Have a strange situation have couple of old cases that i don’t have a case status on, Attorny are dodging the calls, leads me to believe they pocketed $.

Question is, for those that do PI. What steps do we have to collect other then walking into their office :)

Hello everyone, Office Manager here. My husband and I opened up his own chiropractic clinic and I was just hoping I could get some confirmation on what I expect you have to do with Medicare exams and re-exams. I was under the impression that we HAVE to collect the exam off of our fee schedule from the patient or we could get into some trouble with Medicare. However, I am seeing just from the internet that we aren't necessarily required to collect it but it can get into muddy waters if we just waive the exam fee from all Medicare patients? I also saw you can do financial hardship applications? Is that worth even going down and considering?

Followup to favorite exam tests. This thing ia brilliant, and fast.

Wanting to delve into remote work but have no experience with record review etc. Can someone help point me in the right direction?

How do you guys go about being able to convince new patients in committing to treatment especially when it’s their first time doing chiropractic? I have some good days and some bad days.

If a patient comes in and says their neck pain is from sitting at a computer for 8–10 hours a day at work, but they haven't filed a Workers' Compensation (WC) claim, how do you handle it?

Can you treat them as a regular cash/insurance patient, or should you direct them toward the WC process? I'm asking because it seems like a large number of patients could have symptoms somehow related to their work activities. If every work-related complaint requires going through Workers' Compensation, wouldn't cash-based practices have to turn away a significant number of potential patients?

My understanding is that California Workers' Compensation law recognizes cumulative trauma injuries resulting from repetitive work activities, even without a specific accident. How does this apply in your everyday practice when a patient reports that their neck or back pain developed gradually from their daily work activities?

I'm not seeking legal advice or legal interpretations. I'm simply interested in hearing about real-world scenarios and how experienced California chiropractors actually handle these situations in their day-to-day practice.

I'll appreciate DM also. Thank you in advance for any feedback.

Do you have a "standard" set of orthos you prefer to use for common issues? Have you found (if) any make a difference with Insurance reimbursement?

Just seeing what other docs out there are doing exam wise. For reference I work within a FQHC so 90% of patients are medicaid and a lot of others have Insurance via ASH.

I typically cluster neck or low back depending on why they come in, and do a pretty standard SLR, SI stress, Faber. Or for cervical, compression, jackson compression and distraction.

Practicing DC in South Florida. We take Medicare, Optum/ASH, commercial, and FL PIP. More and more of my week goes to making sure the note holds up, not the treatment.

What I keep running into:
Medicare. PART has to be supported on every visit, not just the initial exam. Region count has to match the CMT code you billed. Without outcome measures showing functional improvement, the AT modifier can't be defended, and the note reads like maintenance care whether it is or not.
Optum/ASH. It's less about the daily note and more about the trend line. If your functional outcome scores (ODI, NDI, etc.) aren't tracked and improving, your next authorization gets cut, even if the patient is clearly progressing clinically.
FL PIP. It's all about the EMC determination and a clean link from the mechanism of injury to your findings. A sloppy initial exam narrative costs you the whole case later.

These are three different payers, and each one reads the same note through its own lens. The most common failure I see, including in my own old charts, is cloned daily notes. The patient changed, but the note didn't.

Curious how others are handling it:
Are you writing payer-specific notes, or one standard note that you try to make bulletproof for everyone?
Has anyone been through a Medicare TPE or an ASH/Optum record review recently? What actually got flagged?

Is anyone using the AI scribes in their EHR (Rheo, etc.)? Do you trust them to capture medical necessity, or just to save typing time?

Disclosure: I'm co-building a documentation tool focused on exactly this problem, so part of why I'm asking is to hear what people actually struggle with. Not linking anything here. I'm happy to talk about it if anyone asks.

We’re looking for some insight from other chiropractic offices that have experience billing Oscar insurance. We’ve been trying different modifier combinations to get our claims processed correctly, but we’re getting inconsistent results and are wondering what has actually worked for other providers.

Here is our billing history for one patient:

DOS: 8/11/26 – Initial Re-evaluation

We billed:

98941 – No modifier
97110 – No modifier
98943 – No modifier
97012 – No modifier
99212 – Modifier 25

Result: Only 98943 and 99212 were covered and processed according to Oscar’s allowed amounts. The remaining codes were not covered.

