In the rapidly evolving healthcare landscape, chiropractors often juggle clinical responsibilities with back-office tasks such as insurance billing. While these administrative duties are integral to running a practice, they can often detract from the core objective of providing patient-centered care. One practical solution to this conundrum is outsourcing insurance billing. In this blog post, we’ll delve into the various benefits that outsourced insurance billing can bring to your chiropractic practice.
1. More Time for Patient Care
Outsourcing insurance billing allows you to refocus your attention where it matters most – on your patients. According to a study published in the Annals of Internal Medicine, physicians spend nearly twice as much time on administrative work as on direct patient care. By outsourcing, you can devote more time to patient consultations, treatment, and follow-ups, thereby improving patient satisfaction and care outcomes.
2. Cost-Effective
Employing a dedicated in-house billing team can be expensive when you consider salaries, benefits, training, and turnover. On the other hand, outsourcing to a professional billing service like Holbie eliminates these overhead costs. You pay for the service, not office space, software, hardware, or additional employees. This cost-effectiveness can significantly improve your bottom line.
3. Expertise and Accuracy
Billing companies specialize in healthcare coding and billing. They stay abreast of the latest changes in billing codes, insurance policy updates, and industry trends. This expertise ensures accurate claim submissions, which can improve your reimbursement rates and reduce claim denials. Moreover, billing companies understand the intricacies of different insurance providers, navigating their policies more efficiently than a general office staff member.
4. Cash Flow Consistency
Outsourced billing services can streamline your revenue cycle management. They can quickly submit claims, follow up on unpaid claims, and manage patient invoices and collections. This efficiency ensures a steady, predictable cash flow, providing financial stability to your practice.
5. Stress Reduction
Dealing with insurance companies, following up on unpaid claims, and resolving billing issues can be stressful and time-consuming task. Outsourcing your insurance billing alleviates this stress and frees your team to focus on more immediate and patient-centric tasks.
6. Patient Satisfaction
Outsourced billing services often have the resources to provide patient support for billing questions and issues. This ability to quickly and effectively handle patient inquiries enhances patient satisfaction and can contribute to a better patient experience.
7. Compliance
Billing services are well-versed in the latest healthcare regulations and compliance requirements, including the Health Insurance Portability and Accountability Act (HIPAA). They can help ensure that your practice remains compliant, avoiding potentially costly fines and penalties.
8. Scalability
As your practice grows, so too does the complexity and volume of your billing. Outsourcing your billing allows for scalability without the need for hiring additional staff or worrying about staff turnover during critical periods.
Holbie’s outsourced insurance billing service is a perfect solution for chiropractors looking to reap these benefits. As a leading provider in the industry, Holbie combines advanced technology with expertise in insurance billing to provide seamless billing services to chiropractors. This way, you can focus on patient care while we handle your billing needs.
Outsourcing your insurance billing can be a transformative decision for your practice. It’s about choosing a strategic partner who works towards the success of your practice as much as you do. In essence, outsourcing is more than a service; it’s a pathway to simplified practice management and amplified impact on patient.
There are nearly 11,000 CPT codes to account for all the different variations of healthcare treatments. While your chiropractic practice will only need a fraction of these codes, it’s vital that the chiropractic CPT codes are current and accurately reflect the services rendered.
If you’re utilizing chiropractic CPT codes that aren’t appropriate or are keyed incorrectly, your reimbursements can be delayed or your claims can be rejected. In any case, this will disrupt your overall revenue cycle.
Since the CPT codes are updated to some degree every year, let’s review the new changes and essential codes for your chiropractic practice!
New Chiropractic CPT Codes and Changes for 2023
All chiropractic services rendered in 2023 must align with the patient’s condition and can only be billed if they are reasonably and medically needed.
Along with this, you’ll only bill for direct services provided to patients – care and treatment provided by the patient, unskilled assistant, or office technician without the supervision of a licensed provider won’t be recognized as professional therapy.
A majority of the CPT codes that were updated or revised for 2023 deal with simplifying the language used for evaluation/management (E/M) codes for:
- Inpatient and observation care services
- Consultations
- Emergency department services
- Nursing facilities
- Home and residence services
- Prolonged services.
