Chiropractic Billing Services for Accurate and Timely Reimbursement
Chiropractic billing requires a deep understanding of insurance coverage, patient portions, and the coding nuances that can impact reimbursement. From spinal adjustments to therapeutic exercises, our team ensures that all services provided in a chiropractic office are coded correctly, maximizing both revenue and compliance with payor requirements
Nuances in Chiropractic Billing and Insurance Coverage
Chiropractic care can be covered by both commercial insurance plans and federal programs like Medicare. However, coverage varies significantly between payors, and understanding these variations is key to ensuring accurate billing and minimizing patient portions:
In both federal and commercial plans, medical necessity must be established for chiropractic services to be reimbursable. This often involves clear documentation of the patient’s condition, symptoms, and the expected benefit of chiropractic care.
Patient Portions and Billing
Patients often face out-of-pocket expenses, particularly when insurance limits are reached or when seeking services that are not covered, such as maintenance chiropractic care.
We work to educate patients about their insurance benefits, copays, deductibles, and non-covered services, helping to avoid surprises when it comes time for payment.
Our detailed patient billing process ensures clarity, offering payment plans and support for outstanding balances when necessary.
Most Used CPT Codes for Chiropractic Procedures
- 98940: Chiropractic manipulative treatment (CMT); spinal, one to two regions.
- 98941: CMT; spinal, three to four regions
- 98942: CMT; spinal, five regions.
- 97110: Therapeutic exercises to develop strength and endurance, range of motion, and flexibility.
- 97140: Manual therapy techniques (e.g., mobilization/manipulation, manual lymphatic drainage).
- 97012: Application of traction to the spine (mechanical traction therapy).
- 97035: Ultrasound therapy.
Medical Necessity in Chiropractic Billing
For insurance companies to reimburse chiropractic services, it’s essential to document the medical necessity of the treatment.
This means providing detailed notes about the patient’s condition, diagnosis, and the improvement expected from chiropractic care. Typically, insurance plans cover treatments that address acute conditions such as back pain, neck pain, and musculoskeletal injuries, while excluding coverage for maintenance or wellness visits.
Proper documentation is key to preventing denials and ensuring timely payment.
How Nellikk.ai Enhances Chiropractic Billing
Our partnership with Nellikk.ai provides chiropractors with a streamlined billing process that improves the accuracy and efficiency of claims submissions. By integrating advanced AI and automation into the revenue cycle, Nellikk.ai offers:
- Improved Documentation: Automatically captures and audits patient data to ensure all necessary documentation is present for claims submissions, reducing the risk of denials.
- Enhanced Coding Accuracy: Nellikk.ai’s AI-driven platform ensures that CPT codes and ICD-10 diagnosis codes are accurately matched to services provided, minimizing errors and claim rejections.
- Efficient Denial Management: Our platform tracks denied claims in real-time, offering actionable insights into the reasons for denials and providing automated solutions for resubmissions.
- Optimized Patient Billing: With real-time visibility into patient portions, deductibles, and out-of-pocket expenses, Nellikk.ai ensures that patient billing is transparent and easy to manage.
Why We Stand Ahead of the Competition
What sets us apart is our comprehensive approach to chiropractic billing, enhanced by cutting-edge technology through Nellikk.ai. We:
Maximize Revenue:
Our expert team ensures that every service is accurately billed, from manipulations to therapeutic exercises.
Reduce Denials:
We work proactively to ensure that all claims are submitted with proper documentation, minimizing delays and denials.
Offer Transparency:
With detailed reports and real-time analytics, we provide full visibility into your billing performance, helping you make informed decisions about your practice’s financial health.
Enhance Compliance:
We ensure that all billing processes comply with HIPAA and HITECH standards, safeguarding your practice from legal and regulatory risks.
Partnering with us gives chiropractic practices a competitive edge, ensuring efficient billing processes, maximum reimbursement, and satisfied patients.
