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Evaluating Chiropractic Office Systems
Today, there are hundreds of software systems dedicated to the practice of chiropractic medicine. In a sea of available software programs, which applications pay the biggest dividends? In this 2018 Chiropractic Software review, we look at the top 8 applications prized by savvy chiropractors and chiropractic office managers. The key indicators guiding selection of the right system for your needs include:
Type of Software: Cloud vs Local Server. Desktop vs. Web-Based.
Stand-alone programs vs. All-in-one Systems
Advanced features required by today’s modern chiropractic physician
Define Chiropractic Software. Definition: Chiropractic software refers to the computer programs and software systems chiropractic physicians use to manage their business and document the examination and clinical treatment of diagnoses related to mechanical disorders of the neck and spine. Most often these systems include an appointment calendar to book and keep track of patient appointments, an EHR program used to document clinical exams and treatment, and a billing system designed specifically for chiropractic to apply payments, print receipts, and bill health insurance plans.
Chiropractic is concerned with the diagnosis and treatment of mechanical disorders of the neck and spine, and the software used to organize the practice and document treatment of these disorders is known as chiropractic software.
The Pros & Cons of Chiropractic Office Software
Advantages – The Pros
Many small chiropractic offices can run smoothly without relying on software to organize their workflow or bill insurances, but busier offices find that the efficiencies achieved with specialty specific software create a better patient experience and help make the practice operate smoother and more profitably.
Today’s modern chiropractic physicians rely on smartphones, tablets, laptops, and personal computers to streamline patient workflow and manage cashflow. Good software helps staff organize office tasks, helps physicians document treatment, and allows accounting to reconcile payments – in short, it makes the day run smoother and more efficiently with an eye towards better revenue management.
Disadvantages – The Cons
As mentioned above, good software helps do all these things, but many of the clinical software made for chiropractic offices today are stand-alone programs that don’t speak to one another. In order to achieve efficiencies that can make a busy practice more profitable, there’s a need for integrated all-in-one systems that manages a practice seamlessly, in continuity from end to end.
But many physicians also maintain multiple offices on opposite ends of town to make treatment access easier for clients. Simple desktop programs cannot accommodate the needs of today’s cyber physicians who need access to schedules and patient data where ever they happen to be.
Activating your account is simple and we provide training resources to help you every step of the way.
Cloud-Based Versus Desktop and Local Server Based Systems
Although web-based and cloud based office systems still comprise a smaller percentage of the software market, it’s use is on the rise as chiropractors realize the freedom provided by anywhere, anytime access to data, the advantages of automatic data backup, and increased security against cyber-attacks. As chiropractors become modern cyber warriors, the paradigm of locally installed legacy systems becomes less and less attractive – a glaring misfit to modern chiropractic life. Additionally, the cost of locally installed server-based systems can exceed the cost of web based solutions, but without the added benefits of anywhere, anytime access from any connected device provided by the subscription-based software-as-a-service cloud delivery model (SaaS).
In this 2018 review of the most needed chiropractic applications, the following 8 apps are a must have for today’s DC practises.
Chiropractic Patient Portal with important patient self-service capabilities such as scheduling appointments, securely communicating to the practice, reviewing medical records, and managing their bills
A Check-In Kiosk to automate patient check-in, expedite patient form completion, and reduce wait times
A Chiropractic Appointment Scheduler with the flexibility to accommodate recurring patient visits and reminding patients about upcoming appointments
A Chiropractic EHR software with tools to review, document, and build treatment plans for patients
A Chiropractic Billing System to manage both patient payments and the complex insurance claim filing process
A Product Inventory System which tracks medical supplies used and sold within the chiropractic practice
A Chiropractic Marketing Software to improve patient outreach through online communication and education
An Online Review Management Software to manage patient reviews and monitor patient satisfaction
Improving Patient Care with Web-based Software
Who in the Chiropractic Industry Makes These Advanced EHR Systems?
Vendors of chiropractic EMR software with onc-atcb certification will likely offer one of three ways to buy the software and services. The most modern option is a monthly subscription service through which a practice will be given access to the software based upon the number of users or the numbers of providers. The best monthly subscription models opt to earn the trust of the practice each month without requiring annual contractual agreements. The monthly subscription model also tends to include training on the software, routine updates, and on-going maintenance to the software in the monthly services fee. Users on this model tend to praise the affordability, contractual freedom, and all-inclusive pricing.
