10 Chiropractic Billing Fixes for Faster Payments & Fewer Rejections

Is your practice hemorrhaging money through billing gaps? You're not alone. 

Every denied claim is revenue you’ve already earned but can’t collect.

The good news? Most billing issues are preventable. With the right approach, you can cut denials, speed up reimbursements, and simplify your entire process.

Below, you’ll find practical chiropractic billing tips to fix common mistakes, reduce rejections, and improve cash flow. A few smart changes can turn billing from a hassle into a smooth, predictable process. Let’s get started.

10 Chiropractic Billing Fixes for Faster Payments & Fewer Rejections

Every billing mistake costs money. Whether it’s claims not submitted, coding errors, or delayed follow-ups, these issues create revenue leaks that add up fast. 

Fixing them reduces administrative stress and improves case flow. Here’s how to tighten your chiropractic medical billing process and keep payments coming in without unnecessary headaches.

1. Fixing Billing Setup Errors Before Claims Go Out

Some claims never leave your system, creating an invisible revenue drain. They get stuck due to missing details or software misconfigurations, and you assume they’ve been sent—but they haven’t.

Fix It: Create visibility into your claim submission process with these approaches:

• Audit pending claims weekly to identify those still marked as "created" but not "submitted." Assign a dedicated team member to check the claim queue every Monday morning.
  
  
• Implement a software with built-in tracking that automatically flags unsubmitted claims. Set up automatic alerts that notify your billing staff when claims remain unsubmitted for more than 48 hours. Noterro, a practice management system, offers comprehensive tracking features that monitor the entire workflow from initial claim creation through submission, adjudication, and payment.
  
  
• Run a weekly "claim status report" that identifies common submission barriers like missing tax ID numbers, incorrect place of service codes, or incomplete diagnosis information. Noterro’s reporting features track the entire billing workflow, from claims to payments, making it easier to spot and resolve errors.
  
  
• Implement a submission checklist that staff must complete before marking a claim as ready. This simple step can reduce unsubmitted claims by up to 25%.

The best claims system in the world won't help if your claims never leave the building. Regular monitoring ensures nothing falls through the cracks, and establishing clear responsibility for tracking unsubmitted claims ensures accountability.
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Also Read: Must-Have Features of Medical Billing Software for Healthcare RCM

2. Ensuring Accurate Use of CPT Codes & Modifiers

Billing success depends on accurate coding. Get it right, and the claims process smoothly. Get it wrong, and denials pile up. Missing modifiers or incorrect codes can trigger automatic rejections, costing time and revenue. Each insurance carrier has its own rules, adding to the complexity.

For example, UnitedHealthcare rejects 97014 for electrical stimulation but accepts G0283. Using the wrong code leads to unnecessary denials and extra work.

Fix It:

• Stay updated on CPT code changes. Subscribe to the American Medical Association’s updates and join your state chiropractic association for coding bulletins. Hold quarterly training sessions for your team.
  
  
• Create a quick-reference guide for practice-specific modifiers. For example, Modifier 25 should be used only when an exam is separately billable from an adjustment.
  
  
• Build a payer matrix listing each insurer’s coding requirements. Medicare requires the AT modifier for active treatment, while UnitedHealthcare rejects 97014 but allows G0283 for electrical stimulation.
  

• If a visit includes cervical, thoracic, and lumbar adjustments (98941), therapeutic exercises (97110), and electrical stimulation (G0283), precise coding ensures full reimbursement instead of underpayment.

You can use Noterro to add insurance codes like Modifiers and ICD to avoid any mistakes while billing.

Small mistakes in coding lead to big revenue losses. You should avoid these billing and coding red flags to get payments faster.
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You might also like to read: Insurance Code Recommendations for Your Invoices
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3. Pre-Checking Insurance Eligibility & Pre-Authorizations

Verifying coverage isn't just a good practice—it's essential for maintaining healthy cash flow. Yet many practices check insurance only at a patient's first visit, missing important changes.

Providing treatment without verifying current insurance coverage or obtaining necessary pre-authorizations leads to unpaid claims and frustrated patients.

Insurance details can change monthly, and authorizations expire without notice. Without regular verification, you're essentially providing care with no guarantee of payment.

• Check eligibility before every visit, not just the first one. Run real-time verifications 48 hours before each appointment to confirm active coverage, remaining visits, and deductible status.
  
  
• Use software to track pre-authorizations. Set up a dashboard displaying authorization expiration dates, remaining visits, and required documentation. Configure alerts to trigger at 75% usage to prevent unexpected denials.
  

