Insurance Billing

  • Prepare claims to be billed
  • Correct any problems
  • Bill
  • Handle any denials
  • Commercial, Medicare, Medicaid, Auto/Personal Injury, Workman’s Compensation


Medicare Enrollment
We handle any of the following changes with Medicare:

  • New enrollment or update enrollment
  • Doctor’s Medicare enrollment switched from one practice to another
  • Facility address notification or changes
  • Getting mandatory Electronic Funds Transfer (EFT) set up

Even if you have been set up with Medicare before, if you are moving to a new facility or starting to utilize another entity and/or adding a new doctor to your facility, the paperwork required by Medicare is almost as much as a brand new Medicare enrollment.

Medicaid Enrollment

  • New enrollment
  • Switching enrollment from one practice to another
  • Practice address notification or changes

Other Insurance Companies

  • Practice address notification or changes
  • Giving recommendations if insurance company is a favorable company to get enrolled in
  • Getting enrolled in network if desired

Revalidation Credentialing

Medicare and Medicaid normally require a revalidation every 3 years, for both a doctor and the group practice. With Medicare especially, a revalidation is very similar to doing a new enrollment. Almost the same amount of paperwork to do a revalidation. If revalidation is not done (and not done correctly), then your Medicare enrollment terminates.

  • Doctor Medicare Revalidation
  • Practice Medicare Revalidation
  • Doctor Medicaid Revalidation
  • Practice Medicaid Revalidation

Clinic Set Up for Billing

  • NPI numbers – Confirming that doctor has an individual NPI number and Group NPI number. If not, complete applications for those. Update the doctor’s/practice’s contact information with NPPES if applicable.
  • Tax ID – Confirm entity status for doctor/clinic
  • Chiropractic software – Get software all set up for billing
  • Enter all the billing ID’s correctly (Tax ID, NPI’s, PTAN’s, etc.) in software according to entity structure layout
  • Enter/confirm Insurance companies with electronic payer ID’s
  • Confirm correct billing CPT codes, and confirm Medicare modifiers attached for Medicare payor
  • Enter/confirm allowable Medicare (for your region) ICD-10 codes. Eliminate the unspecified diagnosis codes that Medicare doesn’t allow, but that the Chiropractic software includes
  • Enter/confirm G codes. Eliminate any extra/not applicable G codes from software to simplify process


  • Set up account with clearinghouse for doctor/practice
  • Set up the clearinghouse information in chiropractic software
  • Set up EDI account with Medicare so that you can submit electronic claims to them through clearinghouse
  • Complete the Electronic Remittance Advice applications for insurance companies so that you can receive ERA’s to clearinghouse (e.g. Medicare, Medicaid, BCBS, UHC, and others)

Online accounts set up

  • Medicare online account – to retrieve patients’ enrollment information, eobs if needed
  • Medicaid online account – to retrieve patients’ enrollment information, eobs if needed, for doctor enrollment information, do rebilling
  • (BCBS site) – to retrieve patients’ eligibility/benefit information, check claim status

Billing Review/Audit

  • Review over unpaid claims reports, clearinghouse denials, current billing and coding procedures by clinic, current diagnosis procedures by doctor, etc.
  • Confirm all issues as to why unpaid by insurance
  • Write Billing Errors Report for clinic
  • Write game plan as how to fix issues at clinic so that claims do not continue to be unpaid by insurance