The second model involves the purchase of an annual license to use the software, a very business model in the late 1990’s and early 2000’s. This model follows the traditional software license model where a practice pays an up-front cost for the software. This upfront cost typically includes the first year of access to the software, training, and setup fees. After the first year, the practice will be responsible for on-going support, maintenance, and upgrades which are paid in the form of annual software support fees. These software support fees can range from 10 – 25% of the initial purchase price. Users on this model typically have budget and/or tax reasons to make a larger purchase one year and pay smaller amounts in the following years. These users also don’t mind being under a contractual obligation for 2 – 5+ years.
Evaluate Free and Paid Costs for Chiropractic EHR View Pricing
A third model of purchasing chiropractic EMR software is seldom used today, but historically was the only way to purchase software when physical disks and CDs were bought in boxes on a shelf at retailers – the one-time license fee. In the one-time license model, the practice would pay a set price for the software and then receive the software on a disk, install it on the computers, and use it for as many providers and users as the license allows. Users who elect this model often wish to have no contracts nor any recurring fees. In fact, they may not upgrade or purchase additional features until regulatory changes require an upgrade.
Chiropractic Billing Service Solutions
The management of the chiropractic revenue process is not only critical to business sustainability, but it is also paramount to patient satisfaction. Many Chiropractic physicians elect to primarily focus on providing expert treatment and patient care, which is typically the area of training and passion for chiropractic business owners. With their focus on patient care, they contract with specialized companies to manage the complexities of insurance reimbursements, collections, and payment reconciliation processes. A third-party service benefits chiropractors in many ways:
Reduce Overhead & Risk: Using specific service levels agreements (SLAs) defined by the business relationship between the office and the contracted billing company, Chiropractors can hold these outsourced entities to specific cost thresholds, coverage thresholds, and compliance thresholds. In so doing, they reduce the variability in budget and are better able control risk compared to the hassles of hiring, training, managing, and firing their own employees.
Maximize Revenue: By working with a service that stakes its livelihood on being the expert in obtaining payer reimbursements, chiropractic practices can leverage these experts to maximizing coding, preparation and submittal of insurance claims that have a high probability of being paid quickly, and reduce the accounts receivable and aging payment balances that haunt many offices.
Avoid Costly Reimbursement Mistakes: When working with a company who manages payer reimbursements for many offices, practices benefit from the collective knowledge gained by the service on how to avoid denied claims, how to work with payers, and how to conform with claim requirements for advanced programs such as MU, MACRA, MIPPS, PQRS and other quality-based reimbursement initiatives impacting chiropractic incentive payments.
What Are The Benefits of Offering Your Clinic Doctor Integrated EHR?
A Technology Advocate: With the technology and software apps used for chiropractic insurance adjudication, a third party company provides a layer of expertise on how systems can work together to improve patient flow and revenue. This is commonly an overlooked value of working with a hired service, but can greatly reduce the hassles office staff would be left to deal with on their own. One of the secret weapons used by revenue cycle management services is the EHR (Electronic Health Record) with integrated Practice Management Software. By using a single platform that connects the clinical side of the business with the financial side of the business, the RCM service provider is able expedite the revenue cycle because they receive data instantly from the clinical documentation. The faster the diagnoses, procedure, and other treatment codes get to the partner service, the faster the office will get paid for those services.
And, of course, many chiropractors simply find the greatest value in using an outsourced chiropractic billing company is not just increased collections, but the freedom to focus on serving the health and wellness needs of their patients without getting bogged down in administrative tedium of processing insurance claims. More time with patients equates to greater revenue potential and better work / life balance.
Paid Chiropractic Systems Versus Free
The purchasing models discussed above assume there is a fee for the software, but that is not always the case. Today’s chiropractic offices have the choice to use and/or test drive chiropractic applications without committing to a purchase. Below are several commonly used free options
Free Demos: Most, if not all emr software makers will give prospective practices the chance to see a guided demonstration of the software led by the company’s subject matter expert. This free demo is part of the typical sales cycle and may be one-on-one, pre-recorded, or a part of a group demonstration. Aggressive software makers will take the free demo a step further and give practices access to a limited version of the software to try for themselves. However, the limited version is usually a “sandbox” or non-production environment not to be used for live data or patients.
Free trials for limited time: This free option provides practices access to a fully functioning version of the software. However, the access comes with time restrictions. After 5, 10, 14, or even 30 days of access, the practice must make a purchase decision to buy access to the software should they wish to continue using it. Many chiropractic offices use this method to try out the workflows and may begin use with patients if they are seriously considering the upgrade once the free trial has expired.
