Medical Billing Services For Chiropractors – What You Need to Know
Are you wondering about medical billing for chiropractors? Here’s what you need to know.
The medical billing process can be frustrating for chiropractors. Are you a chiropractor looking to understand billing and insurance claims better? This article has everything you need to know to get started.
Attitudes toward chiropractic treatment have changed in recent years. About a decade ago, chiropractic services were considered nontraditional medicine.
Today, seeing a chiropractor is an accepted practice. Chiropractors are trusted by millions of people worldwide.
These days, chiropractic services are commonly included in medical insurance policies. This makes medical billing for chiropractors more complicated. Here are the most important parts of medical billing that chiropractors must know.
Medical Billing for Chiropractors
If you’re a chiropractor, you know that medical billing is a necessity. It doesn’t have to be a hassle. Here’s help with understanding coding, insurance and billing for chiropractic services.
Medical Coding for Chiropractic Treatment
To get medical insurance to pay, your claims will need to be coded and documented with the right language. You must prove medical necessity for each claim.
Medical coding for chiropractors is very specific. Here is some advice for getting it right.
- Use the Right Terminology – Medical coding is a language all it’s own. You want to learn it to avoid claim denials.Use formal terms to describe procedures, treatments, and locations and parts of the body in your claim. Such terms may include words like manual manipulation, subluxation, maladjustment, treatment, and correction.
- Chiropractic Procedure Codes – Use chiropractic procedure codes in your claim. This is a series of words and numbers that identify the exact procedure you are performing. Using the wrong code can result in a claim denial.This coding is what insurance companies look for in a claim. If your claim is not coded correctly, it will be denied.
- CMT vs. Mechanical Traction – These two codes are really causing some problems with some medical insurance plans. Some claims are being rejected if both are billed on the same day of treatment.It’s important to explain in your claim why Mechanical Traction (CPT 97012) and Chiropractic Manipulative Treatment (CMT 98940-98942) are two different things.
Both might be necessary on the same day of service. Do not accept a denial. Justify your decision to use both codes in an appeal.
- Medicare – Be aware that Medicare has their own set of strict coverage limitations. Some private insurance companies use Medicare coverage limitations as a guideline. Though, there can be differences between the two. Learn about them to avoid claim denials.
- Prepare for an Audit – Your medical billing records can be audited if you are not doing it right! Auditing takes up precious time you need to run your business. Avoid billing and coding errors that can be a red flag for an audit.
Medical Insurance Billing
Not every procedure is covered by medical insurance. In fact, there are strict coverage limitations for what chiropractic services are paid by medical insurance. And for those they will pay, you must document the procedure in a specific way.
Document the procedure, diagnosis and treatment process. Keep descriptions within the limitations of the medical insurance plan. Include proper terminology and chiropractic procedure codes in every claim.
While it may be a necessary part of the diagnosis process, X-rays are not usually covered by most chiropractic insurance plans.
Billing Services and Software
Let’s face it, you want to spend the majority of your time treating patients. Writing claims and billing insurance can be frustrating and take hours outside of your work time. You can purchase software and billing services to do medical billing work for you.
Here are a few things to consider when looking for a billing service.
- Customer Support – Consider how you expect to interact with your billing service. Can you speak to a person immediately to get the help you need? Do they provide on-site support?
- Affordability and Reviews – Cheapest isn’t always best. Consider price relative to the quality of service. It’s better to pay a little more for a service that is reliable and will work hard for you. Use reviews to help you find a billing service that is reliable and well priced.
- Services Provided – Hire a billing service that provides all the services you need. Be wary of a company that doesn’t offer full-service billing. Ask about how the service handles denied claims and appeals.
- Software – You’ll need to use the billing service’s software for all of your billing data. Make sure it’s user-friendly. You don’t want to spend days learning a complex system or make mistakes because it’s too complicated.
A Word About Office Workflow
While medical billing is a system in itself, the flow of work in your office can also simplify the process. Follow these steps to set up a reliable workflow.
- Document the Patient’s Visit – Use the patient’s medical record to set up a procedure for documenting the visit. Check-in and vitals, symptoms, diagnosis, treatment and follow up plans should be documented in the record.
- Set Up a Processing Desk – Once the patient visit is over, the record should follow a process for entry into the records and billing software system. Set up a system that includes baskets for data entry, billing, and claims, follow up and filing. Then use a checklist to be sure all steps for billing are complete.
- Filing System – Create a filing system for patient records. Once records are completely processed into the billing software system, they need to be filed. The filing system makes records easy to find when you need them.
Chiropractors: Start Billing With Confidence
It’s time to take your medical billing process to the next level. Use what you’ve learned to set up a system that takes the hassle out of the billing process. Chiropractors who have less time for billing tasks should consider hiring a medical billing service to take the stress out of it!
Need More Help?
If you’re looking for reviews and quotes for medical billing services–for chiropractors, doctors, and practices alike–you’ve come to the right place. You can get a quote here.
Author: Mike Cynar
Mike Cynar brings buyers and sellers together by producing reviews and creating non biased webpages allowing users to share their experiences on various products and services. He and his staff write informative articles related to the medical field, legal, and other small business industries.