Tame the Chiropractic Billing Beast: 6 Tips for Faster Payments & Fewer Denials

Chiropractic Biller, Catie Lydon, Shares Billing Insights That Can Save Your Practice Thousands

1. Billing Setup Errors That Block Claims from Going Out

After working with so many clinics, one thing is certain: your billing system can either work for you or against you. If it’s not set up correctly, you might assume claims are going out when, in reality, some never leave the system. That means lost revenue and a mess to clean up later.

The Solution

The best way to prevent this is by staying on top of unbilled claims. Regularly checking reports can help catch issues before they turn into bigger problems. In ChiroSpring, the Pending Claims Folder makes this easier by flagging claims that need attention before they’re submitted. Instead of digging through multiple reports, you can quickly see what’s missing, make corrections, and keep everything moving.

Another tool I rely on is ChiroSpring’s color-coded Aging Report. It gives a clear view of every claim’s status, so you’re not chasing payments blindly. Each color represents a different stage—paid, rejected, submitted with no response—so you can quickly spot claims that need attention and follow up before they go unpaid.

2. Incorrect Modifiers & Codes Causing Denials

A rejected claim means wasted time and delayed payments. Yet, one of the biggest reasons for denials is incorrect codes and missing modifiers.  

Most of the time, clinics submit claims assuming they’re correct, only to find out later that insurance companies won’t accept certain codes. UnitedHealthcare, for example, doesn’t allow 97014. But I see it used in about 50 to 60 claims a day.

Importantly, insurance companies don’t fix these mistakes; they just reject the claim. That leaves clinics scrambling to track down the issue, resubmit, and wait even longer to get paid.  

The Solution

• Double-check codes and modifiers before claims go out. Even small errors can lead to denials.
• Use ChiroSpring’s scrubbing technology to catch issues before submission, like missing DOB, provider NPI, incorrect diagnoses, or missing pointing.  
• Save time with automation. Once set up in Settings, ChiroSpring automatically applies the correct modifiers for each payer, reducing errors and helping claims get reimbursed faster.

These mistakes are easy to make, but just as easy to avoid. With better billing habits and a system that flags issues before claims are submitted, you can minimize rejections and accelerate payments.

3. Submitting Claims Without Checking for Errors

Too many clinics assume that once a fee slip is created, the claim is good to go. But skipping the final review is one of the biggest reasons claims get denied or delayed. I’ve worked with countless clinics where claims go out with missing NPIs, incorrect patient details, or missing diagnoses—simple mistakes that could have been caught with a quick check.  ChiroSpring’s claim scrubber flags these issues automatically, so clinics can catch mistakes before submission and avoid costly delays.

Once a claim is denied, fixing it takes time. If no one catches the issue quickly, the same mistake gets repeated on future claims, turning a small oversight into a pattern that drains revenue. The longer the error goes unnoticed, the more claims pile up with the same problem.

The Solution

• Always review claims before submission. A quick check can save hours of rework.

• Use ChiroSpring’s scrubbing technology to flag missing details like DOB, provider NPI, and incomplete information before the claim is sent.

• Take advantage of the pending claims folder. Instead of digging through multiple reports, you can see everything in one place and make corrections before submission.

• Leverage ChiroSpring’s color-coded Aging Report to track claims at a glance.  

• Use the rejection folder to stay organized. Any rejected claim goes straight there, so there’s no digging through reports. It’s saved me 3+ hours per week by keeping denied claims easy to find and fix.

• Track claim statuses regularly. If a claim is rejected, fix the issue immediately to prevent future denials for the same reason.

The fee slip isn’t the final step. Taking a moment to verify claim details before submission can keep revenue flowing and prevent a backlog of denied claims.

4. Not Following Up on Pre-Authorizations

One of the biggest mistakes I see in chiropractic billing is not staying on top of pre-authorizations. Insurance rules are constantly changing, and if a clinic isn’t tracking authorizations properly, it’s only a matter of time before denials start piling up. I’ve seen clinics lose thousands of dollars because they didn’t realize a patient’s authorization had expired or they failed to request a renewal in time.

Fixing this issue isn’t complicated; it just takes consistency.

The Solution

• Use ChiroSpring’s treatment dashboard to track pre-authorizations so nothing slips through the cracks.

• Set reminders for renewals before limits are reached. Waiting until an authorization runs out can lead to unpaid visits and unnecessary rework.

• Make pre-auth follow-ups part of your routine. A quick check now can prevent denied claims later.

Ignoring authorizations is an expensive mistake. A simple follow-up can be the difference between getting paid and writing off thousands in lost revenue

An Alternative Approach: Membership-Based Care

For some clinics, membership-based care is a way to bypass insurance hassles and keep revenue steady. Instead of dealing with pre-authorizations and coverage limits, these practices offer flat-rate memberships for a set number of visits.

