Billing & Coding: Medicare Facts to Know About

Welcome to your billing and coding weekly solutions by H.J.Ross Company where getting your bills paid is what we do best!

Are you finding it a challenge to keep up with constant Medicare regulatory and coding changes, as well as getting your claims paid?

Here are some basic facts chiropractors should know about Medicare.

All chiropractic Medicare covered services must be billed to Medicare by the provider or the provider could face penalties.

All spinal manipulations, including maintenance adjustments, are covered services under Medicare and therefore they must be filed.

An exception is when the beneficiary has signed a valid Advance Beneficiary Notice of Non-coverage (ABN) with Option #2 selected.

Opting out of Medicare is not an option for Doctors of Chiropractic. Opting out and being non-participating are not the same things. Chiropractors may decide to be participating or non-participating with regard to Medicare, but they may not opt out and offer services under a private agreement.

Non-Par providers have the same documentation requirements as par providers.
Chiropractic care has documentation requirements to show medical necessity. The participation status of the provider is irrelevant to the documentation requirements.

Billing with incorrect chiropractic CPT codes can lead to claim rejections and delays in payments, which can have a devastating impact on generating revenue and keeping you in business. 

If you are experiencing insurance claim denial, staff spending too much time trying to get claims paid, and patients asking why their claims have not been paid then H. J. Ross Company is your solution.

H.J Ross Company stays ahead of the curve on the latest trends and changes in billing and coding by utilizing their direct channel of communication with the insurance companies and organizations that set the guidelines.

There is a reason chiropractors have trusted H.J. Ross Company with their business for over 40 years.