Chiropractic medical billing and coding is complex. It constantly changes. In the ever-changing landscape of chiropractic billing, chiropractors need to strategize their revenue cycle and streamline billing workflow. If your chiropractic practice is looking to improve the financial workflow and grow revenue, follow these proven chiropractic medical billing strategies.

1. Establish an Insurance Verification Procedure

The first task in any chiropractic billing process is to verify a patient’s insurance eligibility and benefits. Establishing a verification procedure for your practice can help you gather accurate information on your patient’s insurance coverage.

A majority of denied claims from insurance companies are due to the lack of verifying a patient’s eligibility and benefit information. When verifying a patient’s insurance eligibility, make sure to collect information regarding:

a. Any prior authorization required?

Depending on the patient’s insurance company, some chiropractic services may require the provider to obtain authorization before rendering services.

b. Is the insurance plan active on the date of service (DOS)?

Coverage information on a patient’s insurance plan can change anytime. Make sure to confirm if the patient’s insurance plan is active on the DOS.

c. Are your services covered in the patient’s insurance?

Individual insurance plans vary on which chiropractic services will be covered. Confirm with the insurance company if your services are covered. If not, you can inform the patient that he or she might have to pay out of pocket for non-covered services.

d. How many visits are allowed in a given period?

Some insurances have a limit to how many visits they allow in a given period. If you submit a claim to the insurance company for a patient who has reached his or her maximum visit numbers, then your claim will be denied. Sometimes, insurance companies also put a maximum amount that they will pay to the provider. Make sure you confirm if the patient has met his or her maximum benefits. If not, how many visits are still left according to the patient’s insurance plan for a given period.

2. Ensure Proper Documentation Using EHR Software

The next important step to ensuring correct chiropractic billing involves proper documentation. Documentation errors such as no documentation, insufficient documentation, lack of medical necessity, and incorrect coding often lead to denied or rejected claims.

The Department of Health and Human Services Office of Inspector General (OIG) found that improper payment rates attributed to insufficient documentation rose from 39.5% to 92.2% in the last four years. With the shift towards reimbursement for quality care instead of the quantity of care rendered, investing in HIPAA-compliant EHR software makes sense.

The use of a chiropractic EHR system makes documenting patient encounters much easier, accurate, and legible. zHealthEHR provides EHR software with customized SOAP notes for chiropractic practices. It helps you document Subjective (What is the patient’s complaint?), Objective (What the provider has seen or found through tests, imaging, and X-Ray), Assessment (What the provider learned from patient information and the examinations performed), and Plan (What is your plan of care?) with just a few clicks. Using electronic SOAP notes integrated with an EHR system helps you:

•       Provide ease of reading and understanding of care/treatment/diagnosis

•       Provide details of medical necessity

•       Pass post-review audits

•       Get paid for your services

•       Evaluate a patient’s progress over time

•       Protection against malpractice

•       Stay HIPAA-compliant with secure, legible documentation 

3. Ensure Correct Coding Using Chiropractor Billing Software

Proper coding is crucial to ensure accurate billing and clean claims. Frequent CPT and ICD-10 coding changes and revisions can make it difficult to stay up to date for providers who are busy treating patients. Chiropractor billing software is frequently updated with the new code changes and make it easy for you to choose the correct codes during chiropractic medical billing.

When providers use the best chiropractor billing software, they don’t have to remember each code or search a spreadsheet to find a specific code. CPT codes, ICD-10 codes, and modifiers are auto-populated in the software by typing just a few letters of the diagnosis or procedure performed.

Filling paper HCFA forms and mailing them to the concerned insurance companies is time-consuming and inefficient. Mistakes in paper claims or the staff filling inaccurate information while submitting the claims might lead to denials. With chiropractic insurance billing software, you can submit electronic claims quickly, saving you a lot of time. If you’re using zHealthEHR’s chiropractic billing software, your electronic claims will be scrubbed by the clearinghouse partner – Office Ally. This ensures that accurate and clean claims are sent to the insurance company and you get maximum reimbursements on time.

4. Evaluate Accounts Receivable Regularly

For chiropractors,managing accounts receivable (A/R)successfully is one of the important elements as far as reimbursements are concerned. It is advisable to keep your A/R between 0 to 30 days category. A/R days indicate the average time taken to collect the payments that your practice owe. This means the higher the number of A/R days, the higher the delay in obtaining payments. That’s why it becomes important to evaluate your A/R regularly. The following are some methods to optimize and examine your accounts receivable:

•    File claims accurately on the day of the service.

•    Segregate all account receivables by patient balances and insurance.

•    Evaluate payer-refund patterns on a monthly basis.

•    Understand insurance company-specific guidelines that affect the receivable management.

•    Once the Electronic Remittance Advice (ERA) is received, review it manually.

•    Post your payments accurately. Having an updated fee schedule will allow you to post payments correctly.

•    Secondary claims should be submitted immediately after the ERA is received and posted.

5. Hire Chiropractor Billing Services

When chiropractors spend time managing their billing processes, they can’t focus on their patients and practice as much as they would like. When the billing tasks are handed over to the office manager, they cannot attend to administrative works as they were originally hired to do. That’s why you should hire chiropractic billing services, a team of expert billers. These services help you focus on your core competencies and improve the revenue cycle. Managed billing service providers have experts coders and billers who can review your codes before claim submission, manage insurance rejections and denials, post your payments, and follow-up accounts receivable. With billing reports, you can review your financial information. At zHealth, we manage the financial side of your business so you can focus on growing your practice. Want more information on our chiropractor billing services? Please contact us online or call us at +1-800-939-0319 

Conclusion

Managing patient care and billing activities at the same time might become difficult for chiropractic providers. A combination of the aforementioned chiropractic medical billing strategies and chiropractic software will be necessary to boost monthly revenue for practices. Some of the successful chiropractic practices rely on chiropractor billing services to handle their chiropractic billing processes. If you need more information on how our billing software or managed billing services can help you get paid more and faster, get in touch with us.