2014, by no means, will be an easy year for chiropractic practices with changes in billing and coding regulations and standards. To meet these regulatory challenges, chiropractic services will have to change five things in their medical billing and coding process-
Obamacare and its challenges for chiropractors: There is an ambiguity on how exactly Obamacare will impact chiropractic services. But what is fairly unambiguous by now is that, as the increase in the number of insured Americans is a given, chiropractic practices will see a substantial increase in the number of patients they treat.
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Experts believe chiropractic practices that don’t prepare themselves for this impact– will, instead of gaining financial leverage with the Obamacare opportunity, end up losing revenues whose impact will be felt slowly in two to three years.
Chiropractic practices can prepare for this change by insuring insurance coverage checks, documentation to support claims and staff training in nuances of Medicare rules as most patients coming in due to Obamcare-caused influx will be covered under Medicare.
Even if Obamacare needs are not very clear, addressing the three above-mentioned areas will help chiropractic practices do the following:
- Establish whether their diagnoses correlate with the number of visits made by the patient
- Demonstrate that objective chiropractic measures were used to determine the on-going need of care. This will help them quantify the necessity of the care plan and help PQRS reporting needs
Chiropractic practices will also have to prepare their billing and coding processes to meet ICD 10 needs like –
- MBC’s Revenue Management Consulting services can help you with this by assessing your in-house revenue management cycle and ensuring that there is sound coordination between various components of your chiropractic practice facilitating smooth flow of medical billing data. The outcome of this is sound documentation which will help tie up several loose ends in your billing and coding process. We have also been helping chiropractors with ICD 10 by guiding and recommending appropriate software applications and adjusting the processes to meet other ICD 10 challenges and impacts.
- Understanding ICD 10 codes– ICD 10 codes are much more specific when it comes to covering chiropractic services and sub-services than ICD 9 codes which don’t have separate codes for minor sub-ailments and treatments. This being the nature of ICD 10, it will require practices to figure out which codes will apply to the chiropractic services they offer and use them accurately during chiropractic billing.
- New form – Under ICD 10 a new form has to be used to submit claims and it will require practices to be familiar with its fields and be able to populate it with accurate details and produce supporting documentation, failing which will result in rejected claims.
- Software needs – Thanks to the new codes and forms, practices will have to either update or upgrade their medical billing software platform.
- Account collection monitoring – Given the intricate nature of ICD 10 and an increase in in-coming patients due to expanded medical insurance coverage net, practices are expected to experience mounting account receivables due to rejected claims. They will need to monitor the number of submitted claims against in-coming revenues (in other words how many of them have been rejected) to ensure that+` they re-submit the rejected claims. This will require a claims re-submission process in place.
Medicalbillersandcoders.com the largest consortium of billers and coders in the US, has also been helping several hospitals, in big and small cities of the US, with its Outsourcing services handling the entire range of activities involved in billing and coding starting from preparation of claims through submission to post-submission follow-ups. From our flexible services models you can choose only those bits and pieces that exactly meet your 2014 chiropractic billing and coding needs and avoid paying for the complete service package.