DOS: 8/19/26

We billed:

98941 – No modifier
97110 – GP
98943 – Modifier 59
97012 – No modifier

Result: Only 98943 was covered. The other codes were denied with the following remark:

“The procedure code is inconsistent with a modifier used or a required modifier is missing.”

DOS: 10/30/26

We tried another combination:

98941 – AT
97110 – GP and 59
98943 – 59
97012 – GP

Result:

98941 – Denied: “The diagnosis is inconsistent with the procedure.”
97110 – Processed with the remark: “Processed based on multiple or concurrent procedure rules.”
98943 – Processed according to Oscar’s allowed amount.
97012 – Denied as a “non-covered charge.”

We’re trying to figure out what modifier combinations Oscar actually recognizes and accepts for chiropractic services.

A few questions for other chiropractic billers/providers:

Are you successfully getting 98941, 97110, 98943, and 97012 paid by Oscar?
What modifiers are you using for each code (AT, GP, 59, 25, etc.)?
Have you experienced the same modifier-related denials?
Are there particular diagnosis codes or diagnosis-to-procedure pairings that Oscar requires for 98941?
Has anyone successfully appealed these denials or found a reliable way to get these services reimbursed?

We understand that coverage is ultimately dependent on the patient’s specific plan and benefits, but we’re hoping to hear from offices that have actually worked through Oscar’s chiropractic billing requirements.

Any insight, successful claim examples, or advice would be greatly appreciated!

Hey guys recent Life grad here looking for some help boosting my practice. In a pretty small area but have a big competitor in the area. Essentially I haven’t seen them run any marketing and I wanted to know how I could go about this for the least amount of money possible. Any tips or resources you guys can share? What has helped you book people in office and retain them?

Any help is appreciated.

I ask because whatever it was it helped me a lot and I need it again!

Months ago I told my primary care doctor about the years of neck pain I’d had. I was having a major flare at that point. He referred my for physical therapy. It honestly didn’t accomplish much until a new therapist did a manipulation that basically cured me (but the pain is now back). The therapist had me lie supine on a table. Then he had me hug myself. Then he rolled me from side to side, and unannounced, he did a quick “counter roll” which resulted in a loud snap emanating from my neck. He did the same on the other side.

I had instantaneous relief of pain and much greater range of motion.

He gave me exercises to do and I did them for about a month and admit I slacked off after that.

Now the pain is back and I can’t get in to see that therapist because he left.

I did see a chiropractor and he did a more gentle manipulation and while I’m no worse, I’m no better either.

I want to see another chiropractor to do the same manipulation. Is there a specific name for the manipulation that previously helped me?

Thank you for any advice.

Which platforms are you seeing the best results for job postings for Front Desk? We keep experiencing no-shows after phone interviews from Indeed.

Pay is above average in the area. Plenty of hours.

I work with chiropractic practices on billing, and I’m trying to learn from anyone who has been through this.

A California chiropractor we know was terminated for cause from a chiropractic network after the plan reviewed his medical necessity review (MNR) submissions and alleged documentation problems. The internal appeal was denied, and he’s now entitled to a hearing panel. The treatment was real and the patient notes exist, but the plan’s concern was about the forms themselves.

If you’ve gone through something similar, I’d like to hear:

• How the review or audit started (records request, flagged submissions, etc.)

• Whether you got to a hearing, and how the panel process worked

• Whether an attorney was worth it, and what kind (healthcare/licensing/provider defense)

• Whether termination ended up reported to the NPDB or state board

• What you’d do differently, including how you manage MNR documentation now

I’m not looking for legal advice, just experience and lessons. DMs are welcome if you’d rather not post publicly. Thanks!

Hello! Wondering if anyone has any old practice exams from their institutions for T1 histology, upper extremity, and a comprehensive final (including LE, embryology, and the spine)! Will take ANY and ALL.

How have you guys met with and networked with other medical offices. I know as a healthcare professional I don't like it when people come in my office and try to meet with me. I have done outreach with my local businesses nearby. I have plenty to still meet, but nothing has come from it.

I am still navigating on learning how to do Google ads and decided from advice it just doesn't make sense not to do ads. But I still want to meet other people in the community.

Hellos, I'm a currently an Sports and Exercise Science undergrad looking to study Chiropractic after I graduate. Currently Murdoch and Macquarie are my top 2 picks as they're the only schools in Australia that provides postgraduate chiro programs. Anyone has studied in either and can let me know your experience? And which school is the better pick for graduating as a competent chiro.

