The Significance of Appealing Claims in Chiropractic Practice - Learn through Chiropractic Webinars Posted on Sep 28, 2023

Chiropractic Webinars: The Importance of Appealing ClaimsCCEDseminars| The Top Choice For Continuing Education Chiropractic Courses
Why Appealing Claims is More Than Just 'Grunt Work'
Some practices undervalue the role of appealing claims, relegating it to the category of menial tasks. Contrary to this perception, appealing claims can be a goldmine of missed revenue opportunities for your practice.
Statistical Support for Appealing Claims
It is estimated that over 60% of claims initially denied are later paid when they go through the appeals process. Overlooking this could mean substantial financial losses for healthcare providers, including chiropractors.
The Domino Effect of Ignoring Appeals
Even small claim denials can snowball into significant financial losses over time. More importantly, if a payer repeatedly denies claims and faces no appeals, they may deem the service 'unnecessary,' risking its exclusion in future coverage policies.
Three Common Reasons for Claim Denials
Lack of Benefit: For instance, Medicare might deny coverage for chiropractic extraspinal manipulations.
Lack of Medical Necessity: If the patient has exceeded the maximum number of covered visits, a denial is likely.
Coding Errors: Inaccurate or missing codes can also lead to claim denials.
Appeal or Reprocess: Knowing the Difference
Claims can either be formally appealed or simply reprocessed depending on the nature of the denial. Understanding the difference is vital for efficient claims management.
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