The American Medical Association (AMA) has more details regarding the changes for these categories of care, but some highlights include:
- Editorial revisions to the code descriptors to reflect the structure of total time on the date of the encounter or level of medical decision-making when selecting code level for inpatient and observation care services
- Deletion of lowest level office (99241) and inpatient (99251) consultation codes to align with four levels of Medical Decision Making (MDM)
- Revision to nursing facility guidelines with new “problem addressed” definition of “multiple morbidities requiring intensive management,” to be considered at the high level for initial nursing facility care
- The domiciliary or rest home CPT codes (99334-99340) were deleted and merged with the existing home visit CPT codes (99341-99350)
- A new code (993X0) was created to be analogous to the office visit prolonged services code (99417); this new code is to be used with the inpatient or observation or nursing facility services
Essential Chiropractic CPT Codes and Modifiers for 2023
While there are numerous chiropractic CPT codes, there are four main CPT codes chiropractors use for reimbursements; each code represents a specific region of the spine that was treated. These main codes are as follows:
- 98940: Used for the examination, diagnosis, and manipulative treatment of one to two spinal regions
- 98941: Used for the examination, diagnosis, and manipulative treatment involving three or four spinal regions
- 98942: Used for the examination, diagnosis, and manipulative treatment involving five or more spinal regions
- 98943: Used to report chiropractic manipulation of one or more of the extra-spinal regions
There are additional two chiropractor modifier codes commonly used. These can be attached to certain CPT codes to tell insurance providers that some of the treatments the CPT code describes were slightly altered.
If your selected CPT code requires a modifier but you fail to include it, your claim will likely be denied by the insurance company:
- Modifier 25: This Modifier is used to report a significant and separately identifiable Evaluation and Management (E/M) service on a day when another service was provided to the patient by the same physician or other qualified healthcare professional
- Modifier 59: Use this Modifier to report a procedure or service that was distinct or independent from other non-E/M services performed on the same day
When billing for these chiropractic CPT codes, remember these points:
- Report the initial treatment procedure
- Report the date of the X-ray if it was applied, including the X-ray film
- If an X-ray is unavailable, a physician’s examination may be used to document subluxation. The physical examination record must reflect the subluxation.
- Report subluxation using the recommended ICD-10-CM code
- All treatment procedures should be categorized as maintenance therapy, chronic subluxation, or acute subluxation
Direct Patient-Chiropractor Care CPT Codes
When billing for chiropractic care, you can only quantify the time that is spent with direct patient-chiropractor care; the client waiting for equipment or resting in your office doesn’t qualify as direct care, so it can’t be billed.
Refer to these ranges of chiropractic CPT codes to find the one that is most appropriate for chiropractic services rendered:
- 97032-97039
- 97530-97546
- 97110-97150
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As an experienced EMR and insurance billing provider for holistic practices, Holistic Billing Services can help your practice navigate the billing process to minimize denials and increase revenue. With a knowledgeable partner by your side, you can focus more on treating patients to help your chiropractic practice grow rather than worrying about insurance billing.
To learn more about our chiropractic billing services, talk to one of our friendly billing and coding experts today!
As the healthcare industry continues to fight the opioid epidemic and encourage the use of drug-free alternatives to managing pain and other chronic conditions, it’s important to also expand coverage to enable such movements to spread. Particularly, expanding chiropractic Medicare billing coverage is a vital effort to improve access to drug-free alternatives for seniors covered by this government program.
One recent initiative to expand drug-free coverage under Medicare is the Chiropractic Medicare Coverage Modernization Act proposed by New York Congressman Brian Higgins and championed by the American Chiropractic Association. Officially filed as H.R. 2654, this legislation would significantly improve access to chiropractic treatments and other related drug-free services.
A Look at the Chiropractic Medicare Coverage Modernization Act (H.R. 2654)
The Chiropractic Medicare Coverage Modernization Act (HR 2654) would enable patients under Medicare coverage to visit a chiropractor for their comprehensive services. Such services might include manual manipulation of the spine and extremities, evaluation and management of conditions, diagnostic imaging, and the utilization of other non-drug treatments in an effort to combat prescription abuse and fight the opioid epidemic.
Essentially, this bill:
- Provides patient access to all Medicare-covered benefits as delivered by a chiropractor’s state licensure
- Categorizes a Doctor of Chiropractic (DC) as a “physician” in Medicare’s programming and thus expand their authority as recognized by Medicare
- Requires that DCs complete a documentation webinar
- Has bipartisan support and was introduced by 16 cosponsors from both sides of the political aisle
As a side note, the component regarding completing a documentation webinar means that DCs would be required to participate in a webinar that explains how to include proper documentation for billing Medicare. The medical billing and coding process is rather intricate, so mandating a webinar regarding appropriate documentation for billing Medicare would help inform DCs on the process and, ideally, reduce the number of claims filling inaccurately or incompletely.
