Are you facing reduced fee reimbursements but cannot understand how?

Are you dealing with a lot of confusing paperwork related to insurance billing?

Do you have many denied and rejected claims, and you don’t have anyone to follow them up?

If you answered “yes” to one or all of the above questions, you need to outsource chiropractic billing services to a billing company.

When you outsource chiropractic billing services, you can rest assured that billing specialists are there to help you streamline the business side of your practice and jumpstart a practice’s finances.

The reimbursement laws in the chiropractic industry undergo continuous changes, necessitating the need for constant vigilance of the financial health of chiropractic practices. Outsourcing the billing tasks to professionals has been the go-to option for most practices, especially those who don’t have a billing department at their business’s frontier. When you hire chiropractic medical billing services, all your insurance billing activities are managed by the chiropractic billing services company so your providers and staff can actually focus more on what matters most to them – patient care.

Choosing one of the best chiropractic billing companies is crucial as your billing company will help you increase collection rates and reduce the overall rejection or denial rates. One of the greatest benefits of outsourcing to a chiropractic billing company is the savings. The fees charged by chiropractic billing companies are less expensive than the cost of salary, benefits, and tools you need to manage billing in-house.

Billing companies have professionals who take care of tasks, such as coding, reviewing, claims submissions, appeals, ERA/EOB posting, and reporting. You can free up your staff. Your providers and/or staff will not feel overworked and work more efficiently. And, billing pros always stay up-to-date on the reimbursement regulations in the industry. Ultimately, you get paid faster and save time to focus more on your patients.

Now, the next question that will come to your mind – “How do I select the best chiropractic billing services provider?”

Here is a list of 10 questions that you should ask your chiropractic medical billing services provider.

1. Do you offer denials management?

Approximately 90% of claim denials are preventable. All it takes is a proactive denial prevention strategy, chiropractic billing software, and dedicated professionals. Professional chiropractic billing companies are more capable of managing payer denials. The billing experts should know how to:

• Ensure clean patient data in your chiropractic software
• Check for incomplete or missing information in the submitted claim documents
• Check coverage limits
• Identify errors before claims are submitted for payment
• Track and report denials
• Appeal claims that are denied incorrectly

2. How good are you at code reviewing?

Correct coding is critical to receiving accurate and timely payment for rendered services. If you’re using chiropractic billing software, it becomes easier to save and use your favorite code templates for the most common procedures like lumbar, spine, neck, subluxation, etc. Insurance payers require specific and correct orders of diagnosis and procedural codes to ensure that the services provided by the practice are consistent with the patient’s insurance coverage. The codes should validate the medical necessity and appropriateness of the diagnostic and/or therapeutic services provided.

Coding to the highest level of specificity gives your practice an edge in revenue handling. Select a chiropractic medical billing company that helps you review the correct usage and order of diagnosis and treatment codes reported on the insurance claim form. The certified coders at the company help select codes that best reflect the provider’s rendered services. They help you ensure the codes are payable and get paid for the level of service reported to a payer.

3. Do you offer payment posting services?

Payment posting is an integral part of the revenue cycle management process. A well-done payment posting process helps to increase profits and smooth out the overall billing process.

Payment posting services ensure that practices are able to see daily insurance payments from Explanation of Benefits (EOBs) and Electronic Remittance Advice (ERA), insurance checks, and patient payments. Hiring one of the most reliable chiropractic billing companies to help you post payments and identify issues that may be causing revenue leaks. Ask the chiropractic billing company if they can review your ERA/EOB documents and verify that the claims are processed and paid correctly. The chiropractic billing services provider should check:

• The amount paid by the payer for each procedure
• Patient responsibility amount
• Allowed contract amount for the procedure
• That no procedures were improperly denied
• Identify which codes are being denied and why
• What actions need to be taken if the payments are paid correctly or denied

4. Do your services cover patient eligibility verification?

Chiropractic practices need to verify each patient’s eligibility and benefits to ensure they will receive payment for services rendered. Patient eligibility verification helps you check coverage prior to the office visit. The billing provider should be able to:

• Verify coverage on all primary, secondary, and tertiary payers
• Verify patient responsibility for copays and coinsurance
• Confirm prior authorization for treatment from appropriate sources

If the chiropractic medical billing services provider offers these services, you will be able to eliminate the need for tedious in-house verification processes, free up your staff for other tasks, increase collections, reduce billing errors and denials, and improve patient satisfaction.

5. Do you manage insurance rejections and how?

Claims are rejected when they do not meet specific data requirements or basic formatting required by insurance companies. These claims can be resubmitted once the errors are corrected. Billing professionals properly interpret claims data and pay attention to the details to prevent rejections. If claims are returned, they make corrections in a timely fashion.

