As a chiropractor, managing your billing and coding can be a challenging task. With ever-changing healthcare regulations, it can be difficult to stay on top of the latest billing practices. However, accurate billing and coding are essential for the financial success of your practice. In this blog post, we will share the best billing tips every chiropractor needs to know to ensure they receive accurate and timely reimbursement for their services.
1. Verify insurance coverage before treatment
Before providing treatment to a patient, it’s important to verify their insurance coverage. This will help you determine if the patient is covered and if there are any limitations to their coverage.
You can use chiropractic software or contact the insurance provider directly to verify coverage. This can help prevent denied claims and ensure timely payment.
2. Accurate and complete documentation
Documentation is critical in chiropractic billing, especially in chiropractic care. You need to ensure that you document every service provided and the corresponding diagnosis codes accurately. Use chiropractic EHR to ensure documentation is legible, signed, and dated, and include a detailed description of the treatment provided. This can help support your claims and avoid denied or delayed payments.
3. Use correct billing codes
Using correct billing codes is crucial to ensure that you are accurately billing for the services provided. You should use the correct CPT codes (Current Procedural Terminology) and ICD-10 (International Classification of Diseases) codes for each service provided. Using incorrect codes can result in denied claims or underpayment.
4. Use modifier codes
Modifier codes provide additional information about the service provided and can be used to indicate special circumstances or situations that may affect reimbursement. For example, modifier 25 can be used to indicate that a separately identifiable evaluation and management service was provided on the same day as chiropractic manipulation.
For instance:
A patient presents with neck pain and is referred to a chiropractor for treatment. The chiropractor performs a comprehensive examination and determines that the patient has cervical subluxations that require chiropractic manipulation. The chiropractor also performs a separate service, such as a physical therapy session, on a different day.
Example Documentation:
Day 1:
CPT Code: 98943 – Chiropractic manipulation of the cervical spine
Diagnosis Code: M99.01 – Cervical subluxation
Day 2:
CPT Code: 97110 – Therapeutic procedure, one or more areas, each 15 minutes
Modifier: 59 – Distinct procedural service
Diagnosis Code: M99.01 – Cervical subluxation
5. Properly code and document medical necessity
Medical necessity is a crucial component of chiropractic billing. You need to ensure that the services provided are medically necessary and documented accordingly. This can help support your claims and avoid denied or delayed payments.
For instance:
A patient presents with chronic low back pain and has been referred to a chiropractor for treatment. The chiropractor performs a comprehensive examination, which includes a history and physical examination, and determines that the patient has lumbar subluxations that require chiropractic manipulation.
6. Timely billing
Timely billing is crucial in ensuring prompt payment. You should submit your claims within the designated timeframe outlined by the insurance provider. Late submissions can result in denied claims or delayed payment.
7. Regularly review and update fee schedules
Fee schedules should be reviewed and updated regularly to ensure that they are accurate and up-to-date. This can help ensure that you are charging the appropriate fees for the services provided and avoiding underpayment.
8. Verify patient information
It’s important to verify patient information, such as their name, date of birth, and insurance information, to ensure that the claims are submitted correctly. Incorrect patient information can result in denied or delayed payments.
9. Use chiropractic billing software
Chiropractic EHR and billing software can save time and reduce errors in the billing process. It can also help speed up the payment process and reduce denied claims. You can use billing software to submit claims electronically.
10. Follow up on denied claims
Denied claims should be followed up promptly to resolve any issues and resubmit the claims. You can use billing software for chiropractors to identify issues and resubmit the claims. This can help ensure that you receive timely payment for the services provided.
11. Develop a system for tracking outstanding payments
Tracking outstanding payments can help ensure that you receive timely payment for the services provided. You can use chiropractic software with an integrated billing system to track outstanding payments and follow up on any unpaid claims.
12. Stay up-to-date on billing regulations
It’s important to stay up-to-date on billing regulations to ensure that you are billing accurately and complying with regulations. You can attend training sessions or consult with chiropractic billing companies to stay up-to-date on billing regulations.
13. Stay up-to-date on billing regulations
Outsourcing your billing and coding can be a beneficial option. Chiropractic billing services from expert providers can save time and reduce the risk of errors. Professional billing and coding services providers are experienced in working with insurance companies and can help ensure that your claims are processed accurately and in a timely manner.
[Read More: In-House Chiropractic Billing Or Outsource It – That’s A Million Dollar Question!]
Conclusion
Billing can be a challenging task for chiropractors, but by following these tips, you can streamline the process and ensure accurate and timely payments for the services provided. Remember to always verify insurance coverage, accurately document services provided, use correct billing codes, submit claims timely, and follow up on denied claims promptly. With these tips, you can manage your finances more efficiently and focus on providing quality care to your patients.
At zHeath, we help chiropractors improve their practice’s financial outcomes, and reduce the administrative burden associated with billing and claims management through our managed billing services and chiropractic software.
To learn more about how zHealth help you increase insurance payments and patient collections and improve your revenue cycle management, request a free consultation.
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