Ask the Billing Expert

Samuel A. Collins

Samuel A. Collins is an expert in chiropractic insurance billing for the H.J. Ross Network, a consulting group for doctors on billing and collection for insurance claims. His background is in the chiropractic profession, where he supervised a high-volume chiropractic clinic for 16 years. You are encouraged to submit billing questions to Mr. Collins at sam@hjrossnetwork.com. Your question may be the subject of a future column.

Previous Articles

Multiple-Procedure Claim Reductions?
August 1, 2025 (Vol. 43, Issue 8)
ICD-10 Coding Updates Affecting Chiropractors
December 1, 2024 (Vol. 42, Issue 12)
UHC/Optum Requires Preauthorization for Medicare-Covered Chiropractic Services
November 1, 2024 (Vol. 42, Issue 11)
Is Electronic Billing / EHR Mandatory?
September 1, 2024 (Vol. 42, Issue 09)
New Medicare Payment Increases Offset Earlier 2024 Reductions
July 1, 2024 (Vol. 42, Issue 07)
Requesting a PPO Rate Increase
April 1, 2024 (Vol. 42, Issue 04)
CPT Coding Changes for 2024
February 1 2024 (Vol. 42, Issue 02)
Diagnosis Code Updates for DCs
December 1, 2023 (Vol. 41, Issue 12)
Billing Insurance: Getting Started
August 1, 2023 (Vol. 41, Issue 08)
Can You Bill for Extra Effort?
May 1, 2023 (Vol. 41, Issue 05)
Relative Value Units Up for 2023 - But Are You Getting Paid More?
March 1, 2023 (Vol. 41, Issue 03)
When Insurers Try to Get Your Money Back
January 1, 2023 (Vol. 41, Issue 01)
ICD-10 Diagnosis Code Updates
November 1, 2022 (Vol. 40, Issue 11)
Diagnosis Denials: "Excludes 1" Codes
September 1, 2022 (Vol. 40, Issue 09)
Sequestration: The Reason Why Your Medicare Payment Is Suddenly Lower
July 1, 2022 (Vol. 40, Issue 07)
Insurers Are Contacting DCs About Their Coding Patterns
May 1, 2022 (Vol. 40, Issue 05)
No Surprises Act Takes Effect
March 1, 2022 (Vol. 40, Issue 03)
Medicare Deductible and Rate Changes for 2022
January 1, 2022 (Vol. 40, Issue 01)
Important ICD-10 Coding Changes for Chiropractors
December 1, 2021 (Vol. 39, Issue 12)
Accommodating Your Hearing-Impaired Patients
October 1, 2021 (Vol. 39, Issue 10)
PT Claims Being Denied – What You Can Do About It
August 1, 2021 (Vol. 39, Issue 08)
New Patient Digital Data Access Rule Takes Effect
June 1, 2021 (Vol. 39, Issue 06)
Updated E&M Codes a Big Benefit to Chiropractors
April 1, 2021 (Vol. 39, Issue 04)
Medicare Advantage and Humana Claims Being Denied
February 1, 2021 (Vol. 39, Issue 02)
Can You Overuse a Modifier? Guidelines for Using 59 vs. XS
December 1, 2020 (Vol. 38, Issue 12)
ICD-10 Updates for 2021
October 1, 2020 (Vol. 38, Issue 10)
Using the New Medicare ABN
September 1, 2020 (Vol. 38, Issue 09)
Insurers Expand Billing Options for Telemedicine
May 1, 2020 (Vol. 38, Issue 05)
Billing for Telemedicine Services
May 1, 2020 (Vol. 38, Issue 05)
E&M Denials When Billed With CMT: What to Do
March 1, 2020 (Vol. 38, Issue 03)
Code Changes for 2020
December 1, 2019 (Vol. 37, Issue 12)
Clearing Up the Confusion: Medicare Billing for DCs
October 1, 2019 (Vol. 37, Issue 10)
DME Billing Made Easy: The Modifiers That Matter
July 1, 2019 (Vol. 37, Issue 07)
Medicare Billing Done Right (Even in an All-Cash Practice)
May 1, 2019 (Vol. 37, Issue 05)
Getting Claims Paid: Common (& Not-as-Common) Modifiers
March 1, 2019 (Vol. 37, Issue 03)
VA Choice Claims Denied? Here's How You Can Get Paid
December 1, 2018 (Vol. 36, Issue 12)
Important ICD-10 Updates
October 1, 2018 (Vol. 36, Issue 10)
Why the Automatic Denials for Modifiers 25 and 59?
August 1, 2018 (Vol. 36, Issue 08)
VA and Medicare Billing: Case of the Missing Modifier
June 1, 2018 (Vol. 36, Issue 06)
Does # of Services Raise a Red Flag With Insurers?