Overall, this piece of legislation would grant significantly more access to all services provided by a chiropractor and thus empower chiropractors to treat a new population of patients who are covered by Medicare.
Fighting the opioid epidemic doesn’t happen overnight, nor can it be comprehensively addressed with just a single Act, but every little bit counts. Radically expanding chiropractic Medicare coverage for millions of people is one important step to encouraging drug-free alternatives to pain and ailment management plans.
Current Chiropractic Medicare Billing Coverage
The relationship between chiropractic coverage and Medicare has existed for decades—50 years, in fact.
The field of chiropractic medicine was established in the late 19th-century by Daniel David Palmer; the first chiropractic treatment occurred when Palmer noticed his building’s janitor, who was hard of hearing, had a vertebra out of place. Upon manipulating the vertebra back into place, the janitor’s hearing improved and the rest is history. Manual manipulation of the spine, joints, and holistic body has a long tradition of improving overall health and continues to be a cornerstone alternative to prescription drugs.
Let’s briefly outline the history of chiropractic coverage in relation to federal or national recognition:
- 1972: Medicare introduces chiropractic coverage under the limited scope of spinal manipulation
- 1974: Chiropractic treatments are included as part of the Federal Employees Health Benefits Program
- 1993: Congress passes legislation that includes chiropractic medicine in the US Department of Defense healthcare system
- 1999: Legislation passes to include chiropractic care in the Veterans Affairs healthcare system
- 2014: The VA launched a chiropractic residency program, the first of its kind in the country, where chiropractors train alongside their medical counterparts at VA medical systems around the country
- 2019: H.R. 3654 is introduced to the 116th session of Congress by two New York Congressmen, Brain Higgins and Tom Reed, which would expand coverage of Medicare to include comprehensive services as delivered by a licensed chiropractor; the Bill garners 90 cosponsors but ultimately does not pass before the end of that Congressional session
- 2021: H.R. 2654 is re-introduced by Brian Higgins to the 117th session of Congress and is presented with 16 bipartisan sponsors, which is promising to the future of the Bill; the legislation is the same as the original H.R. 3654 bill
With support from the ACA and chiropractors around the country, H.R. 2654 has a strong chance to pass in this session of Congress and greatly expand coverage of chiropractic services for millions of patients.
Benefits of Chiropractic Treatment
Chiropractic treatment has been proven to deliver several benefits, including:
Proven Alternative to Prescription Opioids
A recent study conducted in 2020 examined two groups of more than 100,000 people total between the ages of 18 and 84: one group, who went to their doctor alone for managing their pain, and another group who received primary care and chiropractic care.
The study found that those who visited a chiropractor in addition to their primary physician were less likely to be prescribed opioids to manage their pain—in fact, they had half the risk of being prescribed opioids. These findings are significant because it proves that chiropractic treatment is an effective and safe drug-free alternative to managing chronic pain, temporary ailments, and more.
Reduces Chronic Back Pain
Of the 22 million people who seek chiropractic treatment any given year, nearly 8 million of them are seeking relief from chronic back pain. Whether caused by an athletic injury, a car accident, a muscle strain, or something else, chiropractic treatment is effective at managing chronic back pain.
Improved Range of Motion
Routine, consistent chiropractic treatments result in an improved range of motion. Chiropractic treatment reduces inflammation, aids in blood flow, and ensures that your spine and joints are in their optimal positions to enable smooth movement. Increasing your range of motion means that regular activities require less effort on your part!
Optimize Your Chiropractic Medicare Billing Cycle with Holistic Billing Services!
Medicare’s expansion to further include comprehensive chiropractic care would provide a huge benefit to your chiropractic practice and could bring in a whole new group of potential patients; how exciting! Want to optimize your practice’s revenue cycle? Partner with an expert medical billing firm that has specialized expertise in handling chiropractic billing and Medicare experience.
At Holistic Billing Services, we deal exclusively with holistic healthcare practices that deliver acupuncture, massage therapy, and chiropractic treatments to communities around the country. Whether you have questions on chiropractic insurance billing or other methods to enhance your revenue cycle management, feel free to contact our team today and let us know how we can help your practice today!
