Chiropractic Medical Billing Services By Preferred MB® Your Chiropractic Billing Partner

We Don't Guess on Code 98942 — We Prove It

Chiropractic Medical Billing Services

Chiropractic billing is unlike any other specialty. Region-based coding, subluxation requirements, modifier dependencies, and Medicare’s narrow coverage make it one of the most commonly underpaid disciplines in outpatient care. Preferred MB ensures each claim reflects the medical necessity, documentation strength, and code integrity needed to earn full reimbursement — without audit risk or billing friction.

Why Clean Claims Begin with Clinical Clarity

The biggest threat to revenue in chiropractic billing isn’t payer denials — it’s clinical ambiguity. When SOAP notes don’t match codes, when subluxations aren’t linked to neuromusculoskeletal symptoms, or when re-evals aren’t timed properly, claims fail silently.

At Preferred MB, we help practices connect what’s documented to what’s billed — with workflows that correct upstream gaps before they cause revenue loss

Where Documentation Misalignment Impacts Revenue

CPT 98941 submitted but only two regions noted in SOAP
Missing subluxation evidence for Medicare-covered services
Time-based services (manual therapy) billed with no duration
Re-evaluation performed but not supported by measurable progress
No modifier 25 used on same-day E/M visit with spinal manipulation

Preferred MB prevents silent write-offs across ENT claims. Every line has documentation. Payer logic is mapped to action. Nothing ages out. Claims finish with payment or appeal success recorded.

Critical Billing Friction Points We Eliminate

Undocumented subluxation linked to billed spinal region

Improper use of AT for Medicare active care

Modifier 59 applied without therapy grouping review

Missing ICD logic for neuromusculoskeletal linkage

Unverified ABN usage on maintenance sessions

Your Chiropractic Billing Workflow — Simplified and Strengthened

We manage the entire chiropractic billing cycle with one goal: make documentation and compliance as seamless as possible without disrupting care.

Standardize Clinical Notes for Coding

We guide providers to document subluxation, region count, and functional goals clearly — aligned with LCDs and payer requirements.

Validate Code and Modifier Use Pre-Bill

Every CPT from 98940 to 98942 is tagged to the documented region count. AT, 25, and 59 modifiers are applied based on documentation logic and policy.

Integrated or Standalone Tech Options

Whether you use Eclipse, ChiroTouch, zHealth, or paper — our system adapts to your workflow with no software changes required.

Intelligent Claims Routing

Claims are routed with real-time payer rules. Denials are preempted through payer-based edit logic, and timelines are tracked automatically.

Denial Response Built on Policy, Not Guesswork

We don’t just resubmit — we appeal with reference to LCDs, MAC bulletins, and documented evidence that supports reimbursement.

Real AR Intelligence

We segment AR by modifier issue, documentation gap, and payer source — giving practices insights they’ve never had access to before.

Operational Blind Spots We Uncover in Chiropractic Clinics — Again and Again

Across hundreds of chiropractic practices, the same hidden gaps keep causing denials, slow payments, and revenue loss. Most of these errors aren’t caught by in-house teams — because they’re buried in documentation habits or workflow defaults.

Our audits expose breakdowns in compliance, CPT logic, and plan interpretation — the kinds that cost thousands monthly but stay unnoticed

41% of CMT claims reviewed had unmatched spinal region counts
28% of rejected Medicare claims were missing AT documentation
3 in 5 same-day E/M + CMT claims lacked valid Modifier 25
Over $1,100/month lost per provider due to misused or unbilled time-based modalities
35% of denials labeled “not medically necessary” were never appealed
1 in 4 practices failed to issue ABNs for maintenance visits
Secondary claims delayed due to diagnosis sequencing errors
Multi-payer clinics showed repeated CMT downcodes tied to vague ICDs
EHR templates used by 52% of clinics failed to meet MAC documentation expectations

Preferred MB builds visibility into each of these risks — and corrects them with documentation logic, policy-driven CPT mapping, and proactive denial targeting before revenue slips away.

Are These Billing Patterns Affecting Your Chiropractic Reimbursement?

Run this 5-point review — if two or more apply, your billing process needs correction.

Subspecialty Chiropractic Billing Built for High-Demand Scenarios

We handle billing for the most active and denial-prone chiropractic services — integrating correct coding, modifiers, payer policies, and documentation standards to ensure consistent reimbursement.

Clinical Scenario

Patient presents after an auto accident with neck pain and whiplash symptoms. Treatment plan includes CMT, supervised modalities, and reevaluations.

Billing Scenario

Preferred MB manages injury-first logic and jurisdictional compliance.

Clinical Scenario

Medicare beneficiary starts care for spinal pain affecting ADLs. Functional goals defined with periodic progress assessments and treatment adjustments.

Billing Scenario

Preferred MB ensures LCD and modifier logic for Medicare compliance.