February 1, 2018 (Vol. 36, Issue 02)
76499: Can I Use This Code?
September 1, 2017 (Vol. 35, Issue 09)
Coding for Maintenance Care
August 1, 2017 (Vol. 35, Issue 08)
Medicare 101: New ABN, Fee Reductions
June 1, 2017 (Vol. 35, Issue 06)
Is the New Medicare Reporting Exemption Right for You?
May 1, 2017 (Vol. 35, Issue 05)
Let's Clear Up the Collection Confusion
February 1, 2017 (Vol. 35, Issue 02)
First Annual ICD-10 Updates Take Effect
November 1, 2016 (Vol. 34, Issue 17)
Code Connection: Guidelines for the Use of Modifier -52
October 1, 2016 (Vol. 34, Issue 16)
Billing One-on-One, Direct Patient Contact
July 1, 2016 (Vol. 34, Issue 13)
Recording and Appropriate Billing of Timed Physical Medicine Services
April 15, 2016 (Vol. 34, Issue 08)
Coding and Billing Updates for Spinal X-Rays
February 15, 2016 (Vol. 34, Issue 04)
ICD-10 Coding Tips: Lesson #1
December 1, 2015 (Vol. 33, Issue 23)
Troubleshooting: Billing Multiple Fees for the Same Service
October 1, 2015 (Vol. 33, Issue 19)
Coding for Functional Performance Testing and Measurements
July 15, 2015 (Vol. 33, Issue 14)
Coding for Strains and Sprains in ICD-10
June 1, 2015 (Vol. 33, Issue 11)
Ringing in the Billing New Year
January 15, 2015 (Vol. 33, Issue 02)
Billing for Same-Visit Extraspinal and Spinal Manipulation
September 1, 2014 (Vol. 32, Issue 17)
Deciphering the New CMS-1500 Claim Form
July 15, 2014 (Vol. 32, Issue 14)
Top 5 Billing Issues for 2014
January 1, 2014 (Vol. 32, Issue 01)
Multi-Therapy Payment Reduction
January 15, 2013 (Vol. 31, Issue 02)
Billing for Groupon-Style Services
November 18, 2012 (Vol. 30, Issue 24)
Billing for Elastic Therapeutic Taping
August 12, 2012 (Vol. 30, Issue 17)
New 5010 Standards, Electronic Health Records and the ICD-10
October 21, 2011 (Vol. 29, Issue 22)
When Is It Appropriate to Use Consultation Codes?
August 12, 2011 (Vol. 29, Issue 17)
Billing for Phone Calls and Communication With Patients and Providers
June 17, 2011 (Vol. 29, Issue 13)
Billing Medicare for Instrument-Assisted Chiropractic Manipulation
February 12, 2011 (Vol. 29, Issue 04)
Minor Code Changes for 2011
January 15, 2011 (Vol. 29, Issue 02)
Billing Q&A: ROM Testing, Record-Keeping, Consultations and More
October 21, 2010 (Vol. 28, Issue 22)
Billing Flexion-Distraction Services
July 29, 2010 (Vol. 28, Issue 16)
Dealing With Visit Caps
June 17, 2010 (Vol. 28, Issue 13)
Billing for Unattended Ultrasound
May 6, 2010 (Vol. 28, Issue 10)
Insurance Waivers and Maintenance Treatment
March 26, 2010 (Vol. 28, Issue 07)
Billing for Modalities
February 12, 2010 (Vol. 28, Issue 04)
Billing Code Updates for the New Year
January 1, 2010 (Vol. 28, Issue 01)
Preventing Identity Theft: What You Need to Do
September 9, 2009 (Vol. 27, Issue 19)
Medicare and Chiropractic: Clearing Up Some Billing Misconceptions
July 15, 2009 (Vol. 27, Issue 15)
Can You Charge for Requests for Records?
July 1, 2009 (Vol. 27, Issue 14)
Coding/Billing for Strapping and Taping
April 9, 2009 (Vol. 27, Issue 08)
New Codes for a New Year
January 15, 2009 (Vol. 27, Issue 02)
Denial for Services Done by Staff
December 2, 2008 (Vol. 26, Issue 25)
Billing for Service to an Area Not Manipulated
November 18, 2008 (Vol. 26, Issue 24)
Coding for Active Care
September 23, 2008 (Vol. 26, Issue 20)
Problems With Medicare Reimbursement
August 12, 2008 (Vol. 26, Issue 17)
Negotiating for Timely Reimbursement
June 3, 2008 (Vol. 26, Issue 12)
Medicare Advanced Beneficiary Notice and Maintenance Services
May 20, 2008 (Vol. 26, Issue 11)
Billing for Missed Appointments
May 6, 2008 (Vol. 26, Issue 10)
Billing for Low-Level Laser Therapy
April 22, 2008 (Vol. 26, Issue 09)
