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Chiropractic Revenue Model Facing Billing Changes in 2013

October 18, 2013

Chiropractic as an alternate field of medicine has always suffered the problems of effective billing and revenue management due to lack of priority given to it as a non primary care practice. However, with recent healthcare reforms bringing change in the way Chiropractic is seen in medical circles, an over hauling of revenue models of chiropractic practices has become the need of the hour. As per the recent healthcare reforms, Chiropractics is being defined as a ‘diagnosis and treatment’ oriented practice instead of just remaining limited to ‘detection and correction by manual means’. Notable changes in the scope of chiropractor’s practice are –

  • Chiropractors can now order full body X-ray for diagnosis
  • Prescription drugs can now be prescribed in addition to herbal, homeopathic and alternative supplements for healthcare
  • Chiropractors can treat diabetes with nutrition and exercise regimens

Chiropractors are now being referred to as chiropractic physicians, clearly signifying the addition of primary care responsibility to the portfolio of services offered by them. The chiropractic revenue model must, therefore, evolve along with the medical reforms happening. Adopting some standard practices can dramatically improve the financial health of a chiropractic clinic, such as -

  • Availing the EMR stimulus – The government is offering hefty EMR stimulus to those practices which have shown ‘meaningful’ use of EMR. This EMR stimulus can provide a much needed financial boost to any chiropractic practice, thereby facilitating both short term and long term plans of the practice. It is, therefore, essential that chiropractors understand the importance of digital medical records and adapt to changing healthcare norms. HIPPA guidelines are also making exchange of medical and patient information a highly scrutinized procedure. Also, penalty of not adopting EMR can be avoided by effective digitalization of revenue model.
  • Accessing Medicare reimbursements – Medicare reimburses diagnosis and treatment of illnesses covered under primary care as well as chronic illnesses like diabetes. With chiropractics now including primary care in its scope, chiropractors must update their revenue models to handle Medicare patients. In addition to handling more and more Medicare patients, chiropractic clinics will also have to adopt billing procedures such as pre-authorization, medical record keeping, and patient history database management to avail Medicare reimbursement.
  • Making coding and billing changes – Chiropractors will continue to correct and detect vertebral subluxations, but in addition to that they will soon be able to move above alternate healthcare and start offering primary care to patients. Millions of new patients are going to be covered medically under Medicare by 2015 and Chiropractics would be expected to shoulder the increased burden on primary healthcare. Therefore, it is the right time for chiropractors to include ICD – 10 codes in their billing process and prepare their revenue model for a tidal wave of patients.
  • RCM for monitoring – Lastly, adopting revenue cycle management to monitor appointment rescheduling, accounts receivable and payers mix can ensure enhanced profitability and financial viability for chiropractic clinics.

Medicalbillersandcoders.com is a billing partner that can help your chiropractic practice adopt these changes effectively and elevate your financial stability in an expert manner. For chiropractors expecting to avail insurance benefits and achieve 100 % claim settlement, medicalbillersandcoders.com can streamline data recording and data transfer as well as install effective RCM for their practice.


Category : Revenue Cycle Management