About 1 in 4 medical students in America is studying to earn their doctor of osteopathy degree, which is comparable to a traditional MD degree. The school of medicine educating the next generation of DO’s has a long history of more than 100 years and, in fact, has a few parallels to the school of chiropractic medicine.
The next time you’re back pain flares up, would you go to an osteopath or a chiropractor? Let’s compare Osteopaths vs Chiropractors: we will dig into what these two lines of medicine are, their histories, and where they differ.
What Is Osteopathy?
Osteopathy is a branch of medicine in the US that focuses on full-body holistic health and wellness by emphasizing how the body’s systems are connected and need to work together in order to maintain health.
Similar to an MD, a doctor of osteopathy—known as a DO—attends medical school and is a fully-licensed physician who can specialize in any area, perform surgeries, work in pediatrics, emergency medicine, and more.
History of Osteopathy
Osteopathy was founded in America by Dr. Andrew Taylor Still, a physician who didn’t agree with the contemporaneous practices of bloodletting, blistering, treatments with mercury, etc. He believed that most ailments could be treated without the use of drugs; this curiosity, grounded in Still’s anatomical studies, lead to him exploring how medical conditions could be treated with a more natural healing process.
Eventually, Dr. Still would open the first osteopathic medical practice and found the first school of osteopathic medicine; here’s a brief timeline of the development of this medical thought from founding to the present day:
- 1826: Andrew Taylor Still is born, the third of nine children to Abram and Martha Still
- 1853: Still becomes a physician, studying closely with his father who was a preacher and physician
- 1861: Still enlists to serve as a physician during the Civil War for the Union state of Kansas
- 1892: The first osteopathic medical school, the American School of Osteopathy, opens in Kirksville, Missouri
- 1897: The American Osteopathic Association (AOA) is founded
- 1929: Pharmacology and surgical education is added to the osteopathic curriculum
- 1957: The US Department of Education recognizes the AOA as an accrediting organization for osteopathic medical education
- 1973: Doctors of Osteopathic medicine are certified in all 50 states and DC
- 2007: Osteopathic medicine is recognized in 45 countries around the world
- 2020: Osteopathic accreditation programs merged into one single accreditation program, further affirming osteopathic medicine’s standing in American healthcare education practices
History of Chiropractic Medicine
The word “chiropractic” derives from the Greek words cheir, meaning “hand”, and praktos, meaning “done”, in essence, “done by hand”. While manual wellness treatments have traditions spanning millennia, the particular profession of chiropractic medicine didn’t take shape until the late 1800s in America.
The birth of chiropractic medicine as we know it today is attributed to Daniel David Palmer, who had a background in magnetic healing and phrenology, or the study of diagnosing illnesses by the bumps on a person’s skull. Due to his dubious attitude toward traditional medical practices in his time, Palmer began experimenting on treating ailments through the manipulation of the spine.
Akin to Still and the birth of osteopathic medicine, Palmer believed that the human body was one organism that needed all parts to function properly for good health; Palmer felt that the origin of good health lay in the spine.
Let’s look at a brief timeline of how chiropractic medicine has developed over the last hundred years:
- 1845: Chiropractic founder Daniel David Palmer is born in Canada and later immigrates to the United States with his family in 1865
- 1895: While working in an office practicing magnetic healing, the building’s janitor, a man named Harvey Lillard, receives the first chiropractic adjustment; Lillard had been partially deaf for almost 20 years and Palmer noticed one of his vertebrae was out of place. After correcting the position of his vertebrae, Lillard reports that his hearing significantly improved
- 1897: Palmer opens the first school of chiropractic medicine, named Palmer School of Chiropractic
- 1913: The first law regarding the licensing of chiropractors is passed and thus makes chiropractic treatment officially legal
- 1964: The Palmer School of Chiropractic is renamed the Palmer College of Chiropractic and made a non-profit institution, thus greatly expanding its campus and student presence
- 1993: Congress passes legislation that includes chiropractic medicine in the US Department of Defense healthcare system
- 2014: The VA launched a chiropractic residency program, the first of its kind in the country, where chiropractors train alongside their medical counterparts at VA medical systems around the country
Osteopath vs Chiropractor: What’s the Difference?
Now that we’ve explored how osteopathic medicine shares some parallels with chiropractic medicine over the course of each practice’s history, let’s flesh out a couple of their differences, particularly in terms of training and treatment intentions.
Training and Education
To be clear, both osteopathy and chiropractic medicines require specialized training and education.