How Often to Bill for Re-Exam
April 8, 2008 (Vol. 26, Issue 08)
Refunds for Expired Policies
February 12, 2008 (Vol. 26, Issue 04)
New Updates to CPT Codes?
January 29, 2008 (Vol. 26, Issue 03)
New Diagnostic Codes for the New Year
January 15, 2008 (Vol. 26, Issue 02)
Codes for Soft-Tissue Work
December 3, 2007 (Vol. 25, Issue 25)
How Do You Code for Spinal Decompression?
November 19, 2007 (Vol. 25, Issue 24)
Discounting Services for Certain Patients
November 5, 2007 (Vol. 25, Issue 23)
Billing for Unusual Procedures or Services
October 8, 2007 (Vol. 25, Issue 21)
Tips on Billing for Multiple Modalities
September 24, 2007 (Vol. 25, Issue 20)
Is This Double-Dipping?
August 27, 2007 (Vol. 25, Issue 18)
Billing Secondary Insurance
August 13, 2007 (Vol. 25, Issue 17)
What Are Bundled Services?
July 16, 2007 (Vol. 25, Issue 15)
Concurrent Billing of Manual Therapy and Chiropractic Manipulative Therapy
June 18, 2007 (Vol. 25, Issue 13)
Deadline to Use Updated CMS 1500 Forms Extended – Again
May 21, 2007 (Vol. 25, Issue 11)
Billing Units of Service: The Element of Time
April 23, 2007 (Vol. 25, Issue 09)
The "G" Code
April 9, 2007 (Vol. 25, Issue 08)
Appropriate Billing for Foot Orthotics
March 26, 2007 (Vol. 25, Issue 07)
Appropriate Billing for Electrical Stimulation
February 26, 2007 (Vol. 25, Issue 05)
What to Know About Coding Changes for 2007
February 12, 2007 (Vol. 25, Issue 04)
Demonstrating/Documenting Functional Improvement
January 29, 2007 (Vol. 25, Issue 03)
Common Errors/Omissions That Will Cause Medicare to Reject Your Claim
January 15, 2007 (Vol. 25, Issue 02)
Billing Secondary Insurance
January 1, 2007 (Vol. 25, Issue 01)
Indicating Place and Type of Service
December 3, 2006 (Vol. 24, Issue 25)
Updates to the ICD-9: How Do They Affect Chiropractic?
November 21, 2006 (Vol. 24, Issue 24)
Can Multiple Services Be Billed in a Single Visit?
November 8, 2006 (Vol. 24, Issue 23)
Common Codes for Supports and Medical Equipment
October 26, 2006 (Vol. 24, Issue 22)
Common Modifiers and How to Use Them
October 12, 2006 (Vol. 24, Issue 21)
Making Sure the Patient Is Covered
September 28, 2006 (Vol. 24, Issue 20)
Revisions to the CMS1500 Form Are on the Way
September 14, 2006 (Vol. 24, Issue 19)
Revisions to the CMS1500 Form Are on the Way
September 14, 2006 (Vol. 24, Issue 19)
Third-Party Fee Reductions
September 1, 2006 (Vol. 24, Issue 18)
What's My NPI?
August 15, 2006 (Vol. 24, Issue 17)
Getting Claims Paid on Time
July 30, 2006 (Vol. 24, Issue 16)
CPT Code Update
July 16, 2006 (Vol. 24, Issue 15)
Billing for Massage - Specific CPT Codes
July 4, 2006 (Vol. 24, Issue 14)
Billing for Review of X-Rays
June 20, 2006 (Vol. 24, Issue 13)
Billing for Sunday Visits and Out-of-Office Visits
June 6, 2006 (Vol. 24, Issue 12)
Billing for Same-Day Visits and Medicare Documentation
May 22, 2006 (Vol. 24, Issue 11)
CPT Coding for Massage
May 8, 2006 (Vol. 24, Issue 10)
Billing for Code 98942
April 24, 2006 (Vol. 24, Issue 09)
What Code Can I Bill for a Report of Findings?
April 10, 2006 (Vol. 24, Issue 08)
Billing for Services: The Element of Time
March 26, 2006 (Vol. 24, Issue 07)
Service/Place of Service Codes
March 12, 2006 (Vol. 24, Issue 06)
Appropriate Use of Billing Code 97140
February 27, 2006 (Vol. 24, Issue 05)
Accounting for Extra Time Spent With the Patient
February 13, 2006 (Vol. 24, Issue 04)
Know Your Billing Codes
January 29, 2006 (Vol. 24, Issue 03)
Medicare Regulations and Limits on Care
January 15, 2006 (Vol. 24, Issue 02)
Examination Denials
January 1, 2006 (Vol. 24, Issue 01)
Trending
Billing / Fees / Insurance
Best Practices for Handling Refund Requests
Handling Refund Requests

