Insurance verification and claims processing

Step-by-Step Breakdown

Detailed explanation of each automated stage in the workflow.

1. 1

   Trigger

   Patient appointment scheduled

   A new patient appointment is booked or an existing patient checks in for their chiropractic treatment session. Patient insurance information is captured in the practice management system.

   ChiroTouchEclipse Practice Management
2. 2

   Action

   Verify insurance eligibility automatically

   System queries insurance databases to verify patient coverage, deductibles, copays, and pre-authorization requirements for chiropractic services. Real-time eligibility data is retrieved and stored.

   ChiroTouchClinicTracker
3. 3

   Decision

   Check coverage requirements

   Workflow branches based on insurance verification results - whether coverage is active, requires pre-authorization, or needs manual review for specific chiropractic treatments.

   Eclipse Practice Management
4. 4

   Action

   Generate treatment documentation

   After patient treatment, system automatically pulls SOAP notes, treatment codes, and diagnostic information to prepare claim documentation. Ensures all required chiropractic-specific fields are completed.

   ChiroPadSOAP Vault
5. 5

   Action

   Submit electronic claims

   Validated claims with proper chiropractic CPT codes and documentation are automatically submitted to insurance carriers via electronic clearinghouse. Claim status tracking begins immediately.

   Genesis Chiropractic SoftwareClinicTracker
6. 6

   Action

   Monitor claim status

   System tracks claim processing status and automatically follows up on pending or denied claims. Sets reminders for resubmission or appeals as needed for chiropractic treatments.

   ChiroTouchEclipse Practice Management
7. 7

   Output

   Generate reimbursement reports

   Produces detailed reports on claim outcomes, payment posting, and outstanding receivables. Provides insights on insurance carrier performance and treatment code reimbursement rates.

   Genesis Chiropractic Software

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