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🚨 ATTENTION CHIROPRACTIC OFFICES & BILLING TEAMS 🚨

Medicare has released an updated Advance Beneficiary Notice (ABN), and there are some important deadlines and changes you need to know!

👉 You may continue using the current ABN form through May 12th
👉 Starting May 12th, all Medicare patients must sign the NEW ABN form at their first visit

💡 Pro Tip:
We highly recommend starting this process BEFORE May 12th to avoid workflow disruptions and stay ahead of compliance requirements.

⚠️ Important Reminders:
✔️ There have been several changes to the new ABN—make sure you are reading and understanding the updated instructions before issuing it to patients
✔️ How you participate with Medicare (participating vs. non-participating) will impact how and when you use the ABN
✔️ Pay close attention to guidance regarding QMB (Qualified Medicare Beneficiary) patients—there are strict rules, and you may NOT bill them in certain situations, even with an ABN

📥 Download the NEW ABN (English & Spanish) + Instructions here:
https://www.cms.gov/medicare/forms-notices/beneficiary-notices-initiative/ffs-abn

If you need help making sure your office is using ABNs correctly, we’re here to help! 💙

FFS ABN | CMS The Advance Beneficiary Notice of Noncoverage (ABN), Form CMS-R-131, is issued by providers (including independent laboratories, home health agencies, and hospices), physicians, practitioners, and suppliers to Original Medicare (fee for service - FFS) beneficiaries in situations where Medicare payme...

🚨 Chiropractors: A Reminder to Protect Your Practice 🚨

A recent lawsuit filed by Allstate against a Texas chiropractic network is making headlines in the healthcare and insurance world. The insurer alleges that over 1,200 auto-injury claims totaling more than $22 million involved standardized treatment plans, excessive services, and improper billing practices.

While the allegations in the case have not yet been proven in court, stories like this serve as an important reminder for all healthcare providers—especially those treating auto accident and personal injury cases—to stay vigilant about compliance and documentation.

✔ Make sure your care is medically necessary and individualized
✔ Ensure accurate documentation and coding
✔ Be cautious with Letters of Protection (LOPs) and billing structures
✔ Maintain proper supervision of staff and assistants
✔ Charge reasonable and defensible fees for services provided

When billing practices become questionable, it doesn’t just impact one clinic—it can bring increased scrutiny to the entire profession.

At the end of the day, ethical billing, strong documentation, and compliance protect your patients, your license, and your practice.

👉 Take a moment to read the article here:
https://www.insurancebusinessmag.com/us/news/claims/allstate-sues-texas-chiropractic-network-over-25-9-million-auto-claims-scheme-567795.aspx

Allstate sues Texas chiropractic network over $25.9 million auto claims scheme 1,253 claims, $22 million+ in charges, and what Allstate describes as 'cookie-cutter' care

Check out our 1st TikTok and meet our team of extraordinary women!

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🎥✨ We’re on TikTok! ✨🎥

C3 Plus is officially on TikTok and we’d love for you to follow along!

We’ll be sharing quick, helpful videos on topics that matter to chiropractic clinics, including:
✔️ Billing tips
✔️ Compliance guidance
✔️ Credentialing help
✔️ Front desk training
✔️ Common insurance mistakes
✔️ Practice growth ideas

Our goal is to help your clinic stay paid, compliant, and confident while giving you easy tips you can actually use in your practice.

👉 Follow us here:
https://www.tiktok.com/.plus?_r=1&_t=ZT-94UmU5suIkX

Let us know in the comments what topics you’d like us to cover! 🎥💬

C3 Plus is expanding our educational content for chiropractic clinics.

We want to hear from YOU.

What would be most helpful right now?

✔ Insurance verification tips
✔ Timely filing appeals
✔ AR clean-up strategies
✔ Credentialing timelines
✔ Compliance guidance
✔ Front desk training checklists
✔ EOB posting workflows

Comment below with topics you’d like us to cover or message us privately.

Our goal is simple: provide practical tools that help your clinic stay compliant, profitable, and organized.

If you’re a chiropractor and you’re not paying attention to credentialing… you should be. 👀

Credentialing isn’t just paperwork — it’s the backbone of getting paid correctly and staying compliant.

Here’s something many providers don’t realize:

👉 Chiropractors cannot opt out of Medicare.

Under Medicare rules, Doctors of Chiropractic are mandatory participating providers for covered chiropractic services (specifically spinal manipulation under Medicare Part B). Unlike some other provider types, chiropractors are not permitted to privately contract with Medicare beneficiaries for covered services by “opting out.”

