Chiropractic Basic Insurance Billing and Coding

Description

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• Defining and understanding insurance as it relates to the chiropractic practice
• Indemnity, PPO, HMO, EPO, HSA, Personal Injury, Workers€ Compensation, Medicaid, Medicare€
• Understanding insurance contracts
• Pros and Cons of insurance
• Managed Care Plans and how they work
• Pros and Cons of being a member provider
• Cash discounts? Can I charge more for billing insurance?
• Collection of payments
• Deductibles, co-pays and what the law requires
• Verifying and monitoring insurance coverage
• Insurance verification protocols, forms, and laws that protect the doctor and the patient
• Standard chiropractic coverage
• Patient intake
• Front desk management
• HIPAA requirements
• Financial policies and agreements
• Forms- case history and personal information
• • Current Procedural Terminology CPT
  • Evaluation and Management (E&M)- codes, definitions, and how to choose the proper level
  • Chiropractic manipulative therapy (CMT)
  • Coding and proper use of E&M with CMT
  • Physical medicine and rehabilitation
  • Modalities supervised v constant attendance
  • Therapeutic procedures
  • Time requirements and minimum standards for timed codes including documentation
  • CPT Special services, record review and consultation
  • Modifiers
  • Common x-ray codes for spine and extremities
  • Durable medical equipment and common HCPCS codes
    • ICD 10 Diagnosis
    • Diagnosis hierarchy and the highest level of specificity
    • Diagnosis specificity including spine regions and A, D, S for sprains and strains
    • Diagnosis coding for the right, the left, unspecified and other specified and their proper use
    • Medical necessity and diagnosis
    • Common chiropractic neuromusculoskeletal diagnosis
    • Chiropractic Basic Insurance Billing and Coding Billing
  • • Superbill
    • Billing insurance without direct billing by the provider
    • Cash and receipts for service
      • Collection and Reconciliation
      • Time frames of payment
      • Reconciling EOBs & payments
      • Common denials and remedies
        • CMS1500
        • Format and instructions
        • Initial visit, follow up and reevaluation
        • Billing multiple units and services
        • 1500 block by block instruction
    • Chiropractic coding and billing quiz
    • Pre and post-course assessment