Refund requests are an unavoidable part of running a chiropractic practice. Whether a patient is unhappy with their care, believes an adjustment caused harm, or simply changes their mind, these situations must be handled carefully to avoid escalation. While chiropractors are not legally obligated to issue refunds in most cases, there are times when doing so is the best business decision to protect the practice.

Brandon Hoffman, BA
Rehab / Recovery / Physiotherapy
Don't Forget the Iliacus
Don't Forget the Iliacus

Back pain? Blame the psoas. Seems as if everybody wants to dive headfirst into their psoas at the first sign of trouble with the lumbopelvic-hip region. Perhaps no other muscle is blamed more for causing problems than the psoas. Yes, it is an important stabilizer of the lumbar spine, but it shouldn't be the only one on which you focus. There is another big player on the scene: the iliacus.

Perry Nickelston, DC, FMS, SFMA
News / Profession
Chiropractic: State by State
Chiropractic: State by State

Interested in providing a new service? Need to know whether you can pursue dry needling, venipuncture or even animal chiropractic? Or perhaps you’re advising a prospective chiropractic student who doesn't know whether a bachelor’s degree is required for licensure in your state. The answers to these questions and more are available on Chiropractic Future’s Government Affairs Hub.

 |  Digital Exclusive
Dynamic Chiropractic Staff