Insurance carriers compensate chiropractors for services rendered to eligible insurance beneficiaries. However, sometimes the settlement process does not happen smoothly— the carriers can reject claims or take unnecessarily long to reimburse due to omissions on the chiropractor’s side.
Fortunately, chiropractic practices can avoid these inconveniences by following the set chiropractic billing best practices.
#1: Pre-authorize Before Offering Service
Ineligibility is one of the primary causes of claim rejections in chiropractic billing. Many insurance providers cover chiropractic services when medically necessary and not when used for wellness maintenance — a move that sets the ground for disputes. For that reason, always do a pre-authorization before offering chiropractic services.
So, what is pre-authorization? It is a process in which you confirm if the insurance provider will cover chiropractic services rendered before serving your client. The insurance provider reviews the case and then decides whether to let you offer the service or request your client pay out of pocket.
#2: Get Chiropractic Coding Right
Insurance providers use CPT codes to determine the type of service they offer and gauge if the billed amount is worth the service. Therefore, quoting the wrong CPT code confuses the people reviewing your claim, often leading to needless rejections.
To avoid such errors, get the codes right every time you prepare a claim. You’d want to train your billing staff about using the codes correctly and monitor changes since the chiropractic codes change from time to time.
#3: Review Claim Forms Before Submitting
A large percentage of claims get rejected due to incorrect or missing information. This makes it ideal to have a checklist that helps you countercheck important details before submitting claims to the payer.
Ensure the information is typed correctly, the patient’s condition is well-documented, and important billing and insurance information is captured accurately. The simple act of counterchecking will keep rejections at a minimum.
#4: Submit Claims at Least Once a Week
Many insurance companies receive thousands of claims daily, making it impossible to review and approve all of them instantly. That is why your clinic has to wait for several days or months before receiving reimbursement.
To avoid a financial crisis, ensure you submit your claims at least once a week instead of hoarding them for several months. That way, you have regular settlements and several claims on the payer’s claims processing queue.
As a rule of thumb, avoid hoarding claims, assuming an insurance carrier will process them immediately after you submit them. Note that the insurance carriers can take up to 6 weeks to process your claim.
#5: Monitor Account Receivables Regularly
Chiropractic billing does not end when you confirm that an insurance provider has approved your claim. Chiropractic clinics should confirm if the payer reimbursed the correct amount into your account. After all, insurance carriers do make errors like any other entity.
Keeping a check on account receivables helps spot payment errors and allows you to follow-up to rectify the discrepancies. Otherwise, the errors in reimbursement could go unnoticed, leading to significant losses.
#6: Outsource Chiropractic Billing if Your Team Gets Overwhelmed
Supposing your chiropractic clinic handles several patients a day and you lack a dedicated billing department, delegate services to a clearinghouse. Chiropractic clearinghouses understand everything required to get the billing process right.
They handle everything from documenting services, checking for errors, submitting claims, and monitoring account receivables efficiently. Clearinghouses save you the amount you could have lost due to rejected claims and takes one more thing off your plate so you don’t have to worry about hiring and training a costly billing staff.
#7: Automate Your Chiropractic Billing
With technological advancements, clinics don’t have to prepare claims manually, as was the case a few years ago. Today, savvy chiropractic practices use automated systems, which are highly efficient and error-free.
The automated systems are designed to avoid human errors like mistyping details and using wrong codes. Furthermore, the automated systems do billing in record time, saving you more time for important processes.
#8: Follow the Rules of Each Insurance Provider
Many chiropractic clinics assume that billing is similar across the industry, overlooking the fact that each insurance carrier runs by its own in-house rules. Therefore, if you wish to get the billing process right every time, familiarize yourself with the claim processes of each insurance carrier serving your clients.
You can get the information online or request it from the insurance carriers. That way, your chiropractic clinic can reduce costly and time-wasting delays associated with mistakes in your billing process.
How Apex EDI’s Services can Help with Chiropractic Billing
Apex EDI is the brain behind Apex EDI One Touch, a software helping chiropractic, dental, optometry, and other medical specialties process claims seamlessly. Our versatile software is designed to manage the billing process from the start to the end, saving you time and resources.
On average, our application executes this process in a record two minutes, giving you more time to attend to patients, or do other important tasks within your practice. Already, chiropractors around the US are using it to send claims at the touch of a button.
Besides sending claims, the Apex One Touch verifies patient eligibility and updates you on the status of submitted claims. Furthermore, the software organizes patient statements and helps with ERA 835 transactions.
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Done unprofessionally, Chiropractic billing leads to unwarranted claim rejections or delays. However, you can minimize the issues by following chiropractic billing best practices like avoiding code errors, submitting claims regularly, or letting a professional clearinghouse handle your billing tasks.
Nevertheless, if following the chiropractic billing best practices does not deliver the results you expect, automate billing with our APEX EDI One Touch chiropractic billing software. The software handles everything, including sending claims, monitoring claim status, scrubbing, and eligibility verification. Contact us or schedule a free, live demonstration to learn how our software works.