Clinical Scenario

Patient undergoing structured rehab plan post-injury. Includes neuromuscular re-ed, electric stim, and therapeutic exercise — supervised in clinic.

Billing Scenario

Preferred MB validates timing, frequency, and CPT units for compliance.

Clinical Scenario

Multidisciplinary clinic treating patients with DC and PT across the same episode of care. Patient receives adjustments, rehab, and manual therapy.

Billing Scenario

Preferred MB ensures provider role clarity and CPT integrity.

Billing Logic Built for Every Chiropractic Operation

Each chiropractic model runs into different billing risks — from how modifiers are used to how services are documented and submitted. Preferred MB tailors claim structure, denial prevention, and follow-up strategy to fit how your clinic operates.

Personal Injury-Focused Chiropractic Clinics

Billing here revolves around accident documentation, lien handling, and external timelines. We align ICD chains to incident details and format SOAP notes to support insurer or legal audits.

Claims built on date-of-injury logic with episode tracking
Notes structured to satisfy PI adjusters and legal reviewers
Lien or third-party routing rules applied from day one

Medicare-Participating Offices

With strict LCD logic and modifier scrutiny, Medicare chiropractic billing demands accuracy in documentation and service classification. We enforce active-care compliance on every claim.

AT modifier used only when functional goals are documented
ABNs issued and archived for non-covered maintenance visits

Regional LCD policies applied to ICD and CPT pairings

Multispecialty Clinics with DC, PT, or MD Staff

Shared systems increase denial risk from overlapping CPTs or unclear roles. We separate services by provider type and ensure correct modifier and NPI usage on every line item.

Provider NPIs mapped to their discipline and scope
CPTs validated for same-day use across DC and PT staff
Duplicate claim flags eliminated via encounter-level tracking

Multi-Location Chiropractic Groups

Scaling brings inconsistency. Documentation formats, coding habits, and denial rates vary across sites. We normalize billing logic to eliminate revenue gaps across your network.

Site-specific audits flag underbilling or CPT misuse
Unified modifier logic applied across all locations
Denial trends are analyzed at location and provider levels

Clinics Exiting Audits or Switching Vendors

Past billing vendors often leave unresolved AR or repeat errors. We perform a full claim history review, flag unresolved rejections, and rebuild compliant billing workflows within 90 days.

Legacy claims categorized by root denial cause
Modifier and CPT logic realigned to payer expectations
Aged AR reviewed for rework eligibility before write-off

Chiropractic Claim Strategies Optimized for Every Payer Class

Every payer group processes chiropractic claims differently, from documentation proof to payment cycles. Preferred MB adjusts workflows to match each payer’s internal system,so your revenue clears faster with fewer rejections.

Strict visit sequencing and care plan validation drive acceptance rates.

Confirms active-treatment goals are updated during the plan of care
Tracks allowable visit counts by episode to avoid system blocks
Links treatment notes directly to reported regions of adjustment
Formats submissions to align with carrier-specific aging cycles

98.1%

Approval rate on Medicare chiropractic claims with visit-to-plan alignment.

Private payers reward precision in care episode coding and benefit tracking.

96.4%

First-pass rate across high-volume commercial chiropractic submissions.

State rules vary, requiring tailored claim pacing and encounter formatting.

94.5%

Compliance rate for Medicaid chiropractic claims under state thresholds.

Legal and insurer timelines require structured reporting and record flow.

92.9%

Acceptance rate for chiropractic PI claims tied to complete case files.

What Changes When We Take Over Your Claims

Chiropractic billing gaps aren’t always obvious — but they cost real money every month. Here’s what clinics see after Preferred MB takes control of the claim process.

Before: 19% Denial Rate
After Preferred MB: 7%
Denials dropped after correcting region-code mismatches and ensuring treatment notes met payer episode rules.

Before: 39-Day AR Cycle
After Preferred MB: 18 Days
Streamlined claim routing and real-time follow-up on payer responses cut AR turnaround in half.

Before: Frequent Same-Day Service Rejections
After Preferred MB: 95.8% Approval on Combined Visits
Ensured compliant pairing of CMT and E/M services with proper justification and sequencing.

Before: 4+ Missed Payer Visit Caps Per Month
After Preferred MB: <1 Monthly
Automated cap tracking by patient and plan prevented non-payable visits before submission.

Before: $750+ Monthly Revenue Loss per Provider
After Preferred MB: Documented $0 Leakage
Recovered income from unbilled maintenance care (with ABNs) and overlooked therapy units.

Stop Losing Chiropractic Billing Revenue

Every untracked claim or denied visit is money your clinic earned but never collected. Our chiropractic medical billing experts close the gaps, reduce AR days, and secure payment for every covered service. The numbers above are not rare results — they are what we deliver every day.

We Don't Guess on Code 98942 — We Prove It