• When a patient reaches 75% of their authorized visits, begin the renewal process 2–3 weeks before expiration.
  
  
• Document eligibility confirmations with time-stamped notes and insurance rep details. This protects you in disputes.
  
  
• Provide a clear summary of coverage limits, copays, and out-of-pocket costs to prevent chiropractic medical billing surprises and improve collections.
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Helpful read: Transform Healthcare Finance with Electronic Medical Billing Solutions
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4. Submitting Claims on Time (No More Delays!)

Timing matters in billing for chiropractic services. The longer you wait to submit claims, the longer you wait to get paid—it's that simple.

Many clinics batch claims weekly or monthly, creating unnecessary delays in payment and increasing the risk of timely filing issues.

This practice essentially provides insurance companies with an interest-free loan of your money. Meanwhile, your practice bears the burden of delayed cash flow.

Fix It:

• Submit claims daily or at least three times a week. Assign a dedicated team member to handle submissions. For smaller practices, set Monday, Wednesday, and Friday as mandatory submission days.
  
  
• Schedule a dedicated submission time. Block morning hours when clearinghouses process claims faster. Treat this time like a patient appointment—non-negotiable.
  
  
• Use batch submission software. Configure your system to group claims by payer for faster processing and fewer errors.
  
  
• Track submission speed and improve it. Monitor days from service to submission and aim for 95% of claims to be sent within 48 hours.
  
  
• Flag high-dollar and out-of-network claims for same-day submission. These should be prioritized to avoid reimbursement delays.

Faster claim submissions mean faster payments. Don’t let delays in your process turn into delays in your revenue.

5. Double-Checking Claims Before Submission (Avoid Common Errors)

A small mistake—like a missing digit or incorrect modifier—can turn a valid claim into a denial nightmare. Fixing rejected claims takes more time and effort than submitting them correctly the first time. Prevention is always faster than correction.

Fix It:

• Set automated checks for missing NPIs, incorrect place-of-service codes, and missing diagnosis pointers. Keep sensitivity high for the first three months to catch more errors upfront.
  
  
• Hold a 15-minute end-of-day check where a specialist reviews claims, focusing on new patients, unusual procedures, and high-dollar encounters.
  
  
• Assign a "claim quality champion." Designate a team member to review all claims before submission. Rotate this role quarterly so everyone gains expertise.
  
  
• Maintain a checklist of the top 10 claim errors. Update it quarterly based on your most common denials.
  
  
• Require a second review for high-value claims. Any claim over $300 should go through an extra verification step before submission.
  
  
• Track your first-pass acceptance rate. Aim for a 95% success rate—top practices achieve this by focusing on pre-submission accuracy.

6. Following Up on Denied Claims Promptly

When claims are denied, the clock starts ticking. Every payer has specific timeframes for appeals, and missing these windows means losing your right to payment.

Many practices delay follow-up on denied claims—or worse, never appeal them at all—resulting in significant revenue loss.

According to industry data, 60% of denied claims are never resubmitted. This represents pure revenue loss for services you've already provided.

Solution:

• Regularly review denial reason codes to identify patterns and address root causes
  
  
• Implement a system that flags rejections immediately for quick response
  
  
• Create a standardized process for appealing denied claims within 30 days
  
  
• Track appeal outcomes to improve future submissions

7. Automating Payment Posting & Reconciliation

Manual payment posting isn't just time-consuming—it's prone to errors that can create accounting nightmares and incorrect patient balances. It leads to discrepancies, reporting inaccuracies, and missed collection opportunities.

When payments aren't properly reconciled with claims, your financial reports become unreliable, making it difficult to identify true collection issues.

Solution:

• Use software that automatically applies payments to the correct patient accounts
  
  
• Regularly reconcile Explanation of Benefits (EOBs) with received payments
  
  
• Set up automated notifications for patients with remaining balances
  
  
• Review payment variance reports to identify systematic underpayments
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Interesting read: Empower Your Chiropractic Practice with Effortless Billing Solutions
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8. Keeping Accounts Receivable (A/R) Under Control

Your accounts receivable represents money earned but not yet collected. The longer a claim remains unpaid, the less likely you are to ever receive payment.

Many clinics allow unpaid claims to linger for months, significantly reducing the probability of collection. Every day an unpaid claim ages, your chances of collection diminish.

Solution: You need to implement proactive A/R management in which you:

• Run reports to identify outstanding claims early before they become overdue. Prioritize high-value claims and repeat payers with slow payment histories.
  
  
• Separate A/R by payer type. Segment your follow-ups based on payer trends (some take longer than others) so you can focus on the ones most likely to delay or deny payments.
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• Follow up on unpaid claims within 30 days. Assign a team member to initiate contact as soon as a claim passes 30 days unpaid.