The best chiropractic billing services provider will help you optimize the claims submission process to bring in higher benefits with a first-pass payment rate and first-pass resolution rate. It also shortens the A/R billing cycle. Hire a chiropractic medical billing company that helps you reduce the claim rejection rate and ensures accurate reimbursement across payers.

6. Do you provide AR follow-up services?

Sometimes, practices have a large number of unresolved ARs because of a lack of resources and time. A team of AR follow-up experts can help practices clear the backlogs within a quick turnaround time. Their financial experts will review the pending claims, investigate claim denials, initiate collections, and track receivable balances to increase cash flow and reduce the number of AR days. Hire one of the most reliable chiropractic billing companies that ensures timely payments of claims by actively following up on all ARs.

7. Are you HIPAA compliant?

Privacy, security, and confidentiality of the protected health information (PHI) must be practiced rigorously by a chiropractic billing service provider. Ask the billing company what are their security protocols. What kind of compliance do they have in place? If they use chiropractic billing software for managing your billing process, ask to make sure the software is HIPPA compliant as well.

8. How often do you share reports?

Ask the billing company how often they share reports with you. The ideal reporting frequency is weekly. The billing reports help you get an overview of the services you received from the billing provider and gauge the financial state of your practice. Ask to see a sample of billing reports to determine if they’ll work for your practice.

9. What type of billing services you don’t handle?

Not all managed billing service providers cover every aspect of revenue cycle management. It is important that you ask upfront and be sure that the company is offering all the services that you want when outsourcing chiropractic billing services. If you have specific billing requirements (such as insurance payer contract issue handling or specific coding for Medicare), ask the billing provider if they can handle your requests. And, if so, what are the charges for those specific chiropractic billing services?

10. What is the pricing breakdown for your services?

Finally, you must ask about the cost of chiropractic billing services. Typically, billing companies charge based on a percentage of what they collect. This means you only pay for claims that get paid. This also incentivizes billing companies and they want you to get paid for your claims as quickly as possible. Some managed billing providers charge a flat monthly fee.

The important thing to note here is that percentage of collections or monthly flat fees does not include other add-on services that you would like to avail such as submitting paper claims, credentialing old AR follow-up, and eligibility or benefits verification. If the chiropractic medical billing services provider specializes in these services, you should know exactly what goes into the cost.

Conclusion

Use these 10 questions to guide your decision when selecting one of the best chiropractic billing companies for your practice. The answers to these questions will help you get the best possible service from the start.

If you’re missing out on the best payouts, have A/R piled up, or need help with denied claims, zHealth is here to help you. zHealth’s chiropractic billing solutions can be customized to streamline revenue cycle management. As one of the leading chiropractic medical billing companies, we offer chiropractors across all states exceptional medical billing and coding services. Our commitment to the utmost ethical standards, strict coding guidelines, and unwavering HIPAA compliance sets us apart. Our suite of chiropractic billing services is designed for seamless payment acceleration:

• Record Verification: As part of our chiropractic billing service, we conduct thorough insurance verifications. This helps ascertain whether patients have obtained necessary healthcare service authorization and are eligible for coverage from leading insurers.
• Chiropractic Coding for Billing: Our coders are well-versed in medical coding and billing systems, including the International Classification of Diseases (ICD), Healthcare Common Procedure Coding System (HCPCS), Current Procedural Terminology (CPT), and more.
• Efficient Claims Denial Management: zHealth takes charge of claims denial management. We analyze denial reasons, harmonize data, enact corrections, and launch appeals, ensuring smoother reimbursement processes and higher returns.
• Comprehensive Reconciliation Services: Our chiropractic billing solutions include closely monitoring claims until final adjudication, including daily reviews of ERA and clearing house reports. This thorough approach enables us to promptly detect any inconsistencies and uphold the financial integrity of your practice.
• Chiropractic Insurance Billing AR Collections: Our proactive team prepares and submits claims swiftly, while also chasing pending insurance matters to expedite cash flow. Experience enhanced financial operations with zHealth by your side.
• Payment Processing: Being one of the leading chiropractor payment processing companies, zHealth also simplifies the patient payment side of your practice. zHealth Pay is a payment processing system designed specifically for chiropractors to simplify the patient experience. Not just insurance billing, we help you collect patient payments with a few clicks. With features like Text-to-Pay, Cards on file, recurring payments, email invoices, payment terminal, and more, you can collect outstanding patient balances with ease.

Contact us right away if you’re ready to outsource chiropractic billing services and want to know more about how we can optimize revenue collection.