Although not medical doctors, chiropractors require at least 7 years of specialized schooling, credentials, and a state license in order to practice and become a Doctor of Chiropractic Medicine. Chiropractors cannot write prescriptions or perform surgeries, unlike those who hold Doctor of Osteopathy degrees; DO school requires several years of medical school and residency experience.
Intended Treatments
Visiting a chiropractor is probably your best method of treatment for alleviating pain caused by a car accident or a fall, especially if the pain is located in your lower back. Same if you find yourself waking up with pain or discomfort after sleeping in the wrong position or if you suffer from chronic back pain, leg pain, or neck pain.
On the other hand, an osteopathic medicine route is best for holistic ailments ranging from infertility, digestive problems, the common cold, and more. Basically, anything you would see a traditional MD for, an osteopath can just as well treat you. Plus, due to their holistic approach to comprehensive medicine, a DO can refer you to a chiropractor when needed.
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With decades of experience dealing with a broad range of medical billing issues for all kinds of holistic practices, the team at HBS has seen just about every kind of medical billing mistake that an organization can make. That’s why our clients trust us to help them manage their insurance claims to ensure they’ll be accepted as clean claims on the first attempt, avoiding lengthy back and forth negotiations with the insurance company. And best of all, you’ll avoid the scrutiny of federal and state auditors.
Contact us today to learn about Holistic Billing Services medical insurance billing services and find out how we can help you maximize your revenue!
Today, chiropractors treat over 27 million Americans every year – which translates into about one million chiropractic adjustments every business day. Chiropractic care continues to grow in popularity as a safe holistic alternative for pain relief, with more people coming into chiropractic practices for a variety of ailments. As more scientific studies are being conducted to prove the benefits of chiropractic adjustments, the more this treatment will cement itself as an accepted holistic practice.
What is Chiropractic Care?
Chiropractic treatment is a system of holistic therapy focused on the structure of the body, specifically the spine. By manipulating the spine’s alignment, a chiropractic adjustment is intended to relieve pain, improve bodily functions, and encourage the body to heal itself.
The goal of chiropractic adjustments is to correct spine misalignments, which are also called subluxations. Chiropractic care believes that these misalignments result in improperly transmitted nerve signals between the spine and body – resulting in negative effects on your health.
What Are The Different Types of Chiropractic Treatments?
All types of chiropractic treatments focus on aligning the spine. There are a wide variety of different types of chiropractic treatments available to suit different needs.
Diversified Technique
One of the most widely used chiropractic methods, the diversified technique is used for three main purposes: restore spine alignment, repair joint dysfunction, and ensure proper mobility and movement. With precise manual thrusts, chiropractors use this method to restore spinal alignment that may be compromised by misaligned bones or joints.
Spinal Manipulation
Also known as spinal mobilization or manual therapy, this technique aims at reducing inflammation, enhancing nerve function, and relieving pressure on joints. Spinal manipulation is similar to the diversified technique in that it is a manual procedure, although it involves more stretching and gentle thrusts.
Thompson Drop-Table Technique
This type of chiropractic treatment requires a specially designed table constructed with padded platforms and drop mechanisms. While the drop mechanisms allow the patient to be “dropped” during the chiropractic adjustment, the padded platforms keep the patient comfortable during the procedure. The drop motion is gentle and designed to resemble a light vibration when the chiropractor applies thrusts.
Gonstead Adjustment
This method is used to restore normal disc alignment for maximum mobility. This chiropractic adjustment can be administered with the patient either laying on their side or sitting up. Unlike other types of chiropractic treatments, the Gonstead Method addresses all of the possible directions in which a spinal bone can misalign and cause nerve irritation.
Flexion-Distraction
The flexion-distraction method uses a special table that moves as the chiropractor manipulates the patient’s spine. The movements of the table are designed to emphasize the spinal manipulations and help stress and decompress the spine. This position helps realign the spine and relieve multiple sources of pain.
Activator Method
The activator method uses a hand-held, spring-loaded instrument known as the Activator adjusting instrument. This method offers two main advantages: high speed and controlled force. As opposed to other techniques, the activator method enables chiropractors to use low-impact and quick thrusts at specific points.
Do Chiropractic Adjustments Work?
Chiropractic adjustments can be effective in treating lower back pain as well as other ailments. A 2018 study is among some of the more recent studies reflecting the effectiveness of chiropractic adjustments. Researchers enrolled 750 active-duty military personnel who complained of back pain; while half were given chiropractic treatment, the others were given conventional care, such as medications.
