Chiropractic has one of the highest denial rates in outpatient care, and a low per-claim value that makes every denial expensive to rework. The margin lives in getting claims right the first time.
Generic billing services treat every claim the same. These are the patterns we look for first in chiropractic practices.
Medicare covers manipulation only for active treatment with documented functional improvement. Care that reads as maintenance in the note gets denied regardless of what was actually delivered.
Omitting it denies the claim. Applying it without documentation that supports active treatment invites recoupment. Both failures are common.
An appeal costs the same staff time whether the claim is $45 or $450. That economics is why chiropractic denials get written off, and why working them systematically is worth outsourcing.
Diagnosis has to identify the region treated and support the level of manipulation billed. Vague coding denies.
Benefits and authorizations checked before the visit, not after the denial.
CPT, ICD-10 and modifiers validated against your documentation, with 100% audits for new clients.
Categorized by root cause, appealed with evidence, and fixed upstream so they stop recurring.
Oldest and largest first, with payments validated against your contracted fee schedule.
Payer enrollment and re-credentialing as part of the standard package, not an add-on.
Accuracy, turnaround and collections sent to you, not buried in a portal.
Send us a month of denied claims. We will categorize them by root cause and show you which are recoverable, free.
Request a free A/R review