Chiropractic Billing Services for Clinics, From 6.5%

Who our chiropractic billing service is for

We bill for chiropractors in solo practice, multi-doctor chiropractic clinics, and integrated clinics where chiropractors work beside physical therapists or medical providers, up to groups of 6–15 clinicians. Hand your billing to us when one of these starts to cost money:

• Medicare adjustments come back denied as maintenance care, and nobody has checked which patients signed an ABN.
• The person running check-in also runs billing, so claims go out in weekly batches instead of daily.
• A commercial plan stops paying mid-course because the visit limit ran out or improvement was not documented.
• Insurance A/R past 90 days keeps growing while the adjusting tables stay full.
• A new chiropractor joins and cannot bill a plan until enrollment clears.

Recognize one of these? Tell us which one; our billing team replies within 1 business day.

What we take over and what your chiropractic clinic keeps

Our chiropractic billing service starts when the daily note is signed and ends when the payer's money is posted to your account. We check every code against your clinician's documentation and never change a code without the clinician's sign-off. Benefit and visit-limit checks run through our eligibility checks before the first adjustment, and maintenance-care and same-day denials go to our denial work and appeals team. The workflow figure in this section shows each hand-off.

Read the workflow as text

1. Check benefits first — Medicare Part B or the plan's visit limit confirmed before the first adjustment. Owner: Our billing team.
2. Sign the daily note — Note names each subluxation level adjusted and active or maintenance care. Owner: Your chiropractors.
3. Match regions to code — Documented regions set 98940, 98941 or 98942; mismatches go back as queries. Owner: Our billing team.
4. Set AT or GA — AT on active Medicare care; GA only with a signed ABN on file. Owner: Our billing team.
5. Submit and post — Item 14 date entered, claim submitted, remittance posted to your account. Owner: Our billing team.
6. Work denials, report — Maintenance denials checked against the ABN log; KPI report every month. Owner: Our billing team.

Where chiropractic claims lose money, and what we do about it

Medicare reviews chiropractic claims closely: a 2024 CMS error-rate review found errors in 33.6% of chiropractic claims. Each point below names a failure CMS or a payer documents, then what we do about it.

What we check on every Medicare chiropractic claim

• Active care without AT, or maintenance billed as active. Medicare treats an adjustment claim without AT as maintenance therapy and denies it (Benefit Policy Manual, chapter 15, section 240). We append AT only where the note shows active or corrective care, and put GA on a maintenance visit only when the patient's signed ABN is in our log.
• Notes that do not support the claim. The CMS chiropractic checklist lists failure to document all treated spinal regions among common denial reasons, and Noridian's JE Part B guidance denies notes that read the same from one day to the next. We check each visit's code against the regions documented that day and flag copied-forward notes to your chiropractor before the claim goes out.
• Item 14 left blank. Medicare edits check for the initial treatment or exacerbation date in Item 14 of the CMS-1500 (Claims Processing Manual, chapter 12, section 220). We enter it from the chart on every Medicare claim.

What we check on same-day therapy and commercial plans

• Therapy billed in the adjusted region. The 2026 NCCI policy manual makes manual therapy, massage and neuromuscular re-education not separately reportable in a spinal region that received the adjustment. We check every same-day therapy line and office visit before release.
• Commercial care with no documented progress. Aetna's chiropractic policy expects improvement documented within the first 2 weeks of care. We read each plan's policy and visit limit before a course of care starts and flag the visit that would exceed it.
• Visits held for a batch near a short deadline. Cigna allows 90 days after the date of service for a participating provider. We submit each visit within 1 business day of complete charges instead of holding a course of care.

Deadlines for other plans are on our timely filing limits by payer page.

What our chiropractic billing costs

Chiropractic clinics bill on the rehab row of our rate card (PT, OT, speech & chiropractic), and the rate drops as you add chiropractors. Our fee is a percentage of insurance payments. Patient payments carry 0%, so copays, cash-plan visits and maintenance visits a Medicare patient pays under a signed ABN never add to it. Setup is $0. Invoices 1–3: only percentage fees on that month's insurance payments, plus any statements or add-ons you order. Percentage fees and mailed statements are capped at 9.0% of that month's insurance payments; from invoice 4, the $400 minimum applies even in a month when the cap comes to less. Multi-specialty practices: each clinician's claims are billed at that clinician's segment rate; the size band counts every clinician. Every segment is on our full rate card.