Free Use for Single user: Software makers who believe even the free version of its software will be valuable will offer a completely free version. Practices typically elect to use this free version to manage the business and clinical activities with real patients in a real production environment. Depending on the size of the organization or the advanced capabilities needed, it may elect to upgrade from the free version to the paid subscription to add more users or to enable the software to handle larger volumes of patient or financial transactions.
When evaluating free options for office software, it is wise to ask questions about access limitations and whether the software maker recommends using the free version with real patients. At FreeChiro, the free appointment scheduler, practice management software, and the free EHR are fully operational production versions of the software and we encourage you to use in real client setting.
What Software Features Should I Look For?
Chiropractic EMR: Document treatment easily and quickly using SOAP Notes EHR Software
Website Connectivity: acquire more patients and better serve existing patients through online services like appointment requests, HIPAA compliant messaging, and medical records access through tools that connect directly to an existing website.
Regulatory Compliance: safety, security, and access controls to help the practice maintain HIPAA compliance thresholds.
Chiropractic-Oriented Scheduling: to meet the demands of chiropractic operations with ability to easily create recurring appointments.
Visit Authorizations: effectively manage total number of visits authorized for a patient case based on authorization given by an insurance company, employer, or pre-purchased by the patient themselves.
Advanced Scheduling Management: tools front-office staff can use to easily capture the patient’s status for a visit – including check-in, rescheduled, no-show, or ready to be seen.
Patient Visit Reminders: modern, automated tools to alert patients of upcoming appointments via text messages and emails.
Cash Patient Collections: tools to easily take online payments, credit cards (including debit, credit, FSA, and HSA), setup payment plans when necessary, and manage post-visit cash collections to prevent aging patient-due AR balances.
Workers Comp Cases: ability to manage workers comp cases including those with primary and secondary payer obligations.
Motor Vehicle and Personal Injury Cases: tools to separate the reimbursement cycle based on company payment obligations and/or insurance related payers.
Coverage Eligibility: alerts that signify eligibility for coverage by insurance payers and give insights into deductibles, copays, and co-insurance
Branded Receipts & Statements: easy tools to automate the documentation of patient charges, total amount due, total amount paid and payment options whether the patient is at the clinic or already returned home.
Documentation & Notes: tools to document adjustments, check-up visits, wellness visits, and track progression on a patient’s treatment path.
Chiropractic Fee Schedule: capability to establish a standard practice fee schedule based on usual and customary fees as well as negotiated insurance specific fee schedules.
Under / Over Payment Analysis: reporting tools to help practices understand if the reimbursements and payments received from insurance companies matches the expected payment or is a under payment.
Executive Dashboard Reports: essential 6 month trending of charges, collections, and appointment efficiency across the organization.
Practice Performance Tracking: real-time dashboards indicating the practice’s status against personalized key performance indicators (KPIs) for the business of chiropractic.
Subscription, Coupons, or Concierge features that provide a way to manage family plans and unlimited monthly visits.
Social media management: Easily manage your online social media accounts from inside your Chiropractic practice management software
Email marketing campaigns: Easily manage email marketing campaigns on a single marketing dashboard from inside your chiropractic practice management software
Why the SOAP NOTE Approach To EHR?
Soap Notes are a simple, quick, and easy way to document the patient’s complaint and the finding of the chiropractic exam, and to document the treatment.
Subjective complaint – or chief reason for the visit
Objective finding of the physician examination
Assessment – or diagnosis (e.g. subluxation of the 4th lumbar)
Plan – or chiropractic adjustment or modalities such as Pulsed electromagnetic field therapy (PEMFT)
Value to Chiropractic Business Owners, Physician, Billers & Coders
Leading chiropractic solutions will have the winning combination of chiropractic-specific capabilities mixed with a level of chiropractic operational know-how by the team building and supporting the software. As a result, the critical stakeholders in a chiropractic organization will all benefit.
Business owners should always…
have tools to support a high standard of patient care
be confident that they will receive payment for services rendered
be able to leverage outreach and marketing tools to expand their patient base
have tools to effectively measure their revenue performance
Chiropractic physicians should always…
have mechanisms to engage patients online and drive high levels of patient satisfaction
be able to easily educate patients on their practice’s services and tips for optimal wellness
document adjustments, treatments, and prescribed wellness plans for patients
have tools to efficiently manage the revenue aspects of a visit
Chiropractic medical billers and coders should always…
have access to chiropractic relevant and billable diagnosis codes that align to today’s latest ICD-10 requirements
be able to accommodate and manage multiple revenue cycles for cash-pay scenarios, complex multi-payer cases, and traditional health insurance reimbursement
have access to tools to help manage recurring patient visit care plans and limits – whether imposed by the payer or as limits to a special care plan membership purchased by the patient.
know the status of payments and have paths to collecting any outstanding balances.
