Reasons why Chiropractic Claims get Delayed or Denied

Are your chiropractic claims getting denied or delayed? If the answer is yes, then you need to put a check on it and get your practice appropriately compensated. No practice can survive in business if too many claims fail. It is necessary to understand the reason why claims are getting denied by payers. Only then it will be easy for you to prevent any financial free-fall.

Here are some of the common reasons that can cause havoc to your chiropractic practice and prevent you from getting paid on time:

• Lack of documentation is one of the main reasons why claims get denied. Each claim needs to be supported with sufficient documentation because insurance companies have specific rules for coverage. For instance, each submitted claim should establish the necessity of patient care. If there is lack of relevant data or if there are inconsistencies, then it will hamper the chances of your claims getting paid.
• It is necessary to make sure that there are no coverage problems in the patient’s plan. For instance, there are chances the insurance coverage of a patient doesn’t cover chiropractic care. To avoid such instances, it is important to verify the insurance plan of patients before providing them care. Regular eligibility check is vital for existing patients too. Don’t wait for the patients to notify you of any changes in their insurance plans. Your chiropractic practice should gather the required data.
• At times, insurance companies reject a claim if a practice is billing them for the wrong amount. This makes it necessary to review the medical billing process on a regular basis. In this scenario, you can also seek help of a clearinghouse for getting your claims checked and processed.
• Errors in coding is another common reason why claims get denied for many chiropractic practices. Errors in coding are very common specially if paper billing is being done. If the billing staff is relying on templates and not cross checking the claims before submission, then it can lead to insurance companies rejecting the claims in case of errors.

Since a significant number of claims get denied by payers, it has become necessary for practices to streamline their billing processes and hire experienced staff.  Many chiropractors are choosing to outsource their billing requirements to a third party. They are hiring a billing company to get paid on time and improve their administrative processes.