How we take over your chiropractic billing

A chiropractic handover puts two things at risk first: inherited claims near their filing limits, and Medicare patients mid-course whose active or maintenance status nobody has checked. Go-live, when your first claims go out, comes within 5 business days of access; any unbilled backlog follows within 10 business days of access. Clock starts with your signed agreement, signed BAA and working system logins; it extends day for day while we wait on access. Every inherited claim within 30 days of a filing, corrected-claim or appeal deadline is worked within 5 business days of access. Starts at access; covers up to 250 claims (more gets a day-1 deadline schedule); worked means submitted, corrected, appealed or returned with the fix.

What we need from your clinic:

1. Your signed service agreement and business associate agreement (BAA).
2. Logins to your practice-management system and clearinghouse, plus read access to the chiropractors' daily notes.
3. A claim-level aging export, so inherited claims are ranked by filing deadline.
4. The list of Medicare patients with signed ABNs and the start dates of active treatment plans.
5. One kickoff call with your office manager.

Our billing handoff plan lists the files to request from your current biller. To see where your A/R stands before you decide, request The Free A/R Deadline Map: A claim-by-claim list of every unpaid insurance claim over 90 days in the aging report you send: payer, amount, the deadline it faces, the denial reason and the next action, sorted by deadline. Clock starts with your claim-level aging export and signed BAA; above 10 requests in a week, we confirm your date within 1 business day.

Monthly reporting, service standards and guarantees

Your KPI report arrives by the 10th of each month, each measure defined in writing, and the table sets the clock on every task we own.

On-Our-Watch Guarantee. If a claim misses a filing, corrected-claim or appeal deadline while it is on our watch, we pay you what it would have paid. Claims we get complete 10+ business days before the deadline; contracted rate less any copay you collected, paid automatically within 30 days of final denial; capped $10,000/month; your holds excluded. On a chiropractic book it matters most on short commercial limits such as Cigna's 90 days for a participating provider.

Clock-or-Credit Guarantee. From go-live, every new claim goes out within 1 business day of complete charge data, and every denial is worked within 2 business days of posting — or $25 comes off your invoice for each late one. Mon–Fri ET business days by your system's timestamps; worked: resubmitted, appealed or returned with the fix; auto-credited; capped at monthly fee; clearinghouse outages excluded.

We publish client results only with written permission. Until we have them, judge us by the guarantees and the free Deadline Map.

Adding a chiropractor, your software and the BAA

Once we confirm it in writing, we work inside the chiropractic software you already use and check that its daily notes record the regions adjusted and whether care is active or maintenance. Read how we work inside your EHR. We sign a business associate agreement before we see any patient data. New-Clinician Enrollment. Clinicians who join while you're a client get enrollment filed with up to 5 payers each (the payer decides), with no per-payer fee. Payers beyond that go through our credentialing and payer enrollment service at $149 per payer. Billed only after the payer confirms your effective date; $0 if denied or panel closed; filed within 5 business days of your complete packet.

Common questions

How much do your chiropractic billing services cost?

6.5% to 7.5% of insurance payments, depending on how many chiropractors you have, with 0% of patient payments and $0 setup. Size bands, the monthly minimum and the fee cap are on our pricing page.

Do you bill Medicare maintenance visits our patients pay for?

Yes. When your chiropractor records that care has become maintenance and the patient signed a valid ABN before the visit, we bill the visit with GA and without AT, so your clinic can collect from the patient once Medicare denies it. We never send AT and GA on one claim, which Noridian's JE Part B guidance calls never appropriate. Those patient payments carry 0% of our fee.

Can you check benefits and visit limits before a new patient's first adjustment?

Yes. Eligibility checks for new patients and changed coverage are part of Full-Service Billing: we confirm Medicare Part B or the plan's chiropractic benefit, the visits left and any authorization the plan requires before visit 1. See insurance eligibility verification.

Which chiropractic software do you work with?

We work inside your existing practice-management system and clearinghouse; tell us which ones and we confirm in writing within 1 business day. You keep your current system and clearinghouse; we need logins and read access to the daily notes.

Do we have to sign a long-term contract?

No. Leave with 30 days' notice and no termination fee. Want a run-out? We keep working the claims we submitted for 90 days at your plan rate. Decline it and we charge nothing on payments that post after you leave. Notice by email; optional run-out covers claims we submitted before your exit date, at your plan rate; handover file within 10 business days of exit.

How long does it take to switch our chiropractic billing?

First claims go out within 5 business days of access. Clock starts with your signed agreement, signed BAA and working system logins; it extends day for day while we wait on access. Inherited claims nearest a filing deadline, and Medicare patients mid-course, are checked first.

Can you credential a new chiropractor joining our clinic?

Yes. New-Clinician Enrollment covers each chiropractor who joins while you are a client; the payer count, the per-payer rate beyond it and the billing terms are in credentialing and systems.