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Wednesday, August 10, 2011

Chiropractic Audits Gone Wild!

Chiropractic Medicare

My phone calls are increasing especially from New York, California, Nevada, and now Alabama!

Palmetto Medicare Carrier in California and Nevada broke the ice and requested thousands of Chiropractic records as both pre-payment and post payments audits. Then, the New York Medicare Carrier went wild with requesting records on every patient.

Now the Alabama Medicare Carrier is following suit with audit after audit on Chiropractors, requesting records/documentation for a specific period of time and any portion of the preceding 6 months prior. 

These audits, first, eat up the small profits we get in Medicare. Secondly, they stress both the doctor and the staff effecting the quality of Chiropractic care delivered.  The major problem is that most Chiropractors lose some or all of their audit because of mistakes or lack of knowledge in Medicare procedures. 

Speaking with hundreds of Chiropractors dealing with audits, they all have made the following errors that cost them big time:
  1. Date of current (HCFA item #14) must never be over 60 days old.

  2. X-ray date must be less than 12 months old (364 days or less), or when no x-ray present, a P.A.R.T. form must be completed each and every visit. 

  3. Diagnosis must make sense and match S.O.A.P. Notes to support the care rendered.

  4. Lack of complete documentation by Federal Standard to proven Medical Necessity.

S.O.A.P. Notes are not the only Chiropractic documentation necessary to make a claim payable.  (Documentation is a federal document.)

Need help and/or assistance so that you can survive a Medicare audit? Please give me a call at (618) 395-3800 or consider ordering or Chiropractic Medicare DVD and booklet - Dr. Street


  1. Back and neck problems are the usual complaints of patients who go to chiropractors, and pain relief is the immediate result they get after a chiropractor visit. However besides the immediate pain relief, a lot of chiropractic patients observe other improvements in their health, specifically in the pulmonary system (i.e. it's now easier to breathe), gastrointestinal system, cardiac/circulation system, and vision.

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