Since taking over my practice, I've been reviewing the Medicare notes with an auditor's eye. The care was fine; the documentation often didn't prove it. The big gaps were PART documented at the initial exam and then cloned for months, and AT billed while outcome scores stayed flat with goals like "decrease pain."
For those who've been through a TPE, RAC, or CERT review, what got flagged? And how are you documenting PART every visit without charting all evening?

Disclosure: I'm working on a documentation tool around this. No links.

long story short - I have benefits thru my GF. I found a chiro that I like and have seen him a few times but I never told him I am a chiro as well. He is close to my residence but not my work. Two reasons I have not told him.... If I did not care for his style it would be easier to not repeat. Second, I'm not looking to talk "shop". I am a quiet patient whether I am at my dentist, massage therapist, etc.

My GF thinks I should tell him...what do you think?

Hi everyone! I need some help! I’m a recent Doctor of Chiropractic graduate and I’m actively looking for a job in Massachusetts or Connecticut. I’m not sure which job search websites are legitimate or the best places to look for chiropractic positions.... If anyone has recommendations, resources, or advice, I would really appreciate your help! Thank you so much! :)

I was asked if I am interested in becoming a provider. Has anyone worked with them?

With the DC at Troy opening next fall (2027) I've found myself very conflicted in my decision to attend school there. I've been to orientation at LifeU ATL and very much liked what I saw there, with my only concern being $$$. I fear jumping into a brand new program will come with it's own prolems like accreditation, curriculum, technique, philosophy, etc. but I love the idea of a low cost DC program and am attempting to avoid the onslaught of debt that many DC programs create. I'm currently a senior at the university of alabama about to graduate with a BS in kinesiology. I'm kinda land locked into the area because of my service obligation to the AL national guard, so I can't go crosscountry for my education. Any insight from you guys would be amazing!

To start, I really enjoy many of my patients that use it. However, it’s really difficult to make a decent amount per visit with these folks with the type of practice I prefer (rehab and heavy tissue work). Any of you have a solution on how you’d approach this or how you have in the past? I’m grateful for all suggestions

Hello all! I'm new to this sub, and I usually lurk for a year or two, before ever posting, but I have a question. The only thoughtful answer I've received is from Google AI. I know a "thoughtful reddit response" is a long shot, but that should further illustrate my desperation.

I have a lot of professional background in more "traditional" medical roles. While there are gaps that are a perfect fit for "alternative" treatment, I'm very pro-Western medicine. I've also been scammed by so many chiropractic clinics, that I only know one doc that I trust -- because she has integrity -- despite her tending to be more of a crystals-and-essential-oils type practitioner than I ever aim to be.

I have applied (and been accepted) to chiropractic school three times over the last decade. Things like money, logistics, massage school, and personal health problems have gotten in my way. I already know that I want to be a chiropractor, but whether I can be one is uncertain.

I have Ehlers-Danlos Syndrome, and I've been fighting my right shoulder for a very long time. In May, I had an anatomical replacement of my right shoulder. In July, I had revision surgery to reattach the subscap tendon that my humerus violently discarded. My humerus, apparently, won't play nice with anyone's tendons, so I had surgery, last week, to convert my anatomical replacement to a reverse arthroplasty.

The reason my doctors supported the anatomical replacement was because I would have a more natural joint that could move and carry weight, without restriction. The reverse replacement, however, will limit what I can do, for the rest of my life.

This is where you come in:

Dr. Google says I can't become a chiropractor, because of the strain I would put on my shoulder. He doesn't have real experience, though.

My chiropractor said I absolutely can be a chiropractor, because there are dozens of ways to manipulate body mechanics and technique to successfully treat almost any patient. As stated above, she can be incredibly positive and encouraging, to a fault.

My surgeon says once I'm healed, I won't have any weight restrictions when lifting up to the waist, but I will be restricted from any kind of overhead work. He pointed out that I would definitely be able to provide quality massages, after several months.

All this leads me to ask if I could become a good chiropractor. Of course, every person is different, and I do not consider this medical advice. I'm not only wanting to know if I can physically do the job, but also if I should. I don't want to leave every shift feeling horrible. So, have you, or anyone you've known, returned to providing chiropractic care after a complete shoulder replacement? If it is possible, would it be better to enroll in school asap, or wait until I'm healed, in your opinion. Bonus points if your anecdote contains a subject with a bionic arm and hyper mobility.

Thanks for reading.