Denial appeals · Chiropractic
“Maintenance care” is the payer's favorite word. Your documentation says otherwise.
Chiropractic claims live under constant medical-necessity pressure: active-treatment denials, visit caps, and Medicare AT-modifier disputes. The dollar amounts per claim are small — the annual write-off isn't.
Free for your first 10 claims. Then 15% of recovered revenue only — upheld denials cost you nothing.
The denials you're seeing
We know these EOBs by heart.
| Denial | What the payer said | Why it's often winnable |
|---|---|---|
| CO-50 | Not medically necessary — 'maintenance care' (98940–98942) | The active-treatment vs. maintenance distinction turns on documented functional improvement. Your SOAP notes usually contain the proof; the denial pretends they don't. |
| AT modifier | Medicare active-treatment disputes | AT-modifier denials hinge on treatment-plan documentation showing expectation of improvement — an evidentiary argument we build claim by claim. |
| CO-151 | Visit limits exceeded | Plan caps with exception provisions get applied as absolute. We force the payer to apply its own exceptions. |
| CO-16 | Missing information — initial exam, X-ray findings | Correctable documentation defects, cured and resubmitted instead of written off. |
| CO-29 | Timely filing | Proof-of-submission and payer-error exceptions recover more of these than expected. |
How we fight them
Specialty-specific arguments, not form letters.
Improvement evidence
We translate your outcome measures — pain scales, Oswestry, ROM — into the payer's own coverage language, showing active treatment, not maintenance.
Beginning, middle, end
Payers deny when care looks open-ended. We frame the documented plan's goals and discharge criteria to defeat the maintenance label.
Batch appeals
Individually, a $60 adjustment denial isn't worth staff time. Batched on contingency, a year of them is real money — and it costs you nothing to find out.
Free 10-claim pilot
Find out what your write-offs were actually worth.
Tell us a little about your practice. We'll reply within one business day with the BAA and a secure upload link.