All about Chiropractic Billing in Healthcare Industry

How challenging is it to run a chiropractic practice? Have you noticed any flaws during chiropractic billing and coding? Did it impact your business? All these questions have answers and, at the same time, require a better understanding of what you are working for. Nothing can be so demanding than having a feasible billing practice with sufficient reimbursements. Effective chiropractic billing and coding practices have many things in common. It includes professionally trained staff, proper coding and documentation, deft practice management, and a healthy accounts receivable, concentrating on ICD-10 and CPT Coding services amongst a lot more.

Since AMA is responsible for publishing and maintaining chiropractic coding and specifications, these are essential principles for chiropractors. Therefore, they have to become familiar with the same. Almost all chiropractic codes feature five alpha-numeric characters that describe evaluations, diagnostic tests, and medical procedures. This article explains the entire chiropractic billing process and ways to avoid pitfalls.


Few Fantastic Chiropractic Billing Services:

  1. Billing System Enrollment
  2. Patient Verification
  3. Chiropractor coding
  4. Medical billing & account reconciliation
  5. Account receivable collections

Billing System Enrollment:

  • The Chiropractic billing experts help patients enroll in the billing system soon after they sign up for a medical consultation.
  • They also ensure if all the information has been captured accurately by meeting all the regulations.
  • Chiropractic billing system enrollment also involves patient demographic capture.

Patient Verification:

  • Highly experienced professionals, including medical coders, must perform in-depth patient verification using proprietary tools and software while indulging in chiropractic medical billing.
  • It’s also essential to ensure and remove the patients who have had horrible payment history and other issues along with irregular insurance information.

Chiropractor Coding:

  • Chiropractic coding aids in timely insurance payouts while tracking the medical history of a patient.
  • It’s also challenging to determine the medical codes for chiropractors, which takes a lot of time.
  • So, considering outsourcing can be a better option for your business. You can also get relieved from the hectic and lengthy process.

Medical Billing & Account Reconciliation:

  • This step-by-step process assures whether the charges are mentioned accurately so that insurance companies can deal efficiently and proactively in terms of payout.

Account Receivables Collections:

  • Being a healthcare professional, you must make sure that balances are appropriately checked, and follow-ups are regularly done for outstanding payments.

Some Surprising Tips for Chiropractic Billing Codes:

  • It is not surprising that chiropractic billing can often be challenging. But feasible reimbursements can happen with the help of perfect CPT codes.
  • Initially, you need to understand the coverage policies of patients and know whether they are capable of claiming the services under those covered policies.
  • For instance, when there are two patients with similar policies, but cases might be different.
  • Insurance companies can reimburse the same while the others cannot do. When it comes to CPT codes, you need to check the claim cycle’s eligibility criteria without fail.
  • Before any treatment, one should know entirely about prior authorization.
  • If you fail to do so, you might need to face denials or rejections, which would become hard to recover.
  • Finally, analyzing denied claims will give you an idea to correct them if required.

Some of the Standard Chiropractic CPT Codes include: 

  • 99203 – This code is used for performing Initial Exam for chiropractic procedures.
  • 97110 – This particular code is used for performing Therapeutic Exercise
  • 98940 – This code is used for performing Chiropractic manipulative treatment (CMT) for Spinal, in 1-2 regions.
  • 97035 – This code is used for Ultrasound or Phonophoresis
  • 97161 – This code is used for PT Evaluation: Low Complexity.

All these top CPT codes for chiropractic billing make the billing process much better when coded with accuracy.

3 Common Mistakes While Submitting Claims for Chiropractic Billing:

  • Mistakes in paperwork or the staff filling inaccurate information while submitting the claims might lead to denials. So, the medical billing team cannot afford to make such huge mistakes as it impacts the entire revenue cycle system.
  • Mistake in not checking for coding errors. If the billing team is habituated to using the paper claims, entirely relying on the templates without checking the coding errors would lead to great destruction. Even after electronic billing in process, most rely on paper claims and older methods that hold them back from getting timely reimbursements.
  • When the claims don’t have sufficient information, they are denied or rejected. Insurance companies hold on to several rules and regulations that it requires keen observance if the claims are establishing the need for patient care. You will need to have complete documentation to avoid payment problems.

Chiropractic Billing tips to Avoid Errors and Boost Revenue:

  • Accurate verification is most important for reimbursements. It ensures that everything is recorded. Errors in inpatient data, providers’ eligibility, patient’s insurance information might lead to loss of full payment; hence accurate verification is necessary.
  • Analyzing denied claims are even more crucial as they prevent disrupting the whole revenue cycle process. You have to look for misspelled names, entering numbers for two parties or more if the beneficiaries are treated out of their networks without your consent.
  • Expert medical billing professionals can send error-free claims, which saves time. They tend to scrutinize claims frequently and thoroughly before submitting the claims. It also helps in reducing denial rates to a greater extent.
  • Improving coding efficiency is necessary, and you can improve it by checking codes before every submission.
  • Reducing AR days can help you in many ways. You will have to separate or segregate all account receivables by patient balances and insurance. The other way is to set different insurance companies apart and understand their specific guidelines that affect the receivable management of your accounts.
  • Moreover, outsourcing chiropractic services can bring you bigger deals in gaining larger reimbursements. It helps you focus on your core competency, improve your revenue and have a smooth financial process.
  • The billing partner also helps you review all suspended claims and identify holes and gaps such as errors and timelines.

All these chiropractic billing tips can ease your practice with less effort and strain. Make your business feasible with larger revenue payments having more concentration on patients. This practice is essential and makes it more efficient to run your business in profits.

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