Chiropractic Systems Distinctives
One of the things that separates software built for Chiropractors from software built for generic medical specialties is the ability to accommodate unique chiropractic codes in the billing process.
Chiropractic Diagnosis Codes: candidates for the best chiropractic EHR software should include specific ICD-10 look-up tools addressing the diagnosis family of codes along with indicators for which codes are actually deemed billable. For instance, code M50.92 for Cervical disc disorder, unspecified in the mid-cervical region can not longer be on a claim. Instead, more detailed codes of M50.920, M50.921, M50.922, and M50.923 must be selected and placed on the claim to avoid risk of claim rejection or denial.
See sample ICD-10 look-up tool below from FreeChiro.com’s free chiropractic office platform.
There are many ICD Codes that can be applied to a chiropractic diagnosis, and although only a handful of CPT codes are reimbursable by medicare, modern integrated chiropractic medicine relies on a full spectrum of adjustment and therapy or treatment modalities for advanced patient care and wellness
CMT CPT Codes
Stretching, exercise and therapy codes
Pulsed electromagnetic field therapy (PEMFT)
Electronic muscle stimulation
New Patient Evaluation & Management
CPT 99201 Outpatient visit for the E&M of a new patient requires 3 key components: • a problem-focused history • a problem-focused examination • straightforward medical decision-making
Manipulative treatment CPT codes covered by Medicare
• 98940 Manipulation spinal, one to two regions. • 98941 Manipulation spinal, three to four regions. • 98942 Manipulation spinal, five regions. and • 98943 extraspinal.
97032 electrical stimulation 97033 iontophoresis 97034 contrast baths 97035 ultrasound 97036 Hubbard tank 97039 Unlisted modality (specify type and time of constant attendance)
Procedures eligible to be reported by a chiropractor are time-based and require direct one-on-one individual contact with the health care provider: • 97110 therapeutic exercises • 97112 strength and endurance, range of motion and flexibility • 97113 neuromuscular reeducation of movement, balance, coordination, kinesthetic sense, posture, and/or proprioception for sitting and/or standing activities • T97140 aquatic therapy with therapeutic exercises • 97140 manual lymphatic drainage, manual traction
What Distinguishes Chiropractic Medical Billing Software from Other Clinic Software?
Chiropractic Billing is different from all other medical billing because chiropractic care is different from traditional medicine in that it seeks to treat the root cause of a patient’s pain rather than treating symptoms. In the chiropractic profession, instead of reaching into a coat pocket and pulling out a handful of pill samples, Chiropractors deal directly and holistically with what is causing the patient’s suffering, thereby seeking to eliminate the cause.
The value of cloud-based practice management software in the chiropractic clinic
Chiropractic treatment has proven highly effective in treating both chronic and acute work related injuries, auto accident injuries, headache, TMJ, neck and back pain, shoulder pain, carpal tunnel, sports related injuries, muscle and joint pain, and disc and spinal injuries. Only a software that is designed specially to meet the needs of a chiropractor can take into account all the details specific to Chiropractic practice management.
Beyond it being flexible, robust, and easy to use, FreeCHIRO is custom tailored to the specific tasks of chiropractic treatment (Check Out Our Free SOAP Notes EHR), and our claim management software is specialized to chiropractic billing and personal injury.
Personal Injury Reimbursement :
Slip and Fall
Muscle Sprain (lower back pain)
Upper Thoracic Pain
Auto Accident Injury Claim Filing:
Chronic Headache due to subluxation.
Workers Compensation Injury Reimbursement:
Lower Back Pain
Middle Back Pain
Upper Back Pain
ALL PAYER Insurance Reimbursement
Personal injury claims
Bill All Payers
Whether you are a Medical Biller looking for Chiropractic Software, or a Chiropractor looking for Billing Software, shopping for a chiropractic system can be a daunting and time consuming task.
What Type of Software Features Should I Look For?
An EHR that’s Easy, Simple, Intuitive and Affordable
One Comprehensive and Complete EHR and Office System
Designed to Meet the Unique needs of Chiropractic Practice
Web Based – On The Cloud – No Software to Install or to Maintain!
