Before implementing a chiropractic billing and practice management system, it is important to examine all of aspects of your practice from an efficiency and cost perspective. The purpose of this article is to provide some insight into how a practice should be examined before implementing a practice management and billing system.

Financial Analysis- First, you should take a look at your practice from a financial perspective to determine if there are areas where the financial performance of your practice can be improved. Here are examples of the areas you should research and the types of questions you should ask:

1. How timely is your submittal of claims? Are claims immediately submitted after a patient is seen or is there a time lag between when a claim is submitted and when the patient is seen?

2. What is the rejection rate of claims submitted that could be remedied by better coding?

3. Are you fully maximizing the reimbursement rate for claims? If not, why not?

4. Of the available patient hours in your practice to see patients, what percent of available hours are you actually seeing patients? How could this be improved?

5. Are you adequately controlling overhead costs? For example, through more efficient management, can you reduce the number of staff hours required to operate your practice?

Operational Analysis. As a first step in operational analysis, workflow diagrams should be developed. For example, a flow chart of patient processing should be drawn showing what happens with an existing patient from the beginning of the visitors to the end of the visit. Other workflow charts that should be developed include how clerical procedures are handled such as processing of a new patient, submittal of claims, and patient recordkeeping.

After the flow chart is developed, the following key questions should be answered:

1. Is this step necessary or can it be eliminated?

2. What is the cost of this step? For example, considering the salary of the person performing the step, what does this step cost? Could the step be performed more cost effectively? If yes, what is the most cost effective approach?

3. Could this step be performed more efficiently? If so, what would be a better way to perform this step?

Important to note is that buying and installing a chiropractic practice and billing system is not a "magic answer" for improved profitability and efficiency. Of course, any good software package will result in improvements, but you will not realize the full benefits of a chiropractic billing and practice management system unless you examine your current practices and procedures first and determine how you might improve those areas. Careful analysis and planning before implementing a chiropractic practice billing and management system will provide the most benefit to you.
There are many benefits of installing a good chiropractic practice management and billing system including reduced audit risk, improve management of receivables, reduction in missed appointments, and maximization of revenue. All of these benefits and more can be optimally achieved with a close examination of your practice first.




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What should a chiropractic office management and billing system provide in terms of front desk processing? Since the front desk is the first point of contact with a patient, this is an important question.

First, front desk software should provide an effective, low cost way to intake existing patients. One successful approach that a software package provides is that patients are given a scanning key tag which they simply scan at a desk for entry. This scanning process automatically initiates setup and processing of the patient's visit. The key tag is often used in other ways such as one key tag being used for an entire family. From a marketing perspective this software company provides the capability to custom imprint a practice's key tag with a logo or important contact information about a chiropractic office.

When the patient scans his tag, if necessary, front desk action notifications occur to alert office staff of a situation that needs to be addressed. For example, if a bill is yet to be paid that can be flagged or if the patient is out of compliance with his practice plan. At the front desk, notifications can be handled as the patient stops by the front desk as instructed at the check-in station.

Other information which could be provided is the number of days left on a care plan, days left in a precertification or care plan, number of insurance visits left, number of cash visits, number of free visits. In effect with the system like this, only the patients will be stopped that actually need to see the front desk after a system checks and verifies over a hundred different variables related to a patient's records.. This frees up staff for other work and provides for a more efficient overall patient flow in the office.

The benefits of using automated patient check in with a key tag are significant. First, less labor is required to process the patient visit. Second, there is less chance of errors that could impact collections, coding mistakes, and other problems. Third, automated check in, often not requiring office staff to be involved, reduces the labor cost associated with check in and also helps to eliminate long waiting periods for patient check in during peak hours for patients.

With a fully automated system such as the one we've described a practice can see anywhere from a hundreds visits a week to a thousand visits a week. The number of visits, of course, a practice sees will significantly impact profits. That's why the payback from investing in chiropractic software can be so substantial.

If you are considering a chiropractic billing and practice management system, you should carefully consider what capabilities you are looking for, read about the features each system offers, and decide what features are important to you. This will help you select software that is a best fit for your practice and software that meets your own budget guidelines.




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A good chiropractic billing and practice management system supplies comprehensive support for all aspects of patient processing and record handling. Such a system should be easy to use, be oriented to providing a high level of service for interacting with the patient, and should reduce paperwork and manual processing as much as possible. The system should also have controls, flags, warnings, and built in processing methods to reduce the chance of an audit- an often costly and time consuming process for a chiropractic practice.

Besides that Chiropractic Billing Software (CBS) can help at the front desk of a practice where patients check in, there are huge benefits at the examining table. In fact, for existing patients, the front desk can be completely eliminated and the patient can be handled by the doctor right at the adjusting table. Bottom line, if implemented correctly, the chiropractic office can be made totally paperless.

How does it work? Quite simply information is directly recorded at the table. From that table the following information can be entered or viewed/accessed:

· Patient images which can be compared period to period to note treatment progress
· Word documents can also be attached and uploaded for easy reference
· Intake documents that have been scanned for electronic access
· Compliance measurement to see if the patient is complying with the recommended visits. If he isn't, this can be discussed with the patient to encourage more regular visits- this improves revenue for the practice.
· Visit history
· Scheduling of the next visit
· Appointment types can also be recorded. In addition, visits that are cash or insurance can be noted.
· Start and end date of the care plan
· Diagnosis and procedure codes

As information is entered, a good billing system also flashes warning such as state or payor related, warnings about problems with procedure codes, and warnings if a modifier or diagnosis link is needed. A good system will also automatically check to make sure documentation supports the billing level of coding on a claim. The system should also allow for the SOAP note to be broken down into subject, objective activities and should allow for recording daily living activities. The system should also allow the doctor to enter his own narrative about a patient visit with the system automatically documenting that.

Another huge benefit of a chiropractic billing and practice management systems is that information entered by the doctor at the adjusting table automatically bills and submits claims for the visit. This is a huge time saver, insures accuracy, and also speed in processing claims. Of course, the system would allow for exception processing such as allowing the doctor to flag visits for later updating by the doctor.

The best practice billing and management systems are not those built primarily by programmers but, rather, those systems that have chiropractors, compliance officers, compliance attorneys, physical therapists and other experts heavily involved in the design and development of a system. Involving a programmer primarily risks the development of a system that isn't designed for the realities of a chiropractic office.




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