Billing and Coding for Chiropractic Speciality
Chiropractic billing and coding involves a series of steps. These ensure chiropractic services are documented properly, coded accurately, and that chiropractic providers receive timely reimbursement. Spinal manipulations, physical therapy, wellness care- all fall under chiropractic care. These specific treatments need specific coding knowledge for proper billing of services rendered.
Instapay Healthcare Services offers chiropractic coding and billing services. Offering end-to-end solutions, our work approach is customized to each healthcare speciality, including chiropractic care. From the first step of patient intake to the final step of payment collection, Instapay Healthcare Services manages all aspects of chiropractic billing and coding.
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Patient Appointment Scheduling
Patient appointment scheduling is the first step. Appointment can be scheduled via calls, text messages, emails or direct walk-ins. Instapay Healthcare Services offers solutions in-house appointment scheduling software that streamlines patient appointments in regards to chiropractors availability. This reduces wait times, takes care of rescheduling and cancellations
Our automated appointment scheduling systems reduce human errors, leading to increased patient satisfaction
For patients that require immediate care for pain relief caused by sudden injuries, we offer same-day scheduling.
Patient Intake and Documentation
After the appointment is scheduled, the patient visits the chiropractor. This is when documentation of all information starts.
Instapay Healthcare Services collects all patient data- personal information, insurance details, medical history, reason for visit, current complaints- in a practice management system (PMS).
Once all the information is collected, the next step is to document it in accordance with industry standards. We, at Instapay Healthcare Services, maintain each patient encounter for further references. This helps in proper coding, which in turn leads to better billing of the claims.
Patient Eligibility and Insurance Verification
a) After obtaining the information, our team carefully reviews if the patient is eligible for the services that will be rendered. Checking their insurance plan coverage, eligibility status and personal demographics is a crucial step for successful claim submission.
b) Instapay Healthcare Services’ collects information from patient insurance identification card. It then compares it against the provider and insurance plan data for any inaccuracies.
c) We validate name, address information and effective date of coverage. All these practices streamline the workflow for chiropractors.
d) Instapay Healthcare Services also confirms what services patients receive are eligible for reimbursement. This determines the patient's responsibility- co-pays, deductibles, out-of-pocket expenses, etc.
Diagnosis and ICD-10 Coding
a) Diagnosis of the issue is done by assigning the most appropriate codes that relate best to the condition. Our coders select precise ICD-10 codes for conditions like musculoskeletal pain, nerve disorders, spinal conditions, subluxations, joint pain, and sciatica.
b) Without correct code selection, claims do not get submitted and reimbursed. ICD-10 codes commonly used in chiropractic care- M99.01 for subluxation of cervical spine and M54.5 for low back pain.
c) Conditional nuances need to be captured well. Instapay Healthcare Services’ is well aware about chiropractic subluxations and spinal misalignments.
CPT coding in Chiropractic Procedures
a) By using CPT codes, Instapay Healthcare Services describes the procedures performed- spinal manipulations, physical therapy, etc. Coding CPT codes well gives providers the accurate reimbursement for the procedures they have carried out.
b) For accuracy, the CPT codes we use for spinal manipulation are: 98940 for a single region, 98941 for two to three regions, or 98942 for four or more regions.
c) CPT codes are also used by us for other additional services that chiropractors offer. Exercise therapy using 97110, therapeutic procedures using 97112, or modalities like ultrasound using 97035 and electrical stimulation using 97014.
d) Instapay Healthcare Services also makes use of modifiers to indicate specific details like multiple procedures and bilateral treatments for higher reimbursement rates due to procedure complexity. Modifier "GA" indicates a waiver of liability for Medicare patients.
Charge Capturing and Charge Entry
Immediately after the chiropractic services are rendered, charges need to be entered in the system without any delays. Instapay Healthcare Services thoroughly verifies charges entered before submission to eliminate common billing errors.
We have seamlessly integrated electronic health records (EHR) and practice management system (PMS) for smoother data transfer without compromising on accuracy.
Claims Audit
Practice integrity is maintained through effective claim audits. Our expert auditors identify inaccuracies to prevent fraud.
Claim Submission
Once patient information and services rendered are documented, and ICD-10 and CPT codes are applied, it is time to submit the claims.
Instapay Healthcare Services’ utilizes clearinghouses to submit electronic claims. This ensures that claims are correctly formatted, meeting all payer-specific requirements. With this, we reduce errors and lower the rates of claim rejections.
In cases where insurance companies require paper claims- CMS-1500 form- Instapay Healthcare Services handles the process, ensuring that all required information is included.
Timely claim submission is extremely important. Instapay Healthcare Services makes sure to submit claims before the insurer's deadline. This eliminates the chances of claims being denied due to late submissions.
Claim Monitoring, Payment and Follow-up
Denial Management, Rejections and Appeals
Payment Billing and Collections
Instapay Healthcare Services generates patient statements, clearly outlining what was covered by insurance and what the patient is responsible for. We make sure patients understand their financial obligations, ensuring transparency. This significantly improves provider-patient relationships.
Reports and Analytics
We provide insights into key metrics such as reimbursement rates, claims acceptance rates, and outstanding balances.
Our reports and analytics dashboard helps chiropractors track their practice’s performance over time. This way, they make informed decisions about their services, pricing, and billing practices.
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In all our above steps, we maintain the highest level of compliance. Instapay Healthcare Services’ solutions are always updated in regards to HIPAA, Medicare guidelines, private insurance regulations, ICD-10 and CPT codes. Your chiropractic practice thrives when it is audit and penalty free.
With our comprehensive solutions, your chiropractic coding and billing is in safe hands. By handling all aspects of your billing cycle, Instapay Healthcare Services allows chiropractic practices to focus on patient care while ensuring you are reimbursed correctly and promptly for services offered.
Contact us : +1646-851-2115Email Address : sales@instapayhealthcareservices.com