By the end of the six-week study, the military personnel who received chiropractic adjustments
- Reported less pain
- Experienced more mobility
- Reported higher satisfaction with their care treatment
- Required fewer pain medications
According to the MayoClinic, other studies also suggest that chiropractic adjustments may also prove to be an effective treatment for headaches and other spine-related conditions, such as neck pain. As more studies are conducted to prove the benefits of this holistic therapy, it’s no doubt that chiropractic care will continue to expand and become even more popular for those seeking a safe alternative for pain relief.
What Are the Benefits of Chiropractic Care?
There are numerous advantages to chiropractic care for people looking to alleviate pain and other symptoms. Some of the most common benefits include:
Alleviates Pains
Of the millions of people who seek chiropractic care, about 35% are seeking relief from back pain alone. Regardless of the cause, such as accidents and sports injuries, back pain can be alleviated from spinal manipulation. Chiropractic adjustments can also help improve neck, arm, and leg pain, as well as headaches and muscle strains.
Enhances Athletic Performance
Chiropractic adjustment can reduce inflammation in the body, helping to improve mobility and limb function. This is especially important for athletes, who must reduce tension and pain in their bodies for top performance. By making athletes more mobile, chiropractic care can help prevent sports injuries. In fact, many sports teams and athletic programs hire chiropractors to ensure the health and safety of athletes.
Improves Symptoms of Neurological Conditions
Chiropractic care may provide relief for some neurological condition symptoms. Since chiropractic treatments help increase blood flow to the brain, it may also increase the flow of cerebral spinal fluid – therefore benefiting people who suffer from neurological conditions such as multiple sclerosis. Currently, chiropractic applications for neurological conditions are still being researched but chiropractic neurology is expanding.
Provides a Safe Opioid-Alternative
The increasing popularity of chiropractic treatments is partly due to their ability to alleviate pain without side -effects. As the opioid crisis grows, more people are choosing holistic therapies over conventional treatments for pain with opioid pain medications, which can lead to addiction. Chiropractic is a safe, non-addictive treatment for people looking for opioid alternatives.
Common Ailments Chiropractors Can Treat
Chiropractic adjustments are known to treat a variety of different ailments, but here are some of the most common ones.
Herniated Disc
A herniated disc is one of the most popular reasons people turn to chiropractic adjustments for relief. Also known as a bulged, slipped, or ruptured disc, this condition of the spinal bones can irritate nerves and result in numbness, pain, and weakness in the leg or arm. Chiropractic care, such as spinal manipulation, manual therapy, and therapeutic exercises can alleviate this condition.
Headaches
Chiropractors commonly see patients come in complaining of migraine headaches. Studies have shown that spinal manipulation may be an effective option for treating tension headaches and headaches that have their origin in the neck.
Rheumatoid Arthritis
A chronic inflammatory disease, rheumatoid arthritis causes joint pain throughout the body. Inflammation can cause swelling, stiffness, and pain that can eventually lead to loss of joint function. Chiropractic care can help ease the tight muscles along the spine and treat the inflammation throughout the body from this condition. Since chiropractors try to improve the relationship between the nervous system and spine by realigning vertebrae, Rheumatoid Arthritis symptoms may be improved.
Sciatica
This condition refers to pain that radiates along the sciatic nerve, which can range from your lower back through your hips and down each leg. Sciatica typically occurs on only one side of the body. Chiropractic care treats the true cause of sciatica, which is nerve compression caused by vertebral subluxations. By making spinal adjustments, the nerve is decompressed and the sciatica pain is alleviated.
Whiplash
Often the result of a car accident, whiplash is neck pain that can also cause stiffness and mobility issues. With chiropractic adjustments and stretching, many people have found their whiplash swelling and pain reduced.
Tinnitus
Ringing in the ears, known as tinnitus, can surprisingly be affected by chiropractic adjustments. Tinnitus is a result of injuries in the upper spinal area. Chiropractors will address the original cervical injury, which is generally a subluxation that can be easily manipulated by adjustments. By alleviating the nerve pressure, tinnitus can be cured by spinal manipulation.
Focus on Providing Better Chiropractic Care While We Focus on Insurance Billing!
With further advancements in chiropractic care, the more this holistic therapy is expected to expand. However, your holistic practice will only expand by ensuring your chiropractic billing is as accurate as possible to prevent any chance of claim denials and delays. That’s where outsourcing your chiropractic insurance billing can help!
