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How Much Does a Chiropractic Medical Billing Service Cost?

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With varying requirements for insurance carriers and regulations that change frequently, medical billing is an often confusing, always time-consuming task. To add to these challenges, chiropractic offices have highly specialized needs. Outsourcing the task to a chiropractic medical billing service helps you save money and time while typically leading to speedier turnaround on claims. In this piece, we describe what you can expect from professional chiropractic billing companies, including costs.

Why Chiropractic Medical Billing Is Different

Chiropractic medical billing is relatively new, as we don't have to look far back to see a time when medical insurers refused to cover chiropractic services. To ensure your services are reimbursed by the patient's insurance company, claims forms must be completed correctly and within compliance guidelines.

Perhaps the biggest challenge for chiropractors is working within the limitations of the insured's coverage restrictions. For example, many patients' insurance only covers manual spinal manipulation. Proper billing requires correct coding of the services provided.

What Services Do Chiropractic Medical Billing Providers Offer?

Services vary by the provider, but most chiropractic billing companies offer the following basic services:

  • Billing system enrollment: Before making any claims, the billing company uploads required data, such as insurer and patient information.
  • Records verification: Includes verifying eligibility for chiropractic services and insurance coverage. This saves you from billing the insurance company only to find out 60 to 90 days later that the patient doesn't have coverage.
  • Chiropractic coding: Medical billing services that specialize in chiropractic have thorough training on coding systems as well as specialty-specific coding.
  • HIPAA compliance: Every aspect of healthcare is subject to HIPAA requirements, including billing. The best medical billing providers have HIPAA-compliant processes and procedures, which they will share with you.
  • Manage denied claims: In the event a claim is denied, you want a billing company that reviews why the claim was denied and then scrubs and resubmits it for payment.
  • Accounts receivable and collections management: Managing AR is vital to ensuring cash flow remains steady. At the same time, you need to focus efforts on patient care. Medical billing companies make it easier for you to improve patient care without sacrificing your bottom line.

How Much Does Chiropractic Medical Billing Cost?

Costs vary according to the level of services you choose, the billing company, and the amount you bill. Typically, medical billing companies charge based on a percentage of what they collect. This is preferred by many chiropractors, since it ensures you only paying for claims that have been paid. It also incentivizes the billing company to get your claims paid as quickly as possible.

  • The average rate for medical billing is between 5 and 10 percent of collections.
  • You may find medical billing ranges as wide as 4 to 15 percent of collections.
  • Services that charge a flat fee average between $4 and $6 per claim.
  • Flat fees range anywhere from $1 per claim to $8, depending on the service.

Some services charge a higher rate, particularly if they specialize in a certain type of coding or collections, such as Medicare or other government-funded insurers. You want to know exactly what goes into the cost. For example, some billing companies charge extra to scrub and resubmit a rejected claim.

One of the most important questions to ask is whether there's a monthly minimum attached to the price quoted. It is not uncommon for billing companies to set monthly minimums so high that few practices could meet them. In these instances, that low rate is not a deal at all.

What Are the Benefits of a Chiropractic Medical Billing Service?

One of the greatest benefits of outsourcing your billing to a service is the savings of resources. The fees charged by these organizations are nearly always less expensive than the cost of salary, benefits, equipment, and billing software. And, the billing professionals are just that: professionals. Their entire job is medical billing. That means in-depth training and a job whose entire focus is submitting claims, both of which lead to fewer errors and increased collections. Outsourced billing also frees up your staff to focus on patient care and other tasks that require their expertise. And, billing pros stay up-to-date on the industry regulations and changes to codes that often lead to incorrect billing. That alone can seem like a full-time job sometimes.

Finally, claims are generally turned around more quickly, with payments occurring in the space of weeks (and sometimes days) instead of months. This is due in part to the heavier volume of claims that billing companies submit, which leads to most insurers prioritizing them.

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