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How to avoid denials and reimbursement delays for your Chiropractic claims

February 14, 2014



As a Chiropractor, you must focus extensively on new advancements in your specialty domain and methods of improving patient care. But like most chiropractors, if you are also a clinic owner or individual medical practitioner, much of your time must also be getting delegated to the financial performance of your practice. Studies have revealed that year on year; medical practitioners lose as much as 30% of their potential and earned revenue due to claim denials and reimbursement delays. Although claim appeals and eventual settlement of accounts receivables can release the money back in your revenue cycle, it is often too little too late. These delayed payments reduce the profitability of your practice and hamper short term as well as long term financial plans.

To avoid denials and reimbursement delays for your chiropractic claims, you can adopt the following billing and claim filing practices –

  • Adopt EMR/EHR for medical billingFirst step towards avoiding claim denials is ensuring proper patient data and medical service record is maintained in your system. Automation of billing processes not only makes it more efficient but also reduces the scope of errors in medical record keeping.
  • Revise coding changes periodically – Most chiropractic claims are denied due to incorrect code allocation for services rendered. ICD10 and CPT codes that apply to chiropractic are very limited and specific. Your medical billing system must revise coding changes in the system periodically to avoid assignment of wrong codes to claims.
  • Ensure compliance – Any failure in HIPAA can also lead to delayed reimbursements, penalties or claim rejections. Therefore, HIPAA compliance must be ensured at the time of sharing or transferring medical data for claim filing.
  • Ensure pre-authorization – Many insurance carriers provide full benefits or settle claims only if pre-authorization is taken before providing medical services. Hence, you must ensure that your medical staff is trained about the importance of taking pre authorization at the time of patient walk-in itself.
  • Monitor claim filing – Many a times minor errors in the claim documents can delay the reimbursements and even cause denials. Every document and standard forms must be scrutinized before filing claims with the carriers or clearinghouses.
  • Conduct regular follow-ups – Follow up on your claim process at regular intervals to be 100% aware of the status of your financials. If the claims department of an insurer sends back incomplete documents or queries pertaining to a coding level of specific cases, you practice should revert with relevant responses within 48 hours of time. Close follow-ups and timely query resolution can enhance your claim settlement ratio by about 25%.
  • File appeals wherever necessary – Even in case of denied claims, you should be prepared to file effective appeals in order to achieve better conversion and settlement ratio.

Your chiropractic clinic can’t be considered financially successful unless it achieves a claim denial ratio of less than 4%. Medicalbillersandcoders.com is one such billing service provider that can take care of all the steps required for effective billing and claim settlement. With medicalbillersandcoders.com as your billing partner, you can focus on the care quality offered by you as a chiropractor and leave the financial hassles to be catered to and resolved by us.

 

Category : Accounts Receivables / Claims Denials