More info

For more information on how to bill Chiropractic Medicare please visit

Thank you for your interest!

Wednesday, January 25, 2012

4010-to-5010 ~ My Filing Nightmares ~ Rejected Claims, Unreadable Reports, and Error Messages, Oh My!

4010-to-5010 My Filing Nightmares
Rejected Claims, Unreadable Reports, and Error Messages, Oh My!

Has the 4010 to 5010 transition confused you or your office staff with rejected claims, unreadable reports, and/or error messages? The following are some helpful websites and information my staff gathered while making the fun transition.

If you upload your claims using a clearinghouse your should get a human readable electronic report. (If you are getting a human readable report, count yourself lucky!) However, if you upload your claims directly to the Medicare Carrier you might only get a 999 file and a 277CA file. Acknowledgement for Health Care Insurance (999) and Claims Acknowledgements (277CA) will open in Notepad and contain a couple lines of code in your report because they no longer require themselves to send human readable reports. Talk to your software company and ask if they can provide the translation software. There HIPAA EDI Viewer software companies out there. More info about this topic:

If you have any questions, or suggestions please feel free to post them below. We are always looking for more information to share.

~Dr. Street

Wednesday, January 11, 2012

Compliance 2012

Chiropractic Medicare
"Compliance 2012"

Dear Doctors and Staff,

2012 should be an exciting year, especially for those taking the step forward, becoming compliant in Medicare and going paperless.  Big step....however, if you plan on being in practice in 2015, this is the year to get into action.

Three areas are critical for Chiropractors who wish to stay in practice after 2015.

1.  We must know and follow the Medicare guidelines.  We have all signed a contract with CMS that we know and will follow all the rules in Medicare.  With Chiropractors across the USA having a 67% Error Rate, even just filing a Medicare claim, it's pretty obvious most Chiropractors think they know how to do Medicare, but they don't.  They usually find that out after a failed audit and a donation of money back to the Medicare carrier.

2.  We must be protecting personal health information that we have collected on our patients in our office.  Specific guidelines and procedures must be followed by the doctor and all staff at all times.  Those procedures and policies of how your are protecting personal health information must be made available to your patients.

3.  We now have 11 1/2 months to become Medicare Compliant.  There are seven areas specifically presented by the government that we are required to address.  We are required to take specific action steps, develop policies and procedures, appoint Compliance Officers, etc.  It's no little job, but it is required by the government.....only if you plan on being in practice in 2015.

We do offer a Compliance Guide Book and CD.  Policies and procedures are completed, ready to be reviewed, and can be used as your Medicare Compliance Program.  It took me 2 1/2 months to develop.

Do you know the importance of learning the correct way to do Medicare by federal standards and becoming Medicare Compliant?
Have questions? Give me a call today 618-395-3800.

~Dr. Gary R. Street

Tuesday, January 3, 2012

Happy New Year 2012

Chiropractic Medicare
"Happy New Year 2012"

Dear Doctors and Staff,

The window to change your participation status in Medicare ended Saturday, December 31st.  I hope you made sure to send any request for change of status by certified mail.

Congress did pass the 2 month extension bill that assures our Medicare reimbursement fees will not be decreased on January 1st by 27%.  However, that extension is only for two months.  Our Medicare reimbursement will probably be a little higher in January 2012 than what it was in 2011 because of relative values. To check your specific fees.... go to your Medicare Carrier web site, search fees. On about page 245? you will come to 98940, 98941, 98942. The code without the pound (#) sign will be your fees in your local. If the fees you see are still decreased.... your Medicare Carrier does not have the new fees posted as of yet.

Software contractors for electronic billing should have met their mandated deadline to be in compliance for 2012.  They must be prepared with the 5010 software that begins our compliance process in 2012 to start using the ICD-10 codes.

We Chiropractors and staff must also become compliant in Medicare if we plan on being in practice five years from now.  While the Chiropractic Medicare Compliance is voluntary, in the first 5 years it carries substantial positive incentives that makes it attractive to all eligible entities.  However, entities that do not demonstrate "meaningful use" of electronic health record technology will be subject to significant Medicare payment reductions after the fifth year.

Questions? Please give me a call.

Dr. Gary R. Street