Chiropractic billing for Medicare and commercial plansM-F 8am-5pm PT · 702-800-5852

eChiro Billing · chiropractic billing company

Chiropractic billing services, from the adjustment to the deposit

We enter your charges, send claims daily, get each scanned EOB posted within 24 hours and appeal denials the day they're processed. You pay 4.75% of collections. There's no startup fee or long-term contract, and you can try the service free for 30 days.

702-800-5852 · info@echirobilling.com

33.6%

That's the improper payment rate CMS reported for chiropractic services in its 2024 Medicare data. Insufficient documentation accounted for 95.5% of those improper payments.

Documentation, more than the adjustment itself, decides whether a claim stays paid. The notes are yours to write; the clerical check we run on every claim is there to catch slips like a missing AT modifier before Medicare sees them.

Source: CMS Medicare Provider Compliance Tips: Chiropractic Services

Where chiropractic claims go wrong

Six problems that sink chiropractic claims

  1. Active care sent without AT

    Medicare reads a manipulation line without the AT modifier as not medically necessary and denies it. The notes still have to show the care is active, not maintenance.

  2. Maintenance without an ABN

    With a signed ABN, a maintenance visit goes out with GA and the patient can be billed. Without one, the practice usually ends up absorbing the visit.

  3. Thin subluxation notes

    Medicare's PART test needs two of four findings: pain, asymmetry, range of motion and tissue changes. One of the two has to be asymmetry or range of motion.Source: CMS compliance tips, linked above

  4. Exams and x-rays billed to Medicare

    Medicare doesn't pay chiropractors for exams or for x-rays they order. Those charges belong with the patient or a secondary plan, set up correctly from the start.Source: Medicare.gov, linked above

  5. Secondary claims left waiting

    A secondary payer won't move until it sees the primary's EOB. Primary and secondary claims are processed daily, so neither one waits on us.

  6. Missing patient details

    A wrong member ID or an outdated policy gets a claim rejected or denied. Each patient file is checked for errors, and anything we find goes into your daily email summary.

The work

What eChiro handles for your practice

Full service list
CLAIMS

Primary and secondary claims processed every day.

AUDIT

A clerical check on every claim before a payer ever sees it. We will ensure that 95% of your claims will pass the first time.

EOB POSTING

Scanned EOBs posted to the right patient accounts within 24 hours.

DENIALS

Reviewed and appealed on the day they're processed.

A/R

Insurance balances past 30 days followed up weekly.

AGING

A monthly breakdown of your insurance aging report.

DAILY EMAIL

What was worked today, plus anything slowing collections down.

UNBILLED

Procedures not attached to a claim, batched every day.

In their words

Two chiropractors on handing off their billing

A Colorado chiropractor on going hands-off with billing

“I'd probably be seeing about two-thirds of the patients that I am.”

A Texas chiropractor on buying back his time

“Probably take me about anywhere from two to four hours to do billing a week. And if I'm not wasting my time doing the billing, I can be spending time with my kids or doing something else.”

Their practices, their own words. Results vary.

4.75%

of collections. That's the fee.

  • Zero startup fees
  • Monthly terms, no long-term contract
  • 30-day free trial. Cancel inside it and you owe nothing
  • Medicare, Medicaid and commercial claims

Bring what you pay for billing today, staff time included, to the strategy call and compare it with 4.75%.

Comparing chiropractic billing companies? Use our billing-company comparison checklist.

Onboarding

Four steps from first call to daily claims

No new software to learn and no long contract to sign. The work happens in the system your front desk already uses.

  1. Strategy call

    Fifteen minutes with Alex on how you bill today and where claims stall.

  2. Paperwork in

    Day sheets, patient information and insurance details come to us through secure fax and email.

  3. Claims set up

    We enter insurance, patient and visit information, verify coverage and start submitting.

  4. Daily rhythm

    Claims leave daily, EOBs post within 24 hours of scanning, and an end-of-day email tells you what moved.

