Chiropractic Medical Billing & Credentialing Services

Streamlined RCM Support for Chiropractors, Chiropractic Clinics & Integrated Practices

Chiropractic billing is a high-risk, highly audited specialty. With strict documentation requirements, limited covered services, and CPT coding variations by payer, chiropractors face more denials and clawbacks than nearly any other specialty. Oakview Medical Billing Solutions helps chiropractors and multi-specialty practices eliminate these risks and optimize collections.

From solo practitioners to large integrative clinics, we provide end-to-end revenue cycle management (RCM), coding accuracy, and credentialing services built specifically for chiropractic care.

Key Chiropractic Billing Challenges

Chiropractic billing is complex due to:

Limited Insurance Coverage: Most plans only cover spinal manipulation for subluxation—not maintenance or wellness care.
Medical Necessity Documentation: Medicare and other payers demand detailed SOAP notes (Subjective, Objective, Assessment, Plan) for every visit.
AT Modifiers & CMT Codes: Misuse of modifier AT (Active Treatment) or incorrect use of CPT 98940–98942 often leads to audits.
Treatment Plans & Reassessments: Re-evaluations must be documented clearly at regular intervals to prove ongoing necessity.
Routine Maintenance Denials: Non-covered services billed without GY/GZ modifiers trigger automatic denials or overpayment recovery.
ICD-10 Diagnosis Codes: Using symptom codes instead of primary spinal conditions leads to medical necessity denials.
X-Ray & Physical Therapy Bundling: Improper bundling of services can flag compliance risks.

Most Common Chiropractic CPT Codes

Chiropractic Credentialing & Contracting Services

We credential chiropractors for both commercial and government payers, ensuring your practice gets on the panels that matter most.

Includes:

CAQH profile setup & attestation
NPI (individual & group)
State licensure verification
Medicare/Medicaid enrollment
Contract negotiation & fee schedule assistance
PPO & HMO panel enrollment (UHC, Aetna, BCBS, Cigna, etc.)
Multi-location group credentialing
Integrative practice support (e.g., DC + PT + MD)

Who We Work With

Solo chiropractors (DC)
Chiropractic clinics with multiple providers
Integrated practices (DCs, NPs, PTs, Acupuncturists)
Rehab centers & sports therapy clinics
Chiropractic telehealth platforms

Common Chiropractic RCM Pain Points We Fix

✔ AT modifier tracking
✔ Custom SOAP note audits
✔ Monthly Medicare cap monitoring
✔ Claims rejections for medically unnecessary services
✔ X-ray and therapy bundling
✔ Overuse of 97140/98941 flagged for audit
✔ CMS compliance for maintenance care
✔ Denied re-exams & missing reassessments
✔ Payer-specific charting templates

Top Payers We Handle

Medicare (MACs)
Medicaid MCOs
UHC, Aetna, Cigna, Humana, BCBS
Auto Insurance & Personal Injury Protection (PIP)
Workers’ Compensation
VA Community Care Network
TriWest, TriCare
ChiroHealthUSA, Zelis, Multiplan

Oakview's Chiropractic Billing Advantage

Chiropractic-trained CPC coders
Custom documentation templates
Medicare audit prevention
Dedicated billing manager
Real-time claim tracking & denial alerts
Insurance verification within 24 hrs
No long-term contracts

Why Chiropractors Trust Oakview

✔ 100% HIPAA-compliant system
✔ No volume minimums
✔ Credentialing + billing bundled for savings
✔ Re-submission and appeal handling
✔ Performance dashboard and reporting
✔ Affordable pricing without hidden fees

Let’s Get You Paid Faster

Whether you’re billing 98940 daily or managing a large chiropractic/rehab team, Oakview Medical Billing Solutions is your back-office partner for compliant, profitable practice growth.