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Chiropractic documentation gap analysis

Recognize what’s missing to master your reimbursement and collections!

This Documentation Gap Analysis allows us to evaluate the significant components of your current Documentation program. It should take less than 5 minutes to complete.

Take The Billing GAP Analysis
Telemedicine

Need more guided help? Work with a KMC coach 1-on-1

Sometimes you need more than a self-service, on-demand program and need an expert to analyze your issues, train the corrections, and help you implement the changes, so they stick

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Dr Alan Sokoloff 1

New Course Available!

This course explains the significant role chiropractic care can play in the sports industry and how a DC can succeed as a Sports Chiropractor. Start your steps to success here!

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OIG

There's no need to fear the OIG. We've got your back!

The most effective chiropractic OIG compliance programs are scaled according to the size of the practice!

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Important Medicare Definitions

Acute Treatment

CMS considers treatment acute when “a patient is being treated for a new injury, identified by x-ray or physical exam. . . . The result of chiropractic manipulation is expected to be an improvement in, or arrest of progression of, the patient’s condition.”

Chronic Treatment

CMS considers treatment chronic when the patient’s condition is “not expected to significantly improve or be resolved with further treatment (as is the case with an acute condition), but where the continued therapy can be expected to result in some functional improvement. Once the clinical status has remained stable for a given condition, without expectation of additional objective clinical improvements, further manipulative treatment is considered maintenance therapy and is not covered.”

Maintenance Therapy

CMS considers treatment maintenance therapy when the therapy in question “is not considered to be medically reasonable or necessary under the Medicare program, and is therefore not payable. Maintenance therapy is defined as a treatment plan that seeks to prevent disease, promote health, and prolong and enhance the quality of life; or therapy that is performed to maintain or prevent deterioration of a chronic condition. When further clinical improvement cannot reasonably be expected from continuous ongoing care, and the chiropractic treatment becomes supportive rather than corrective in nature, the treatment is then considered maintenance therapy.”

Medical Necessity for Chiropractic Adjustment According to Medicare

“The patient must have a significant health problem in the form of a neuromusculoskeletal condition necessitating treatment, and the manipulative services rendered must have a direct therapeutic relationship to the patient’s condition and provide reasonable expectation of recovery or improvement of FUNCTION.”

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I just wanted to touch base and let you know how much you have helped my daily routine. I just can't tell you how much time and effort I have put in trying to figure out and correct the modifiers on our claims. We have been putting those in by hand and as you can well imagine there were many errors and many times our claims were stopped or just not paid. It seems to me half my life was spent trying to figure out just why we weren't getting paid. I am in awe of how you just clicked buttons and made my life so much easier. I can't thank you enough. I have a pile of old corrections to fix and after that I am done with this issue for good. I am working hard on my homework and although it is extremely difficult and tedious I do see light at the end of the tunnel. Just want you to know I appreciate more than you will ever know. Thanks again.

Peggy Mitchell