I recently started working with a ChiroSpring clinic using this model, and it’s been great to see how quickly it’s taken off. Patients get affordable, predictable care (often at a discount), and the clinic benefits from recurring revenue without chasing claims. It’s not for everyone, but for some practices, it simplifies billing and makes chiropractic care more accessible.

5. Front Desk Errors: Unapplied Payments & Claim Mismatches

A lot of billing issues start at the front desk. When payments aren’t applied correctly, reports become unreliable, balances go uncollected, and clinics lose money they should have received. The money’s there, but because no one applied it to the right claim, it looks like the patient still owes.

ChiroSpring prevents these mistakes by applying payments automatically and flagging outstanding balances at checkout. It also tracks Patient Member Responsibility (PMR), so if an insurance adjustment increases what a patient owes, the front desk sees it immediately and can collect before the patient leaves.

The Solution

• Apply payments correctly to avoid reporting errors and unpaid claims.

• Use ChiroSpring’s automated payment application to eliminate manual mistakes.

• Check PMR at checkout so patients don’t leave with unpaid balances.

It doesn’t take much for these errors to pile up. A quick review at checkout keeps everything accurate and prevents bigger issues down the line.

6. Falling Behind on Documentation

It’s easy to put off notes when the day gets busy, but waiting too long makes billing harder than it needs to be. I’ve seen clinics where doctors fall two to three days behind, and by then, details get fuzzy, mistakes slip through, and claims get delayed. The longer documentation lags, the more time it takes to sort things out. By industry standards, notes should be completed within 24 hours to keep billing accurate and avoid issues.

The Solution

Your best bet to stay on track is to make documentation part of the daily routine. ChiroSpring’s Visit Compliance Report helps identify missing notes before they become an issue. A quick review each day keeps billing moving and prevents costly delays. Notes also carry over from the previous visit, so providers only need to make small updates, saving time without sacrificing accuracy.

Stop Letting Chiropractic Billing Mistakes Cost You

After nearly three decades in billing, I’ve seen what works and what doesn’t. The clinics that struggle the most are the ones that don’t have the right systems in place.  

Small mistakes—missed modifiers, unapplied payments, unsubmitted claims—add up quickly, costing thousands in lost revenue. But when billing is done right, claims go out clean, payments come in faster, and staff spend less time fixing preventable errors.

That’s why I always recommend ChiroSpring. I’ve worked with several systems, and I won’t even take on clinics using certain platforms because I know they’ll be fighting their software every step of the way. ChiroSpring is user-friendly, built for billers and everyday users, and constantly improving with new features that help clinics avoid costly mistakes.

The clinics I work with don’t waste time fixing billing mistakes. They get it right the first time with ChiroSpring. See how it can work for your practice. Schedule a demo today.

Billing for Chiropractors FAQs

How long does it typically take for insurance claims to be processed and paid? Most claims take 2-4 weeks if submitted correctly, but errors or missing details can cause delays. Checking claim status regularly and fixing rejections quickly helps speed up payments.

What’s the best way to handle patient balances and unpaid claims? Send clear, itemized statements and make it easy for patients to pay with multiple options. It’s also helpful to collect balances at checkout whenever possible to reduce overdue accounts.

How can chiropractors improve insurance claim approval rates? Ensure codes, modifiers, and documentation are correct before submitting claims. Use claim scrubbing tools to catch mistakes early, and review denials regularly to prevent repeat errors.

Does ChiroSpring help with tracking claims and reducing denials? Yes! ChiroSpring’s built-in clearinghouse ensures claims are accurate before submission, reducing rejections. Advanced claim scrubbing flags errors upfront, and the Aging Report helps you track unpaid claims so you can follow up faster.

How does ChiroSpring help automate billing and reduce manual work? ChiroSpring automatically creates claims from signed SOAP notes, auto-posts ERAs, and uses advanced ditto functionality to prevent missed charges. These features save hours every week and help eliminate billing errors.

About the Author

Catie Lydon has 27 years of experience in chiropractic, integrated, and physical therapy billing. Known for her expertise and results-driven approach, she works exclusively by referral and maintains a waiting list of clinics seeking her guidance. Her deep industry knowledge helps practices streamline billing, reduce denials, and maximize revenue.

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References

Hurt, A. (2018, June 7). Billing success starts at the medical practice front desk. Physicians Practice. https://www.physicianspractice.com/view/billing-success-starts-medical-practice-front-desk

Replacement Codes Policy, Professional. (2025). UnitedHealthcare. https://www.uhcprovider.com/content/dam/provider/docs/public/policies/comm-reimbursement/COMM-Replacement-Codes-Policy.pdf

Subscriptions: The Modern Revenue Model for Chiropractors. (2025, January 24). ChiroSpring. https://www.chirospring.com/articles/subscriptions-the-modern-revenue-model-for-chiropractors

Timely Chiropractic Documentation. (n.d.). KMC University. Retrieved February 13, 2025, from https://kmcuniversity.com/timely-chiropractic-documentation/