50 - Can You Bill for Everything You Do?
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50 - Can You Bill for Everything You Do?
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Hosts Paul Andrews and Dr. Mark Davini tackle the central question: can you bill for every service rendered in your chiropractic office? This episode unpacks the difference between documenting care and reporting codes on claims, and why clinical necessity and complete notes are always essential.
They dig into common coding pitfalls—modifiers like 25 and 52, NCCI bundling versus AMA CPT guidance, manual therapy/neuromuscular re‑education/massage coding conflicts, timed modality rules, and the risk of insurer claw backs when claims don’t match documentation.
The conversation also covers practical business issues: when to ask patients to self‑pay, using non‑covered service waivers and ABNs, the impact of in‑network contracts, verifying benefits, and compliance with the No Surprises Act. They emphasize reading contracts, educating staff, and clear patient communication.
Listeners will walk away with concrete takeaways to protect clinical integrity and revenue—know what to document, what you can bill, when to collect from patients, and how to avoid common compliance and reimbursement traps.