘primary provider’ for this case. If we are not your primary provider on the case, we will require a referral from that provider. If a denial occurs, you will be fully responsible for the balance of your account. We do not bill L&I directly but can provide you with a superbill for reimbursement. L& I claims must be paid a Time-of-Service. 5. HSA card payments-While massage may be an allowable purchase on your HSA card, you may be required to obtain a referral from your doctor in order for it to be legally covered. However, because HSA cards behave like debit cards, Harvest of Peace assumes no responsibility in obtaining referrals for massage when an HSA card is used. It is this patient’s responsibility to know the requirements of their insurance agreement and submit the referral to Harvest of Peace via email before services are rendered. If your insurance company denies the purchase at a later date because you did not comply with your agreement, the patient is still responsible for services rendered. If we have to do additional billing to collect, we will assess a billing fee and add back any time-of-service discounts that were applied to the original bill. Please, check your benefits before using them.

Infectious Disease Policy

Massage and bodywork requires close contact. Massage increases circulation which can exacerbate symptoms of illness. Illness can lay dormant in your system for many days prior to onset of symptoms. Please do not come to your appointment if you have any of the following symptoms: fever, chills, nausea, cough, sinus infection/pain, unexplained rash or skin conditions or have been exposed to any one with these conditions in the last 7 days. Please contact us immediately to reschedule your appointment at anytime with out penalty.

We currently do not require masks but are happy to wear one at your request. We abide by the CDC recommendations regarding infectious disease. This policy may be subject to change with out warning.

Informed Consent

I understand that I may ask questions and request changes to the treatment plan at anytime. I understand that at any time during the massage, I or the massage therapist, may withdraw consent and the treatment will be stopped.

I understand that massage is entirely therapeutic and non-sexual in nature. If any sexual advances are made, the session will be terminated immediately and client will be charged for the full session. Draping will be used if you have chosen to remove clothing for your session. Removing clothing is required for some techniques but is not necessary to receive an excellent massage. Please discuss this with your therapist if you have questions or concerns.

Informed written consent must be provided by a parent or legal guardian for any client under the age of 17.