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Friday, March 7, 2014

Important “Little” Things in Chiropractic Medicare

Important “Little” Things in Chiropractic Medicare

  • Item 14, date of current, must never be over 60 days old. When billing a covered service with an “AT” modifier (active treatment) and date of current is over 60 days old, this claim will be denied or flag an audit. 
  • Treatment plan: Absence of a treatment plan is the greatest reason chiropractors lose their audits. A treatment plan may be one to 6 visits with an exacerbation as long as it is documented with a Federal Document.
  • Maintenance care: For those chiropractors “treating” patient symptoms instead of correcting vertebral subluxations, think about this: Your patient is taking 9 prescription drugs, 5 being pain killers. They can’t feel anything from their waste down and you are going to call your adjustment “Maintenance care” because they have no pain? Need to rethink what your job really is.
  • Medicare Replacement Plans: A Medicare replacement plan is a “cheaper” type of Medicare coverage that costs less with co-pays. The problem: Some Medicare replacement plans are IN Medicare and some replacement plans are OUT of Medicare. 
    • IN Medicare plans, you must follow Medicare guidelines.
    • OUT of Medicare plans, your patients are like any other patient out of Medicare and you do not have to follow Medicare guidelines UNLESS you bill the Medicare replacement company…. Now you have to follow Medicare guidelines. 

This is just a small example of the important Medicare information in our Seminars and/or in our Chiropractic Medicare DVD.

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