CMS Clarifies Medical Necessity Requirements

CMS Clarifies Medical Necessity Requirements

Share this page: On December 23, 2015, the Centers for Medicare and Medicaid Services (CMS) released a new instructional video describing their policies and procedures for establishing medical necessity of chiropractic care.1 The video was released on the heels of a...
Billing & Coding for Wellness Services

Billing & Coding for Wellness Services

Share this page: Question: Dr Kotlar, “Do insurance companies pay for wellness services?” Answer: Yes, some carriers pay for wellness exams, preventive medicine services and maintenance care. Here are a few examples: 1. Preventive Medicine Exam – New...
Speed, Communication and Relationships

Speed, Communication and Relationships

Share this page: Speed, Communication and Relationships The new economy driving the healthcare marketplace today is forcing chiropractors to transform the way that they do business on many levels. There is no question that times have changed. Many doctors who were...
Are Your Medicare Notes Functional?

Are Your Medicare Notes Functional?

Share this page: Many are seeing increased denials of care for medical necessity in Medicare. A closer look at the reasons for the denials reveals a change in Medicare’s interpretation of medical necessity and progress in care. The evolution of their interpretation...
That’s Just “Sick”

That’s Just “Sick”

At one point, the idea of chiropractic diagnosis was somewhat controversial. In fact, it’s said that, when pressed for a diagnosis, BJ Palmer himself would only describe a patient as “sick.” But BJ Palmer didn’t have to submit claims to Medicare or other third-party...
Provider Risk in ICD-10

Provider Risk in ICD-10

Share this page: On July 7, 2015, the acting administrator for the Centers for Medicare and Medicaid Services (CMS), Andrew M. Slavitt, sent out a notice to all providers that CMS would be lenient in processing of the claim forms as long as provider’s codes are in the...