The billing cycle

How chiropractic billing works, step by step

Chiropractic billing is the work of turning a patient visit into a paid insurance claim. The steps below are the usual order. Each one links to the matching part of our chiropractic billing tips, where the sources are listed.

  1. Check coverage before the visit

    Check eligibility, benefits, network status and any required prior authorization for the planned services. An eligibility check does not guarantee payment. See verifying patient benefits and prior authorization.

  2. Document the visit

    The patient record has to support what is billed. For Medicare, the record must support active or corrective treatment of a spinal subluxation.

  3. Code the services provided

    Report the services actually provided, with the diagnosis codes, procedure codes and modifiers the payer requires. For Medicare active treatment, CPT 98940, 98941 and 98942 need the AT modifier, and AT is not used for maintenance therapy. See the Medicare codes and modifiers table.

  4. Submit the claim on time

    Use the format the payer requires and file inside its deadline. CMS generally requires initial Medicare claims to be submitted electronically, no later than one calendar year after the date of service. Other payers set their own limits. See claim-submission format, timely-filing limits and the CMS-1500 form.

  5. Confirm the claim was accepted

    Do not assume every submission was accepted. Check claim status and clearinghouse reports, fix any rejection and confirm acceptance. See claim acknowledgements and rejections.

  6. Post the payment and check it

    Post the insurance payment and adjustments to the patient ledger, then compare the remittance with the contract, fee schedule and patient responsibility. Investigate unexplained differences. See ERA payment posting and comparing each remittance.

  7. Work each denial

    Read the denial reason first. If claim details are wrong, use the payer’s correction process. If you disagree with the decision, use its reconsideration or appeal process. See reviewing denials and the denial codes behind the 10 most common chiropractic claim denials.

  8. Bill the next payer and follow up

    Determine which payer is primary, submit to that payer first, then follow the secondary payer’s rules. Monitor your aging reports and act on unpaid claims. See payer order, accounts receivable and unresolved claims.

eChiro Billing takes on the insurance side of this process for a practice: primary and secondary claims, daily EOB posting, denied-claim appeals and follow-up on overdue insurance balances.

FAQ

Chiropractic billing questions

What does a chiropractic billing service do?

It runs the insurance side of the practice: entering charges, sending primary and secondary claims, posting EOBs, appealing denials and following up on unpaid balances, so your front desk can stay with patients.

Do you work with our existing chiropractic EHR or practice software?

Yes. We bill inside the practice software your front desk already runs. Name your system on the strategy call and we will confirm how we will work in it.

Which parts of the revenue cycle can you take over?

Claim submission, payment posting, denial appeals, accounts receivable follow-up and reporting. Hand over all of it, or start with the part causing the most trouble.

Is there a trial or a consultation?

Both. The strategy call is free, and the service starts with a 30-day free trial. Cancel during the trial and you owe nothing.

What are your hours and where are you based?

Monday to Friday, 8am to 5pm Pacific. We are based at 2300 W Sahara Ave, Ste 800, Las Vegas, NV 89102, and we bill in your practice's own software, so you do not need to be in Nevada.

How do you handle claim denials?

Denials get reviewed and appealed on the day they're processed, and the balance stays on our follow-up list until it is resolved. For the usual causes, see our top 10 chiropractic denial reasons.

Does eChiro Billing offer credentialing, and what does it cost?

Yes. eChiro Billing offers insurance credentialing for $200 per provider, per insurance company.

Does Medicare pay for chiropractic exams or x-rays?

No. For chiropractors, Medicare Part B covers adjustments of the spine to correct a subluxation (CPT 98940 to 98942). It does not cover other services or tests a chiropractor orders, such as x-rays, and it does not cover extraspinal manipulation (CPT 98943).

Let's look at your chiropractic billing

Book a 15-minute strategy call with Alex. Bring your latest denials and your questions.