Simple & Optimized Process to Improved Revenue Cycle
Chiropractic care is a crucial part of healthcare, helping patients manage pain, restore mobility, and improve their overall well-being. However, billing for chiropractic services can be highly complex due to strict insurance requirements, specific CPT codes, frequent denials, and limited covered services. Chiropractors often face unique challenges in medical billing, requiring a deep understanding of insurance policies, regulatory compliance, and coding precision.
Chiropractic billing is uniquely complex due to strict insurance coverage limitations, high denial rates, and frequent compliance challenges. Chiropractors must navigate numerous CPT codes, document medical necessities meticulously, and handle pre-authorization processes effectively. Outsourcing chiropractic billing to a professional medical billing company ensures higher reimbursement rates, lower claim denials, better compliance with insurance guidelines and faster revenue cycle management.
Unbeatable Service, Quality & Price
ACCURACY
0
%
TURNAROUND TIME
<
0
Hours
COLLECTION
0
%
PRICE
Starting from $
1100
/Month
CHALLENGES
Challenges in Chiropractic Practice Billing
Documentation Challenges: Payers require detailed SOAP notes (Subjective, Objective, Assessment, Plan) for every visit. Many chiropractors struggle with insufficient documentation proving medical necessity, inconsistent progress notes for continued care and incomplete patient history and treatment plans.
Medicare-Specific Challenges: Medicare only covers spinal manipulation for active treatment and denies maintenance care outright. Additionally, chiropractors must use modifier AT (Acute Treatment) to indicate that the care is medically necessary.
Underpayment and Audit Risks: Chiropractic practices frequently deal with downcoded claims or post-payment audits where insurers request refunds due to improper coding.
OUR PROCESS
Our Dermatology Billing Services Workflow
At RCM Workshop, chiropractic practice billing process workflow involves several critical steps to ensure accurate and timely reimbursement. It begins with patient registration, where we collect and verify personal and insurance information. Next, during insurance verification, we confirm the patient’s coverage, benefits, and any pre-authorization requirements. After that, we carry out accurate documentation of patient visits using Electronic Health Records (EHR) software and use appropriate ICD-10 and CPT codes to represent diagnoses and procedures performed. Then we submit claims to insurance companies, ensuring all information is accurate and complete.
After that, we monitor the status of claims, address any denials and resubmit the claims if necessary. We record and reconcile payments received from insurance companies and patients and send bills to patients for any remaining balances. We analyze financial data to identify trends, improve processes, and ensure your practice’s financial health. By following these steps, chiropractic practices can streamline their billing processes, reduce errors, and enhance revenue cycle management.
Scheduling & Registration
Carry out well-coordinated appointment scheduling, update insurance details, and handle inbound and outbound calls from/to patients.
Eligibility & Benefits Verification
Confirm primary and secondary insurance and benefits coverage of patients and verify their coverage, co-pays, co-insurance, and deductibles.
Prior Authorization
Initiate request for prior authorization with the payer, follow up to check its status till closure and finally update the system with Auth approval reference number.
Medical Coding
Check the accuracy of codes and modifiers according to specialty and assign corresponding and appropriate charges to the codes.
Charge Posting
Enter the charges for the services provided into the billing system including the cost of the medication and the administration fee.
Claims Edits & Submission
Audit the claims thoroughly to check for accuracy and edit if necessary and submit claims – both EDI and paper format.
Payment Posting
Carry out both auto as well as manual posting for payments received and conduct reconciliation against claims.
Denial Management
Analyze and categorize denial claim according to denial codes, $ amount and payers, and resubmit claims after correction.
AR Management
Follow-up with payers to gather status for unpaid claims, and their resolution.
Patient Collection
Sending patient statements and follow-up with patients for final and outstanding payment.
You can confidently rely on us to manage your entire billing process, or you have the flexibility to select specific DME billing services that suit your needs, ensuring a seamless operation without any interruptions.
BENEFITS
Outcomes guaranteed
We utilize leading industry practices and a data-driven strategy to streamline revenue cycle processes while upholding the highest quality standards. Our goal is not just to manage your revenue but to enhance it. Our chiropractic billing services are customized to align with your workflow, ensuring markedly better financial results.
WHY US?
Why partner with us
Your chiropractic practice can benefit significantly from partnering with us by gaining access to specialized expertise in billing and coding, which reduces errors and increases reimbursement rates. This partnership allows chiropractors to focus more on patient care rather than administrative tasks, leading to improved patient satisfaction. Additionally, medical billing companies stay updated with the latest regulations and payer requirements, ensuring compliance and reducing the risk of claim denials. By outsourcing billing, chiropractic practices can also save on costs associated with in-house billing staff and technology, ultimately enhancing their financial performance and operational efficiency.