NO ANNUAL UPGRADE FEES, ANNUAL SUPPORT OR LICENSING FEES
Beyond the information found on this resource guide, we encourage all practices to sign up for periodic alerts from FreeChiro.com’s expert interview series with practicing DC’s and practical operational tips from business managers and consultants.
State chiropractic organizations also provide incredible opportunities for state-level localization on policy and clinical care.
Links to State Chiropractic Associations
Conclusion – 6,000 Chiropractors Make Good Software!
One hundred percent of our office solution was designed by requests, suggestions, and feedback from all +6,000 Chiropractors using our system.
In this review of the best chiropractic software for 2018, the key indicators guiding selection of the right system for your needs include: 1) Office Setting. 2) Affordability. 3) Type of Software: Cloud vs Local Server. Desktop vs. Web-Based. 4) All-in-one Systems vs. stand-alone modules. 5) Support. 6) Advanced features such as patient portal, marketing modules, and online review management available.
A Word of Caution
When Chiropractic billing is misunderstood, the result can be thousands of dollars lost. Comprehensive chiropractic EHR with integrated claim management capabilities provides the tools every Chiropractic practice needs to be successful. Look for chiropractic office management software that offers credit-card processing and an emr solution combined with electronic billing with chiropractic icd codes such as 98941, 98942, 9894 or 99201 among the others referenced.
WHAT WOULD YOU LIKE TO SEE IN YOUR IDEAL SOFTWARE?
Chiropractic practice management provides the following chiropractor specific Features & Benefits to help make your practice more efficient and more profitable. Here are some major benefits!
Simple, Intuitive, Easy, and Affordable
Designed to Meet the Specific Needs of Chiropractors!
PATIENT SCHEDULING > CLINICAL EHR > BACK OFFICE > EDI > RCM > PRACTICE MANAGEMENT
ADDITIONAL POWERFUL practice management FEATURES:
Powerful & Flexible Patient Scheduler
Ease of Use: Create a New Patient Record in Under 6 Seconds!
Customize Intake & Registration Forms
Customize New patient Questionnaire Forms
Customizable Super-Bills and Fee Slips.
Process Co-pays, Deductibles, Print Receipts
ADDITIONAL POWERFUL BILLING OFFICE FEATURES:
Eligibility Verification Integrated Within the System
Allows for Multiple Financial Cases Per Patient
Bundle Codes & Modifiers. Enter New Procedure Codes Easily.
Create Favorites List of ICD-10 and CPT Codes with Full Searchability
Consistently Produce Accurate Claims
Front-end Claim Edits That Reduce Denials
Collections and Denials Workbench for Follow-up and Action
Generate Appeal Letter for Denials
Alerts to Automatically Push All Unpaid Claims to the Collections Workbench for Follow-up.
Automated Patient Statements and Collections Letters (Clear, Easy to Read Patient Statements)
POWERFUL FLEXIBLE FRONT OFFICE
Setup CASH / SELF-PAY pricing, and discounts for full payment upfront
Track number of visits: Visits used, visits left, w/ authorization expiration alerts!
Legal Forms such as Assignment of Benefits, HIPAA forms & More.
ERA: Electronic Remittance Advice for Bulk Check Posting
Handles your retail merchant account processing or cash plan
POWERFUL practice management REPORTING FEATURES:
Single-click Dashboard Reporting of all financials
Examine all Cash Flow Blockers At a Glance
View the entire financial health of your practice instantly in a single report
What Types of ADVANCED PRACTICE MANAGEMENT REPORTS Should I Look for?:
Accounts Receivable Reporting
Insurance Aging Reporting
Patient Aging Reporting
Detailed Aging Reporting
Insurance collections summary
Insurance collections detail
Patient collections summary
Patient collections detail
Denial Summary Report
Patient balance summary
Patient balance detail
Patient referrals summary
Patient insurance authorization
In conclusion, Soap notes and electronic health records such as chirotouch software or e-z bis provide chiropractic soap notes for accurate description of subluxation and misalignment of the neck and spine. Electronic medical records from cloud-based software can provide better soap notes and easier record access for mid-sized business practitioners of chiropractic. And using integrated Appointment scheduling can help reduce or avoid costly scheduling conflicts. If you have ever used genesis chiropractic software, practicestudio net, atlas chiropractic software, or herfert software, you know doubt had a good product overview of features, advantages, and maybe even disadvantages found while researching software reviews such as this one.
Chiropractic Billing Software
– CMS-1500 Billing Software – Specifically for Chiropractic Billing – 5010 Compliant. HIPAA Compliant – Bill Cash, MVA, WC, PI. & All Payers