Who we serve · Chiropractic
Chiropractic practices. Each plan's line, drawn before the visit.
We enroll the practice and each chiropractor, write down what every plan covers and what the record must show, and bill each visit to those rules.
Summary
Can a chiropractor bill medical insurance?
Yes, once the practice and each chiropractor are enrolled with the payer. Medicare pays a chiropractor for one service, manual manipulation of the spine to correct a subluxation, and the record has to show the subluxation, the treatment plan and progress against it. Commercial plans set their own coverage and visit rules.
Coverage is narrow, and the record carries it.
The exam, the x-ray and any other treatment the chiropractor provides are not covered when the chiropractor bills them.
Medicare also separates active treatment from maintenance. A visit that corrects the problem is billed with the AT modifier, and the record has to show the subluxation, the treatment plan and progress against it. Care that only maintains the patient's condition is not covered.
Commercial plans draw wider lines, each in its own place: visit caps in a plan year, authorization after a set number of visits, and in some plans a separate company that manages the chiropractic benefit and takes its own enrollment.
Enrollment, each plan's rules on paper, and claims built to them.
- Enrollment
- The practice and each chiropractor with Medicare, Medicaid where your state covers chiropractic, each commercial plan you name, and any company that manages a plan's chiropractic benefit.
- A rule sheet per plan
- What each plan covers, its visit caps, when it wants an authorization and what the record must show. Your front desk works from it.
- Claims and denials
- Each visit billed to that plan's rules, with the right modifier, and each denial traced to its cause and appealed where the practice is owed.
- Your work status
- Open applications first. Once billing runs, what was paid, what was denied and why.
| Piece of work | Fee |
|---|---|
| A solo chiropractor who owns the practice, per payer | $450 |
| A group: the practice, per payer | $450 |
| A group: each chiropractor, per payer | $350 |
| Billing and revenue cycle work | By agreement |
Common questions from chiropractic practices.
Should we enroll with Medicare if it covers so little?
Usually, if your patients carry it. Medicare pays for the adjustment, and enrollment lets you bill it. The review looks at your patient mix in general terms and tells you whether it is worth the application.
Our denials say the care was not medically necessary. Can that be fixed?
Often it is a documentation gap, not a coverage gap. We read the denials against the plan's rules, appeal the ones the record supports and show you what the next visit's note needs.
Bring us the plans you bill and the denials you get.
We tell you which lines each plan draws and where your claims cross them. The billing review starts from report totals.
Say which plans cap your visits and which ask for progress notes.