medical necessity confusion

Mastering Chiropractic Medical Necessity in 2015 (Part 1)

Eventually, most of us will receive an insurance denial claiming that our chiropractic services were not “medically necessary.” Certainly, this is a frustrating experience. After all, who is more knowledgeable about our patients’ needs than we are? Most of us understand the concept of medical necessity and are aware that our services are reimbursable only when deemed medically necessary. For …

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Chiropractic Services Rank #1 on Medicare’s List

Chiropractic services ranked #1 on Medicare’s recent report of the top 20 services with the highest rates of improper payments as detailed in the recently released Medicare Fee-for-Service Improper Payments Report. Unfortunately, the claims of chiropractors came in at a whopping 54.1% error rate – meaning that (according to Medicare’s opinion) CMS should not have paid chiropractors in 2014 54% …

adminChiropractic Services Rank #1 on Medicare’s List

6 Things Chiropractic Insurance Payers Won’t Tell You

I frequently get asked the question “should I take XYZ insurance?” by new chiropractors or veterans that are contemplating a change. While it’s difficult to give a stock answer for everyone, everywhere there are definitely some considerations you need to make with respect to insurance participation — regardless of whether you are thinking of getting in or getting out. These things …

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Multiply By Four — Your Chiropractic “BFF”

Far too many chiropractors labor for far too long on the business roller-coaster watching their income dip and dive to the tune of consistent unpredictability.  Sure, the twister is a fun ride at the amusement park, but let’s talk about creating a more steady stream of success in your practice using what I call your Chiropractic “BFF”.   And don’t …

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Lawmakers Meet Again About ICD-10 (Chiropractors Prepare!)

On Wednesday February 11, 2015, the Energy and Commerce Committee’s Subcommittee on Health met (yet again) to discuss the upcoming October 1, 2015 ICD-10 Implementation Date. The results were clearer than ever: no further delays. Any hope of a future date was effectively squashed by Rep. Joe Pitts (R-Pa.), chairman of the Energy and Commerce Committee’s Subcommittee on Health, which …

adminLawmakers Meet Again About ICD-10 (Chiropractors Prepare!)

Why Chiropractors Need to Quit Focusing on Goals

  Admittedly, we all have goals. Whether you are in the habit of writing goals down, reviewing them frequently or even carrying them in your wallet, blogger James Clear provides an interesting perspective that can easily apply to chiropractors. Stop focusing on goals – and start focusing on the systems that will enable you to reach those goals. To get to …

adminWhy Chiropractors Need to Quit Focusing on Goals

Are You Working Smarter in 2015? What Do Your Results Show?!

Put on your chiropractic “thinking cap” and let’s start with some tough questions — How is your New Year turning out so far? Did you know that by February, 95% of the people who have made a New Years Resolution have broken it already? In fact, most people don’t even make resolutions because they get disappointed year after year that they …

adminAre You Working Smarter in 2015? What Do Your Results Show?!

2015 Brings Clarity to ICD-10 Chiropractic Subluxation Codes

Ever since the initial announcements regarding ICD-10, chiropractors have been wondering what is going to happen to chiropractic subluxation coding in ICD-10.  After all, adjusting the chiropractic subluxation is central to what we do and in Medicare, it’s the only service that is covered. So it stands to reason that we would be curious about how the subluxation diagnosis coding …

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Fixing Chiropractic Collections Problems in 2015 (Before They Start)

During the recent recession years, most chiropractic practices saw the beginning of a changing landscape that was somewhat blurred by the overarching recession. A few years later – it’s now 2015 and many chiropractors realize the payment environment has changed radically. Patients are now responsible for a much larger portion of their chiropractic bill, and there has been a significant …

adminFixing Chiropractic Collections Problems in 2015 (Before They Start)

Big Goof Affects 26,000 Premera Members + Your Chiropractic Patients

Premera recently posted a notification on their website that there was a small goof in their network thanks to an error caused by the Washington Health Benefit Exchange. Unfortunately the goof accidentally terminated over 26,000 existing Premera members who were supposed to have coverage. Undoubtedly, some of these are your chiropractic patients if you practice in Washington State and the …

adminBig Goof Affects 26,000 Premera Members + Your Chiropractic Patients