• Aim to keep claims older than 90 days below 15% of total A/R. If you notice an increase, adjust your follow-up and submission process to prevent delays.

9. Training Front Desk Staff on Billing Best Practices

The revenue cycle begins the moment a patient schedules an appointment. Your front desk team plays a critical role in preventing billing problems before they start.

Many payment errors originate at check-in, with incorrect insurance information, missing demographics, or uncollected copays.

Solution:

• Train staff on insurance verification and copay collection. Teach them how to verify eligibility, coverage limits, deductibles, and required authorizations before each visit.
  
  
• Standardize patient intake procedures. Ensure every new and returning patient’s insurance, contact details, and billing information are accurately recorded at check-in.
  
  
• Use patient responsibility calculators. Estimate copays, deductibles, and out-of-pocket costs before services are provided to reduce billing confusion.
  
  
• Audit front desk activities regularly. Run monthly reports to catch errors early, provide feedback, and ensure proper procedures are followed.
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Your next read: The Comprehensive Growth Plan for Chiropractic Practices: From Startup to Scalable Success
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10. Leveraging A Billing Software for Efficiency

Manual processes simply can't keep pace with today's complex billing requirements. Modern software solutions automate repetitive tasks while reducing human error.

Outdated or paper-based systems slow down reimbursements and increase error rates.

Every manual step in your chiropractic medical billing process represents an opportunity for mistakes and delays. Technology can eliminate many of these vulnerabilities while speeding up your entire revenue cycle.

Solution:

• Use chiropractic-specific software. Noterro is built for spine care practices, handling modifiers, payer rules, and common procedure codes correctly for accurate claims.

• Simplify insurance claims with TELUS eClaims & CMS-1500 exports. For Canadian clinics, Noterro integrates with TELUS eClaims for direct claim submissions, while US clinics can easily export CMS-1500 forms to speed up their workflow.
  
  
• Coordinate multiple insurers on a single invoice. This chiropractic practice management solution allows you to enter Primary, Secondary, and Tertiary claims, automatically evaluating estimated coverage for easier claim management.
  
  
• Enable automated claim scrubbing. Catch missing NPIs, incorrect service codes, and incomplete patient info before submission to reduce denials.
  
  
• Track claim status in real time. Set up alerts for stalled or rejected claims so you can fix issues before they delay payments.
  
  
• Run analytics reports to spot trends. Identify common denial reasons, slow-paying insurers, and bottlenecks so you can improve efficiency.

Optimize Your Billing for a Thriving Practice

Billing shouldn’t be a constant headache. With the right chiropractic billing tips, you can reduce denials, speed up payments, and free your team from unnecessary admin work. 

Even small changes—like catching claim errors early or submitting claims faster—can have a big impact on cash flow and efficiency.

By applying these strategies, you can:

• Significantly cut denials, recovering lost revenue
• Get paid faster with a smoother claims process
• Give your team more time to focus on patient care

For a smarter, more efficient process, Noterro helps at every step. From CMS-1500 exports for US users and TELUS eClaims integration for Canadian clinics to automated follow-ups and real-time claim tracking, it ensures you stay on top of your revenue cycle with less effort.

Billing success isn’t about a complete overhaul—it’s about consistent improvements. Start with what impacts your bottom line the most, and build from there. The right systems and tools make all the difference.

FAQs

1. How do I handle patients with high deductibles who struggle to pay their portion?

For patients with high deductibles, set clear payment expectations upfront. Offer pre-treatment cost estimates, flexible payment plans, and digital payment options. Consider automating patient reminders for outstanding balances to avoid delayed collections.

2. What’s the best way to track and manage underpayments from insurance companies?

Regularly review Explanation of Benefits (EOBs) to catch underpayments. Use billing software that provides variance reports comparing expected vs. actual payments. Noterro’s real-time payment tracking helps identify discrepancies so you can dispute incorrect reimbursements promptly.

3. How can I improve billing accuracy when multiple providers work in the same practice?

Ensure each provider uses consistent documentation and coding practices by implementing standardized billing workflows. Assign a billing lead to review claims for accuracy before submission. Using a centralized system like Noterro helps manage provider-specific billing rules efficiently.

4. What steps should I take if an insurance provider repeatedly delays payments?

Track payment timelines for each insurer and set escalation procedures for delayed claims. If a payer consistently delays reimbursements, follow up aggressively with documented proof of submission dates. Consider joining a provider advocacy group or negotiating contracts to avoid recurring payment bottlenecks.