That means:
✔️ If you treat a Medicare patient for a covered chiropractic service
✔️ You must bill Medicare
✔️ You must follow Medicare documentation and coverage rules
✔️ You cannot bypass Medicare and charge the patient privately for covered adjustments

Failing to credential properly — or misunderstanding Medicare participation rules — can lead to:
• Payment delays
• Recoupments
• Compliance issues
• Audit exposure

Credentialing isn’t optional. Compliance isn’t optional. And Medicare rules definitely aren’t optional.

If you’re unsure about your Medicare status, revalidation dates, or payer enrollments, now is the time to review them. Staying proactive protects your license, your revenue, and your clinic. 💼📋

🎂 Understanding the Insurance “Birthday Rule” 🎂

If you or your child have two insurance plans, one is considered primary and the other secondary. Insurance companies use the Birthday Rule to determine which plan pays first.

Here’s how it works:📅 It goes in order of Month → Day → Year📅 The parent whose birthday comes first in the calendar year has the primary insurance📅 The other parent’s plan becomes secondary

Examples:

✔ Example 1 (Different Months):Mom: March 10, 1985Dad: August 22, 1980➡ Mom’s insurance is primary because March comes before August.

✔ Example 2 (Same Month, Different Day):Mom: June 5, 1987Dad: June 18, 1983➡ Mom’s insurance is primary because the 5th comes before the 18th.

✔ Example 3 (Same Month and Day, Different Year):Mom: September 12, 1990Dad: September 12, 1985➡ Dad’s insurance is primary because his birth year is earlier.

This rule also applies with spouses.

Why this matters:✔ Prevents claim delays and denials✔ Ensures insurance pays correctly✔ Helps maximize your benefits

💡 Always have your patients bring ALL active insurance cards and notify us of any changes so we can verify your coverage properly.

We’re here to help make your care simple and stress-free! 🤍

🚨 New Year = New Insurance Rules! 🚨

Chiropractic offices — The new year is NOT the time to assume everything stayed the same.

With the start of a new year, patients often have:

✔️ New insurance plans
✔️ New member ID numbers
✔️ New deductibles
✔️ Reset benefits
✔️ New referral requirements
✔️ Updated prior authorization rules

Even if it’s the same insurance company, their plan details likely changed.

📌 Best Practice Checklist for Your Front Desk:

🔎 Always request a copy of the new insurance card (front AND back)
📞 Re-verify benefits — don’t rely on last year’s notes
📄 Confirm if a new referral or authorization is required
💰 Check updated deductible and out-of-pocket amounts
🗓 Confirm visit limits for chiropractic care

Skipping these steps can lead to claim denials, delayed payments, and frustrated patients.

The beginning of the year sets the tone for your entire revenue cycle. A few extra minutes verifying coverage can save months of AR cleanup later.

Start the year strong. 💪

Send a message to learn more

🚨 PROVIDERS: Don’t Let an Outdated CAQH Cost You Money 🚨

Keeping your CAQH profile up to date and revalidated is one of the most important (and most overlooked) steps in maintaining your insurance contracts.

✔️ Insurance companies will NOT process credentialing, recredentialing, or claims if your CAQH is expired or incomplete
✔️ CAQH must be attested every 120 days—even if nothing has changed
✔️ Missing revalidation can lead to payment delays, claim denials, or inactivation with payers

📌 Pro tip: Set a reminder and update your CAQH anytime there’s a change to:
• License
• Malpractice insurance
• Practice location
• Tax ID or ownership
• W-9 or EFT info

Staying current = staying paid.

🚨 Attention Chiropractors! 🚨

A few changes are coming with the ICD-10 updates on October 1st, especially in the musculoskeletal category! 🦴✨

These updates aim to improve coding specificity and accuracy, enhancing patient care and streamlining billing processes.

Under M51 Thoracic, thoracolumbar, and lumbosacral intervertebral disk disorders, there are new six-character codes that allow the practitioner to specify the location of pain more succinctly.

Be sure to review the new codes, as they can impact your practice and how you document musculoskeletal conditions.

Stay informed, get ready to adapt, and let’s keep providing the best care possible! 💪

Send a message to learn more

Looking for a great seminar to get your CE hours and the Texas Mandatory 4-board hours. Join us September 6-8. The Texas board hours will be on Sunday, September 8 from 8-12 in person or webinar options available.

Courtney Gowin is hosting the pediatric CE Seminar on Friday and Sat and I will be teaching the board hours on Sunday. Looking forward to seeing you. Contact me for further questions.

wanderlearn.wetravel.com