As an experienced billing provider for holistic practices, Holistic Billing Services can handle all your insurance billing details to minimize errors while you can focus on delivering the best care to your patients. Want to learn more? Talk to one of our billing and coding experts today.
Chiropractic CPT codes are some of the most important components of the insurance billing process. Accurate chiropractic insurance billing is essential for your practice’s revenue cycle management, but errors can cause costly denials and delays.
As a billing company focused on holistic healthcare providers, Holistic Billing has the answers to many of the most common questions about chiropractic insurance billing and CPT codes. Find the answers below!
How Do You Bill for Chiropractic Treatments?
Chiropractic practices must bill insurance companies to receive insurance reimbursements using specific chiropractic CPT codes. These special CPT codes characterize the type of procedure being done so healthcare providers – whether conventional or holistic – can bill insurance companies for the right services and receive their due payment for treatments.
Holistic practices have their unique requirements when it comes to receiving insurance reimbursements. For a streamlined insurance billing process, practices must use accurate CPT codes that are unique to their specialty and procedures. Chiropractic CPT codes are some of the most important code sets for chiropractors.
In the world of billing insurance, insurers improperly issue medical necessity denial claims on the basis of treatments being not medically necessary quite frequently. This is especially true in cases where you are billing insurance for acupuncture, medical massage, or chiropractic treatments. Sometimes such denials are a mistake, but all too often, these denials by insurers are intentional and intended to avoid coverage for treatments.
Since these persistent denials exist, it is important for you to understand how to fight a medical necessity denial in order for your patient to receive all of the coverage they are entitled to. Learn more about how to appeal a medical necessity denial claim and the medical appeal letter template you should use for your best chances of revoking the denial.
Is Acupuncture Covered by Insurance?
Healthcare coverage for integrative medicine treatments like acupuncture and massage therapy has come a long way in the United States. Nowadays, it is common practice to complement traditional health care with other modalities like massage and acupuncture. However, not all health insurance plans cover these services, and those that do vary when and what they cover. On top of this, the insurance industry makes the billing process for acupuncture and other holistic treatments difficult and complicated. While some insurance plans will allow these sorts of treatments for a wide variety of medical conditions, others will have more limited plans.
Medicare has special requirements for acupuncture; recently in January 2020, the Centers for Medicare and Medicaid Services (CMS) announced their decision to cover acupuncture for chronic low back pain. Although the update was especially important, as it marks the first time acupuncture codes can be reimbursed by Medicare, the additional requirements made it impossible for most licensed acupuncturists to take advantage of it.
Unfortunately for holistic practitioners, the insurance industry makes billing for acupuncture and massage complicated with a variety of accompanying regulations and requirements. The majority of covered acupuncture services that need to be billed to insurance fall under four essential acupuncture CPT codes and two medical massage codes. Like other similar therapy-based practices, integrative health practitioners bill their services according to Current Procedural Terminology (CPT) codes. Each code is considered a billable unit used to track what treatments have been administered.
Acupuncture and massage services are always billed in 15-minute increments. For instance, in acupuncture, you will use one code for the initial 15 minutes of service and then a separate code for additional units of time. If you include electronic stimulation in your treatment, your codes will vary as well.
Evaluation and management services, or office visits, may be billed by acupuncture physicians on the initial patient evaluation and periodic follow-up evaluations, typically every 30 days or every sixth visit. However, it is not appropriate to bill these codes every time the patient receives acupuncture treatments, as acupuncture CPT codes 97810, 97813, 97811, and 97814 all include evaluation and management done as part of the overall daily treatment.
Are Chiropractic Treatments Covered by Insurance?
Just as with acupuncture, chiropractic treatments used to be rarely covered by insurance. This has since changed; most health insurance plans now cover chiropractic treatments due to the holistic practice’s positive reputation among many Americans for effective treatments for neck and back pain. In fact, chiropractors see an estimated 35 million people every year in the United States alone. Despite its popularity, insurance may only pay a certain amount of chiropractic treatments or under certain circumstances just as with other holistic disciplines.
Medicare will cover chiropractic manipulation of the spine for back pain management, but there are additional caveats just as with acupuncture Medicare coverage. To qualify for Medicare reimbursement, the patient must have active back pain and seek out chiropractic care that corrects this problem. Any chiropractic services administered as maintenance or preventative will not be covered, as well as any massage therapy or X-rays.