Billing guides · For chiropractic offices
Billing guides for chiropractic offices.
Plain guides to the insurance side of a chiropractic practice: how to start billing insurance, what happens after a claim goes out, and how to choose who bills your claims. Each one cites its sources and says what it does not cover.
Starting with insurance
Deciding, enrolling with payers, setting fees, checking coverage and building clean claims, in the order a new practice needs them. Start with the overview
Should your cash-pay practice accept insurance?
Test demand, economics and a safe way back out before you change how your practice gets paid.
Read the guide Decide firstCan you accept insurance without hiring a biller?
Map every insurance queue to an owner before you decide a new hire is unnecessary.
Read the guide Step 01Getting in network: payer enrollment for a chiropractic practice.
NPIs, the CAQH profile, credentialing and contracts, Medicare, effective dates, then claims, remittances and payments.
Read the guide Step 02Setting your fee schedule when you take insurance.
Charges vs allowed amounts, one schedule for every payer, and the rules on discounts and copay waivers.
Read the guide Step 03Check chiropractic coverage before the visit.
The electronic eligibility check for chiropractic, visit limits, authorizations and who manages the benefit.
Read the guide Step 04What a clean chiropractic claim needs.
Identifiers, the CMT code that matches the note, diagnoses in order, modifiers and dates.
Read the guideAfter the claim goes out
Rejections, denials, remittances, deposits and patient balances, in the order a claim reaches them. Start with the overview
A rejected claim is not a denied claim.
What the 999 and 277CA tell you, why a rejected claim never shows up on the ERA, and which fix each one needs.
Read the guide Stop 02How to read an ERA, line by line.
The payment header, the claim, the service line and every adjustment, read the way the payer wrote them.
Read the guide Stop 03Chiropractic denial codes, and what to do with each one.
The reason codes chiropractic offices see most, what each means, and who on your team owns the fix.
Read the guide Stop 04Match each insurance deposit to the payment behind it.
The trace number that ties a deposit to its ERA, and why a deposit comes in short.
Read the guide Stop 05What the patient owes after insurance pays.
Deductible, coinsurance and copay from the ERA, what you write off, and when a second payer comes next.
Read the guideChoosing how to bill
In-house staff, a billing company or a billing service: what each costs, how to tell whether it works and how to change. Start with the overview
What a chiropractic billing service costs.
Percentage, per-claim and flat fees priced against your own volume, and what each quote leaves out.
Read the guide Guide 02Five numbers that show whether your billing works.
Net collection rate, days in A/R, old A/R, denial rate and unworked items, with the formula for each.
Read the guide Guide 03Questions to ask a billing service before you sign.
Price, scope, people, money, reporting and the exit: what to ask, and what a good answer sounds like.
Read the guide Guide 04How to switch billers without losing claims in progress.
Contract terms, the accounts you must own, the open-claims inventory and a side-by-side period.
Read the guideGet started
Rather hand this work to someone?
Claims Native is a billing service for chiropractic practices. We file, follow up, post each payment with its adjustments, match deposits and tell you what each patient owes.
Would you rather talk first? Email Ian Harman.