Medical Billing Forum

Billing => Billing => : arathbone August 29, 2008, 01:20:23 AM

: Chiropractic Billing
: arathbone August 29, 2008, 01:20:23 AM
Got a few questions:

Just beginning my business with a chiropractor who has been using a couple of people to do his billing. He has no office staff at the moment because he leases space from a MD for his business.  His medical records are in need of clean up. Also, the payments are not coming in like they are supposed to because the billers have filed the claims using the contracted amounts as the visit charges, which in turn has caused this Dr to lose alot of money. Is there any way for me to recoup the lost money for him? Also, they have used no modifiers when billing MCD/MCR, therefore has alot of denied claims. Also saw denials on MCD eob's for invalid NPI.
He has been in business for 1 year, so I don't have to go back too far. Also, the medical billing/practice management software he uses is Autumn8, which he is supplying to me in order to bring his business up to speed. Will begin training on that tomorrow.

Any input on how I can help him turn this around really quick is greatly appreciated.

Angela Rathbone
A*Claim Advantage
: Re: Chiropractic Billing
: Michele August 29, 2008, 09:47:17 AM
Wow, you've got your work cut out for you on your first client!  It's a great way to start though.  You will do such a great job for this guy that hopefully he will tell all of his colleagues. 

The first thing you should do is get the current billing out and out correctly.  It is important that you break the cycle of incorrect billing. 

As far as the old stuff that was billed incorrectly, I would pick some guidelines to go by and stick to them.  For example, I would definitely go back and resubmit any claims that were not paid.  I would resubmit them the way they should have been billed in the first place.  If they were denied for no modifier, or some other reason, I would correct it and resubmit with the correct billed amounts.  If a claim was not paid, I would also resubmit it with correct billed amounts.

But if a claim was already processed and paid with incorrect billed amounts, I don't think I would resubmit for reprocessing.  Having claims reprocessed that have already paid out gets messy from both ends.  Resubmitting claims that were denied is no big deal.  From the sounds of it, not too many got paid anyway. 

This is really a great opportunity for you.  You are going to change this Dr's income immediately. 

Good luck!

Michele