If you’re a chiropractor, one of the most important skills you can learn is how to bill your patients properly. It doesn’t matter if they come in with their insurance; if they don’t pay you on time, you won’t get paid for it all! That’s why it’s crucial to know how billing works in the first place. This process requires a chiropractor to accurately identify the services provided, assign appropriate codes, compile the necessary paperwork, and submit the claim to the correct insurance company.
Chiropractic Billing Process
Chiropractic billing is the process of billing a patient for services rendered by a chiropractor. This typically includes chiropractic adjustment, massage therapy, physical therapy, and other services the chiropractor has provided. Chiropractic billing is a complex process that requires detailed documentation and coding to ensure accuracy and compliance. The process can be divided into three main components: patient documentation, coding, and billing. Documentation involves recording patient information to provide a complete patient care record. Coding is the process of assigning specific codes to the diagnoses and treatments for billing purposes. Finally, billing involves transmitting the regulations to the insurance company or other payer for payment.
A chiropractic billing process follows the same steps as most other healthcare billing processes. First, a patient will receive treatment from a chiropractor, and a claim will be submitted to their insurance provider. The insurance provider will then review the claim and accept or deny it, depending on their coverage and other factors. Once the claim is accepted, the provider will send out an Explanation of Benefits (EOB) to the patient, which outlines the amount of the claim that their insurance will cover. The patient will then be responsible for paying their out-of-pocket costs, including their portion of the claim, any deductible, co-insurance, and co-pay that may be required. Once the patient has paid the out-of-pocket costs, the chiropractor will bill the insurance provider for the remaining claim amount.
CPT Codes in Chiropractic
Chiropractic CPT codes describe the various operations done on patients by chiropractors. These codes indicate chiropractic exams, treatments, imaging investigations, and more. Although the entire code set is pervasive and includes codes for tens of thousands of operations, most chiropractors only use a subset of these CPT codes when billing.
Commonly Used Chiropractic CPT Codes
Chiropractors, unlike healthcare professionals, employ a limited set of CPT codes. Chiropractic CPT codes for chiropractic manipulative treatment or chiropractic adjustments are the most widely utilized. Chiropractic manipulation has only four codes, each dependent on the spinal regions addressed.
- CPT Code 98940; spinal, 1-2 regions
- CPT Code 98941; spinal, 3-4 regions
- CPT Code 98942; spinal, five regions
- CPT Code 98943; extra spinal, one or more regions
How to Reduce Chiropractic Denials and Delays?
Following are the ways to reduce denial and delays in chiropractic billing.
- Review the practice’s billing guidelines carefully.
- Ensure the accuracy of patient information, such as insurance information and diagnosis codes.
- Ensure that all necessary documentation is included with each claim.
- Stay up-to-date with insurance company policies and changes.
- Regularly review rejected or delayed claims to identify patterns.
- Appeal denied claims quickly and thoroughly.
- Invest in a practice management system to track claims and identify errors.
- Consider outsourcing billing and coding tasks to a professional.
Tips to Boost Revenue in Chiropractic Billing
Chiropractic billing is a complex field and requires a lot of knowledge. You need to know the insurance regulations and policies and keep up with the latest changes in those regulations and policies. This cannot be easy if you don’t have time or resources like an accountant who will help you with this task for free! In this blog, we’ll provide an overview of chiropractic billing so that you can effectively maximize your revenue and achieve long-term financial success. Here are some tips to boost your revenue:
Utilize billing software
Quality billing software can assist with the submission and tracking of claims. This software can help ensure that claims are filed the first time correctly, reducing the amount of rejected claims. Regular billing software maintenance and monitoring are essential to ensure accuracy and compliance.
Utilize electronic claims filing
An electronic billing system allows faster and more accurate claims processing and simplifies the process of submitting patient and billing information. Electronic claims filing can help reduce the time it takes for claims to be processed, increasing the likelihood that claims will be paid quickly.
Follow Up on Unpaid Claims
It is essential to follow up on any unpaid claims or billing inquiries promptly to ensure that the patient is billed correctly and that the payment is received promptly.
Utilizing the correct ICD-10 codes
The International Classification of Diseases (ICD-10) codes document diagnoses and treatments and should be used accurately to ensure maximum reimbursement.
Train Your Staff
The best practice management systems will only be effective with adequately trained staff. Every staff member should be trained on the basics of medical billing and coding and your specific practice’s processes. Ensure that your team is well-versed in your state’s particular regulations and requirements.
Utilize Automation
Automating systems to streamline your practice’s operations can make all the difference in successful chiropractic coding and billing. Automation speeds up processes and increases accuracy, reducing the risk of billing errors and denied claims.
Clean Up Your Accounts Receivables
Healthy accounts receivables are essential to successful chiropractic coding and billing. Monitor your accounts regularly to identify and resolve any issues causing payment delays.
Proper Use Of Modifiers
To maximize reimbursement, you need to use modifiers correctly. Modifiers increase reimbursement by indicating a specific service or procedure, patient condition or medical device, drug, or biological product used during treatment.
Hire Professional Chiropractic Billing Services
Outsourcing your chiropractic billing helps your practice stay competitive in today’s ever-changing healthcare landscape. It helps ensure you receive the reimbursements you’re due while freeing up your practice staff’s time to focus on providing excellent patient care. When selecting a billing partner, the most crucial factor is to find one with experience in your specialty. They should know the nuances of the rules and regulations for your particular type of practice. Ask about the types of claims they have experience with, their team’s credentials, and the software platforms they use. They should also be able to explain their processes and provide references from other chiropractors.
Outsourcing your billing can help your practice become more efficient, save your office time and resources, and ultimately improve your profitability.
- Decreased administrative costs
- Better compliance
- A more streamlined workflow
- Reduced audit risk
- Improved patient experience
